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Colijn MA, Carrion P, Poirier-Morency G, Rogic S, Torres I, Menon M, Lisonek M, Cook C, DeGraaf A, Thammaiah SP, Neelakant H, Willaeys V, Leonova O, White RF, Yip S, Mungall AJ, MacLeod PM, Gibson WT, Sullivan PF, Honer WG, Pavlidis P, Stowe RM. SETD1A variant-associated psychosis: A systematic review of the clinical literature and description of two new cases. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110888. [PMID: 37918557 DOI: 10.1016/j.pnpbp.2023.110888] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/18/2023] [Accepted: 10/29/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE SETD1A encodes a histone methyltransferase involved in various cell cycle regulatory processes. Loss-of-function SETD1A variants have been associated with numerous neurodevelopmental phenotypes, including intellectual disability and schizophrenia. While the association between rare coding variants in SETD1A and schizophrenia has achieved genome-wide significance by rare variant burden testing, only a few studies have described the psychiatric phenomenology of such individuals in detail. This systematic review and case report aims to characterize the neurodevelopmental and psychiatric phenotypes of SETD1A variant-associated schizophrenia. METHODS A PubMed search was completed in July 2022 and updated in May 2023. Only studies that reported individuals with a SETD1A variant as well as a primary psychotic disorder were ultimately included. Additionally, another two previously unpublished cases of SETD1A variant-associated psychosis from our own sequencing cohort are described. RESULTS The search yielded 32 articles. While 15 articles met inclusion criteria, only five provided case descriptions. In total, phenotypic information was available for 11 individuals, in addition to our own two unpublished cases. Our findings suggest that although individuals with SETD1A variant-associated schizophrenia may share a number of common features, phenotypic variability nonetheless exists. Moreover, although such individuals may exhibit numerous other neurodevelopmental features suggestive of the syndrome, their psychiatric presentations appear to be similar to those of general schizophrenia populations. CONCLUSIONS Loss-of-function SETD1A variants may underlie the development of psychosis in a small percentage of individuals with schizophrenia. Identifying such individuals may become increasingly important, given the potential for advances in precision medicine treatment approaches.
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Affiliation(s)
- Mark A Colijn
- Department of Psychiatry, Hotchkiss Brain Institute, and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada.
| | - Prescilla Carrion
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Sanja Rogic
- Department of Psychiatry and Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Ivan Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services, Vancouver, BC, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Courtney Cook
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Ashley DeGraaf
- Heart Centre, St. Paul's Hospital and Providence Health, Vancouver, BC, Canada
| | | | - Harish Neelakant
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Veerle Willaeys
- BC Psychosis Program, British Columbia Mental Health & Substance Use Services, Vancouver, BC, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Randall F White
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Stephen Yip
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrew J Mungall
- Canada's Michael Smith Genome Sciences Centre, Vancouver, BC, Canada
| | - Patrick M MacLeod
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - William T Gibson
- Department of Medical Genetics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Patrick F Sullivan
- Psychiatry and Genetics, University of North Carolina at Chapel Hill, NC, USA; Karolinska Institut, Stockholm, Sweden
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Paul Pavlidis
- Department of Psychiatry, Michael Smith Laboratories, and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Robert M Stowe
- Departments of Psychiatry and Neurology (Medicine), BC Neuropsychiatry Program, and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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Murphy KA, Sarker E, Stuart EA, Cook C, Goldsholl S, Daumit GL. Effect of Care Management on Cholesterol for Individuals with Serious Mental Illness: a Secondary Analysis of an RCT. J Gen Intern Med 2024; 39:354-356. [PMID: 37950107 PMCID: PMC10853150 DOI: 10.1007/s11606-023-08510-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Karly A Murphy
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Elizabeth Sarker
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Courtney Cook
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Biadgilign S, Mgutshini T, Gebremichael B, Berhanu L, Cook C, Deribew A, Gebre B, Memiah P. Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia. BMJ Nutr Prev Health 2023; 6:203-211. [PMID: 38618527 PMCID: PMC11009522 DOI: 10.1136/bmjnph-2021-000415] [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: 12/17/2021] [Accepted: 09/19/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction The upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine socioeconomic and sociodemographic factors, dietary intake and eating behaviours of children and adolescents in Ethiopia and their association with OW/OB. Methods A cross-sectional study was conducted among 632 children and adolescents-parent dyads. To identify overweight/obese among children and adolescents, body mass index-for-age Z-scores by sex and age relative to WHO 2007 reference was calculated using WHO AnthroPlus software. A multivariable logistic regression model fitted to determine the adjusted associations between the outcome and the predictors selected from the bivariate analyses. Data analysis was carried out using STATA V.15.0. Results The proportion of participants with low, medium and high dietary diversity scores was 7.28%, 22.5%, and 70.2%, respectively. Participants aged 13-18 years were less likely to be overweight or obese [adjusted OR (aOR) = 0.40; 95%CI: 0.26, 0.64] to those aged 5-12 years. Children in a family with the richest or highest socioeconomic status (SES) were more likely to be overweight or obese than those in families with the poorest or lowest status. Children and adolescents who consumed soft drinks (sugar-sweetened beverages) four or more times per week [aOR = 3.24; 95%CI: 1.13, 7.95] were more likely to be overweight or obese to those who did not consume soft drinks. Conclusions The study identified factors such as younger age (<12 years), high SES and consumption of soft drinks as key contributors to overweight and obesity among children and adolescents. Therefore, interventions targeting behavioural prevention and reduction of overweight and obesity among children and adolescents should be cognizant of the above factors during implementation in order to achieve desired outcomes, further guided by exploratory qualitative studies to identify public perceptions and attitudes affecting dietary practices.
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Affiliation(s)
- Sibhatu Biadgilign
- Department of Health Studies, College of Human Sciences, University of South Africa, Addis Ababa, Ethiopia
| | | | - Bereket Gebremichael
- Pediatrics and Child Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Lioul Berhanu
- Nutrition Unit, Save the Children International, Addis Ababa, Ethiopia
| | - Courtney Cook
- Department of Nursing, Fortis Institute - Pensacola, Pensacola, Florida, USA
| | - Amare Deribew
- School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Nutrition International, Addis Ababa, Ethiopia
| | - Betemariam Gebre
- Public Health Unit, International Medical Corps, Khartoum, Sudan
| | - Peter Memiah
- Graduate School, University of Maryland, Baltimore, Maryland, USA
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Daumit GL, Evins AE, Cather C, Dalcin AT, Dickerson FB, Miller ER, Appel LJ, Jerome GJ, McCann U, Ford DE, Charleston JB, Young DR, Gennusa JV, Goldsholl S, Cook C, Fink T, Wang NY. Effect of a Tobacco Cessation Intervention Incorporating Weight Management for Adults With Serious Mental Illness: A Randomized Clinical Trial. JAMA Psychiatry 2023; 80:895-904. [PMID: 37378972 PMCID: PMC10308301 DOI: 10.1001/jamapsychiatry.2023.1691] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/05/2023] [Indexed: 06/29/2023]
Abstract
Importance Tobacco smoking drives markedly elevated cardiovascular disease risk and preventable death in persons with serious mental illness, and these risks are compounded by the high prevalence of overweight/obesity that smoking cessation can exacerbate. Guideline-concordant combined pharmacotherapy and behavioral smoking cessation treatment improves abstinence but is not routinely offered in community settings, particularly to those not seeking to quit smoking immediately. Objective To determine the effectiveness of an 18-month pharmacotherapy and behavioral smoking cessation intervention incorporating weight management and support for physical activity in adults with serious mental illness interested in quitting smoking within 1 or 6 months. Design, Setting, and Participants This was a randomized clinical trial conducted from July 25, 2016, to March 20, 2020, at 4 community health programs. Adults with serious mental illness who smoked tobacco daily were included in the study. Participants were randomly assigned to intervention or control, stratified by willingness to try to quit immediately (within 1 month) or within 6 months. Assessors were masked to group assignment. Interventions Pharmacotherapy, primarily varenicline, dual-form nicotine replacement, or their combination; tailored individual and group counseling for motivational enhancement; smoking cessation and relapse prevention; weight management counseling; and support for physical activity. Controls received quitline referrals. Main Outcome and Measures The primary outcome was biochemically validated, 7-day point-prevalence tobacco abstinence at 18 months. Results Of the 298 individuals screened for study inclusion, 192 enrolled (mean [SD] age, 49.6 [11.7] years; 97 women [50.5%]) and were randomly assigned to intervention (97 [50.5%]) or control (95 [49.5%]) groups. Participants self-identified with the following race and ethnicity categories: 93 Black or African American (48.4%), 6 Hispanic or Latino (3.1%), 90 White (46.9%), and 9 other (4.7%). A total of 82 participants (42.7%) had a schizophrenia spectrum disorder, 62 (32.3%) had bipolar disorder, and 48 (25.0%) had major depressive disorder; 119 participants (62%) reported interest in quitting immediately (within 1 month). Primary outcome data were collected in 183 participants (95.3%). At 18 months, 26.4% of participants (observed count, 27 of 97 [27.8%]) in the intervention group and 5.7% of participants (observed count, 6 of 95 [6.3%]) in the control group achieved abstinence (adjusted odds ratio [OR], 5.9; 95% CI, 2.3-15.4; P < .001). Readiness to quit within 1 month did not statistically significantly modify the intervention's effect on abstinence. The intervention group did not have significantly greater weight gain than the control group (mean weight change difference, 1.6 kg; 95% CI, -1.5 to 4.7 kg). Conclusions and Relevance Findings of this randomized clinical trial showed that in persons with serious mental illness who are interested in quitting smoking within 6 months, an 18-month intervention with first-line pharmacotherapy and tailored behavioral support for smoking cessation and weight management increased tobacco abstinence without significant weight gain. Trial Registration ClinicalTrials.gov Identifier: NCT02424188.
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Affiliation(s)
- Gail L. Daumit
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - A. Eden Evins
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Corinne Cather
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Arlene T. Dalcin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | | | - Edgar R. Miller
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lawrence J. Appel
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gerald J. Jerome
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- College of Health Professions, Towson University, Towson, Maryland
| | - Una McCann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel E. Ford
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jeanne B. Charleston
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Deborah R. Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Joseph V. Gennusa
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stacy Goldsholl
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Courtney Cook
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tyler Fink
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Hillman C, Lindsey A, Ottwell R, Arthur W, Cook C, Howard H, Wright DN, Hartwell M, Chen S, Miao Z, Vassar M. An Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses on the Treatment of Psoriasis: A Cross-sectional Analysis. Cutis 2023; 111:E21-E29. [PMID: 37406323 DOI: 10.12788/cutis.0742] [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: 07/07/2023]
Abstract
Spin is a way of reporting that distorts the true findings; we sought to investigate the prevalence of spin in systematic review abstracts on psoriasis treatments and whether study characteristics were associated with spin. We searched MEDLINE and Embase to obtain our sample. Screening and data extraction were performed in a masked duplicate fashion. Each included study was evaluated for the 9 most severe types of spin and other study characteristics. The methodological quality was assessed to explore potential relationships between spin and study quality. Search queries returned 3200 articles, which included 173 systematic reviews. Spin was present in systematic review abstracts. Preventing spin is essential for improving future systematic reviews.
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Affiliation(s)
- Cody Hillman
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Alyssa Lindsey
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Ryan Ottwell
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Wade Arthur
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Courtney Cook
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Hannah Howard
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Drew N Wright
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Micah Hartwell
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Suhao Chen
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Zhuqi Miao
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
| | - Matt Vassar
- Cody Hillman, Alyssa Lindsey, and Drs. Arthur, Cook, Howard, Hartwell, and Vassar are from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa. Drs. Hartwell and Vassar also are from the Department of Psychiatry and Behavioral Sciences. Dr. Ottwell is from the University of Oklahoma School of Community Medicine, Tulsa, and the Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan. Drew N. Wright is from the Department of Information Technology and Services, Weill Cornell Medicine, New Yok, New York. Suhao Chen is from the Department of Industrial Engineering, South Dakota School of Mines and Technology, Rapid City. Dr. Miao is from the School of Business, State University of New York at New Paltz
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Bhanot A, Papac N, Cook C. 33952 GNAS mutations: Case report and relevant updates. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Taylor M, Cook C, Liu Y, Schmidt R, Hailer A, North J, Wang H, Kashem S, Purdom E, Marson A, Ramos S, Cho R, Cheng J. 509 A single-cell transcriptional gradient in human cutaneous memory T cells suppresses pathogenic Th17 inflammation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hailer A, Liu Y, Wang H, Taylor M, Cook C, North J, Mauro T, Purdom E, Cheng J, Cho R. 862 RashX: Immune single-cell transcriptional classification of human chronic inflammatory skin disease. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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DI Iorio M, Cook C, Vanni K, Patel N, D’silva K, Fu X, Wang J, Prisco L, Kowalski E, Zaccardelli A, Martin L, Qian G, Hsu T, Wallace Z, Sparks J. POS1234 DMARD DISRUPTION, INCREASED DISEASE ACTIVITY, AND PROLONGED SYMPTOM DURATION AFTER ACUTE COVID-19 AMONG PATIENTS WITH RHEUMATIC DISEASE: A PROSPECTIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSystemic autoimmune rheumatic disease (SARD) patients may be at risk for disease flare and prolonged symptom duration after COVID-19, perhaps related to DMARD disruption and immune activation.ObjectivesTo describe DMARD disruption and identify differences in SARD activity among patients with and without prolonged COVID-19 symptom duration.MethodsWe identified all SARD patients with confirmed COVID-19 at the Mass General Brigham healthcare system in Boston, USA; prospective recruitment is ongoing. Surveys were used to collect demographics, clinical characteristics, DMARD disruption, COVID-19 course, and SARD disease activity before and after COVID-19. The survey included validated instruments measuring disease activity, pain, fatigue, functional status, and respiratory quality of life. Prolonged symptom duration was defined as COVID-19 symptoms lasting ≥28 days. We compared differences in patient-reported measures between those with and without prolonged symptoms.ResultsWe analyzed survey responses from 174 COVID-19 survivors with SARDs (mean age 52±16 years, 81% female, 80% White). The most common SARDs were RA (40%) and SLE (14%). Fifty-one percent of the 127 respondents on any DMARD reported a disruption to their regimen at COVID-19 onset (Figure 1). Among individual DMARDs, 56-77% were reported to have any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41% of respondents (Table 1). Patient global assessment of SARD activity was worse after COVID-19 (mean 7.6±2.3 before vs. 6.6±2.9 after COVID-19, p<0.001). Prolonged symptom duration was reported by 45% of participants. Those with prolonged symptoms had a higher initial COVID-19 symptom count (median 7 vs. 4, p<0.001) and were more likely to be hospitalized for COVID-19 (28% vs. 17%, p=0.001). Respondents experiencing prolonged symptom duration had higher disease activity on RAPID3 (p=0.007) as well as more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms.Table 1.Acute COVID-19 course, SARD flare/activity, and patient-reported outcomes among COVID-19 survivors with SARDs.All COVID-19 survivors with SARDs (n=174)Prolonged symptom duration ≥28 days (n=78)No prolonged symptom duration/(n=96)p-value (prolonged vs. not)Acute COVID-19 courseCOVID-19 symptom duration, days, median [IQR]14 [9, 29]46 [30, 65]11 [7, 14]<0.0001Initial symptom count, median [IQR]6 [3, 8]7 [6, 9]4 [2, 7]<0.001Hospitalized, n (%)38 (22)22 (28)16 (17)0.001SARD flare/activitySelf-reported SARD flare after COVID-19, n (%)71 (41)38 (49)33 (34)0.15Disease activity by RAPID3, median [IQR]9 [4, 14]11.2 [6, 16]7 [3, 13]0.0067RAPID3 categorical score, n (%)0.13Remission (0)11 (7)4 (5)7 (7)Near remission (0.3-1.0)23 (14)5 (7)18 (19)Low severity (1.3-2.0)26 (15)10 (14)16 (17)Moderate severity (2.3-4.0)55 (33)27 (36)28 (29)High severity (4.3-10.0)54 (32)28 (38)26 (27)Patient-reported outcomesPain by SF-MPQ, median [IQR]2 [1, 2]2 [1, 2]1 [0, 2]0.0008Fatigue by FSI, median [IQR]53 [27, 84]66 [31, 91.5]43 [26, 76]0.031mHAQ, median [IQR]0.125 [0, 0.38]0.25 [0, 0.75]0.125 [0, 0.38]0.11Respiratory quality of life by SGRQ, global [IQR]15 [4, 29]16 [4, 36]10 [4, 26]0.49RAPID3, Routine Assessment of Patient Index Data 3; SF-MPQ, Short-form McGill Pain Questionnaire; FSI, Fatigue Symptom Inventory; mHAQ, modified Health Assessment Questionnaire; SGRQ, Saint George’s Respiratory Questionnaire.Figure 1.Frequency of baseline DMARD use and proportion with any disruption at COVID-19 onset.ConclusionDMARD disruption, SARD flare, and prolonged symptoms were common in this prospective study of COVID-19 survivors with SARDs. Those with prolonged COVID-19 symptom duration, defined as ≥28 days, had higher SARD activity, more pain, and more fatigue compared to those without prolonged symptoms. These findings suggest that post-acute sequelae of COVID-19 may have a large impact on underlying SARD activity and quality of life.Disclosure of InterestsMichael Di Iorio: None declared, Claire Cook: None declared, Kathleen Vanni: None declared, Naomi Patel Consultant of: Receives consulting fees from FVC Health unrelated to this work., Kristin D’Silva: None declared, Xiaoqing Fu: None declared, Jiaqi Wang: None declared, Lauren Prisco: None declared, Emily Kowalski: None declared, Alessandra Zaccardelli: None declared, Lily Martin: None declared, Grace Qian: None declared, Tiffany Hsu: None declared, Zachary Wallace Consultant of: Receives consulting fees from Viela Bio, Zenas BioPharma, and MedPace unrelated to this work., Grant/research support from: Receives research support from Bristol-Myers Squibb and Principia/Sanofi., Jeffrey Sparks Consultant of: Receives consultant fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer unrelated to this work., Grant/research support from: Receives research support from Bristol Myers Squibb.
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Gilbert E, Figueroa-Parra G, Valenzuela-Almada M, Vallejo S, Neville MR, Patel N, Cook C, Fu X, Hagi R, McDermott G, Di Iorio M, Masto L, Vanni K, Kowalski E, Qian G, Wallace Z, Duarte-Garcia A, Sparks J. OP0251 IMPACT OF INTERSTITIAL LUNG DISEASE ON SEVERE COVID-19 OUTCOMES FOR PATIENTS WITH RHEUMATOID ARTHRITIS: A MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRA has been associated with poor COVID-19 outcomes, but few studies have investigated outcomes in RA features such as interstitial lung disease.ObjectivesTo assess COVID-19 outcomes in patients with RA overall, and those with and without ILD, compared to general population comparators.MethodsA multicenter, retrospective cohort study was conducted at Mayo Clinic (19 hospitals and affiliated outpatient centers in 4 states) and Mass General Brigham (14 hospitals and affiliated outpatient centers in New England). Consecutive patients with RA meeting ACR/EULAR criteria and a positive COVID-19 test from March 1, 2020 through June 6, 2021 were matched 1:5 on age, sex, race, and COVID-19 test date with general population comparators without RA. RA features assessed included: RA-ILD per Bongartz criteria [1], duration, rheumatoid factor (RF), cyclic citrullinated peptide antibody (CCP), bone erosions, and treatments. The primary outcome was a composite of hospitalization or death following COVID-19 diagnosis. We used multivariable Cox regression to investigate the association of RA, and features such as ILD, with COVID-19 outcomes compared to matched comparators.ResultsWe analyzed 582 patients with RA and 2892 comparators without RA, all with COVID-19. Mean age was 62 years, 51% were female, and 79% were White. Mean RA duration was 11 years, 67% were seropositive (52% RF+ and 54% CCP+), 27% had bone erosions, 28% were on steroids, and 79% were on DMARDs. 50/582 (9%) patients with RA had ILD.The COVID-19 hospitalization or death rate for RA patients was higher than comparators (3.0 per 1,000 days [95% CI 2.5-3.6] vs. 1.9 per 1,000 days [95% CI 1.7-2.1], respectively). Overall, RA patients had a 53% higher risk of hospitalization or death than comparators after adjustment (95% CI 1.20-1.94).Among those with RA-ILD, the hospitalization or death rate was significantly higher than comparators (10.9 [95% CI 6.7-15.2] vs. 2.5 per 1,000 days [1.8-3.2], respectively). RA-ILD was associated with nearly 3-fold higher risk for hospitalization or death than comparators (multivariable HR 2.84 [95% CI 1.64-4.91], Table 1). There was a significant interaction between RA/comparator status and presence/absence of ILD for risk of severe COVID-19 (p<0.001, Figure 1). The elevated risk for severe COVID-19 was similar for RA subgroups defined by serostatus or bone erosions.Table 1.Frequencies, proportions, and hazard ratios for COVID-19 outcomes, comparing all RA patients, and subgroups with or without RA-ILD, to matched comparators.COVID-19 OutcomesAll RA Patients (n=582)RA-ILD (n=50)RA Patients without ILD (n=532)Comparators (n=2,892)Hospitalization, n (%)121 (21)24 (48)97 (18)402 (14)Unadjusted HR (95% CI)1.58 (1.27, 1.96)2.65 (1.71, 4.09)1.43 (1.12, 1.82)Ref.Adjusted* HR (95% CI)1.45 (1.14, 1.83)2.35 (1.38, 4.00)1.31 (1.00, 1.70)Ref.Death, n (%)26 (4)9 (18)17 (3)63 (2)Unadjusted HR (95% CI)1.72 (0.98, 3.01)5.88 (2.07, 16.71)1.13 (0.56, 2.29)Ref.Adjusted* HR (95% CI)1.24 (0.66, 2.32)13.94 (4.30, 45.18)0.75 (0.35, 1.63)Ref.Hospitalization or death, n (%)126 (22)25 (50)101 (19)419 (14)Unadjusted HR (95% CI)1.66 (1.33, 2.07)3.01 (1.93, 4.70)1.47 (1.14, 1.89)Ref.Adjusted* HR (95% CI)1.53 (1.20, 1.94)2.84 (1.64, 4.91)1.34 (1.02, 1.77)Ref.*Adjusted for age, sex, race, and smokingFigure 1.Multivariable hazard ratios for the composite outcome of hospitalization or death from COVID-19, comparing all RA and subgroups by serostatus, bone erosions, and ILD to matched comparators without RA.ConclusionWe confirmed that RA was associated with severe COVID-19 outcomes compared to the general population. We found evidence that ILD may be an effect modifier for the relationship between RA and severe COVID-19 outcomes, but RA subgroups defined by serostatus and bone erosions had similarly elevated risk. These findings suggest that ILD or its treatment may be a major contributor to severe COVID-19 outcomes in RA.References[1]Bongartz, T, et al, Arthritis Rheum. 2010 Jun;62(6):1583-91.Disclosure of InterestsNone declared
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Wallace Z, Weber B, Parks S, Cook C, Huck D, Brown J, Divakaran S, Hainer J, Bibbo C, Taqueti V, Dorbala S, Blankenstein R, Liao K, Aghayev A, Choi H, Di Carli M. AB0624 Patients with vasculitis have a high prevalence of coronary microvascular dysfunction. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVasculitides are a heterogenous group of diseases characterized by intense vessel wall inflammation, endothelial injury, and systemic inflammation. Several vasculitides are associated with high risk of cardiovascular (CV) disease, an important source of morbidity and mortality in this population. This excess CV risk is attributed both to a high burden of traditional risk factors and to inflammation, but this remains poorly studied. Indeed, inflammation is a known risk factor for CV disease and implicated in coronary microvascular dysfunction (CMD) which may precede obstructive coronary artery disease (CAD).ObjectivesWe sought to assess whether vasculitis is associated with CMD in the absence of obstructive CAD.MethodsWe retrospectively identified subjects with systemic vasculitis who underwent symptom prompted rest/stress myocardial perfusion PET. Patients with an abnormal myocardial perfusion study (summed stress score ≥3) or LVEF<40% were excluded. Controls were identified from the same population and matched on age, gender and cardiovascular risk factors (CAD, hypertension, dyslipidemia, diabetes mellitus, and obesity). Coronary flow reserve (CFR), was calculated as the ratio of myocardial blood flow (ml/min/g) at peak stress compared to rest. CMD was defined as CFR <2.ResultsWe studied 26 vasculitis cases and 66 matched controls. The most common vasculitides were giant cell arteritis (38%), ANCA-associated vasculitis (31%), and Takayasu’s arteritis (12%). Median (IQR) time between diagnosis and PET was 6.5 (2.9, 14.2) years. Seven (27%) cases had active vascultis at the time of PET. Cases and controls were well-matched on age, sex, and CV risk factors (Table 1). Despite a similar prevalence of CV risk factors, coronary flow reserve (reflected by CMD) was abnormal in 38% of vasculitis cases compared to 15% of controls (p=0.004). The mean [SD] CFR was 19% lower in vasculitis cases vs controls (2.11 [0.5] versus 2.6 [0.7], p=0.003).Table 1.The presence of coronary microvasculature dysfunction in patients with systemic vasculitis without obstructive coronary artery diseaseCohort characteristicsVasculitis (n=26)Control (n=66)P-valueAge at PET, years62 (18)61 (17)0.24Time from Vasculitis Diagnosis to PET, years (median, IQR)6.5 (2.9, 14.2)n/aFemale, n (%)18 (72%)43 (65%)0.99Vasculitis CharacteristicsLarge Vessel (e.g., giant cell arteritis, Takayasu’s), n(%)13 (50%)n/an/aMedium Vessel (e.g., polyarteritis nodosa, Kawasaki’s arteritis), n(%)2 (8%)n/an/aSmall Vessel (e.g., ANCA-associated vasculitis, Henoch-Schonlein Purpura), n(%)11 (42%)n/an/aCardiovascular Risk FactorsAt DiagnosisAt PETAt PETHypertension, n (%)12 (46%)20 (71%)47 (80%)0.47Obesity, n (%)3 (12%)2 (32%)2 (32%)0.84Diabetes, n (%)3 (12%)5 (20%)13 (20%)0.99Dyslipidemia, n (%)4 (15%)15 (58%)40 (61%)0.99Known CAD, n (%)0 (0%)1 (4%)1 (2%)0.48Imaging FindingsRest myocardial blood flow, ml/min/g1.0 (0.3)1.0 (0.3)0.8Stress myocardial blood flow, ml/min/g2.1 (0.6)2.6 (1.0)0.008Coronary Flow Reserve, ml/min/g*2.1 (0.5)2.6 (0.7)0.003Coronary Microvasculature Dysfunction** (CMD), n (%)10 (38%)11 (15%)0.004ConclusionPatients with systemic vasculitis, even in the absence of obstructive CAD, have a high prevalence of CMD compared with non-vasculitis patients. These differences were observed despite matching cases and controls on traditional CV risk factors, highlighting the importance of other factors, such as inflammation and vasculitis treatments on CMD and CV disease in this population. CMD is a known independent risk factor for CV mortality. Future prospective studies are needed to understand the relationship between vasculitis, systemic inflammation, and CMD.Disclosure of InterestsNone declared
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Grupstra CGB, Lemoine NP, Cook C, Correa AMS. Thank you for biting: dispersal of beneficial microbiota through 'antagonistic' interactions. Trends Microbiol 2022; 30:930-939. [PMID: 35393166 DOI: 10.1016/j.tim.2022.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 09/30/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 12/23/2022]
Abstract
Multicellular organisms harbor populations of microbial symbionts; some of these symbionts can be dispersed through the feeding activities of consumers. Studies of consumer-mediated microbiota dispersal generally focus on pathogenic microorganisms; the dispersal of beneficial microorganisms has received less attention, especially in the context of 'antagonistic' trophic interactions (e.g., herbivory, parasitism, predation). Yet, this 'trophic transmission' of beneficial symbionts has significant implications for microbiota assembly and resource species (e.g., prey) health. For example, trophic transmission of microorganisms could assist with environmental acclimatization and help resource species to suppress other consumers or competitors. Here, we highlight model systems and approaches that have revealed these potential 'silver-linings' of antagonism as well as opportunities and challenges for future research.
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Affiliation(s)
- C G B Grupstra
- BioSciences Department, Rice University, Houston, TX 77098, USA.
| | - N P Lemoine
- Department of Biological Sciences, Marquette University, Milwaukee, WI 53233, USA; Department of Zoology, Milwaukee Public Museum, Milwaukee, WI 53233, USA
| | - C Cook
- Department of Biological Sciences, Marquette University, Milwaukee, WI 53233, USA
| | - A M S Correa
- BioSciences Department, Rice University, Houston, TX 77098, USA
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Nowlin R, Wirtz A, Wenger D, Ottwell R, Cook C, Arthur W, Sallee B, Levin J, Hartwell M, Wright D, Sealey M, Zhu L, Vassar M. Spin in Abstracts of Systematic Reviews and Meta-analyses of Melanoma Therapies: Cross-sectional Analysis. JMIR Dermatol 2022; 5:e33996. [PMID: 37632865 PMCID: PMC10334896 DOI: 10.2196/33996] [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: 10/05/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Spin is defined as the misrepresentation of a study's results, which may lead to misperceptions or misinterpretation of the findings. Spin has previously been found in randomized controlled trials and systematic reviews of acne vulgaris treatments and treatments of various nondermatological conditions. OBJECTIVE The purpose of this study was to quantify the presence of spin in abstracts of systematic reviews and meta-analyses of melanoma therapies and identify any related secondary characteristics of these articles. METHODS We used a cross-sectional approach on June 2, 2020, to search the MEDLINE and Embase databases from their inception. To meet inclusion criteria, a study was required to be a systematic review or meta-analysis pertaining to the treatment of melanoma in human subjects, and reported in English. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) definition of systematic reviews and meta-analyses. Data were extracted in a masked, duplicate fashion. We conducted a powered bivariate linear regression and calculated odds ratios for each study characteristic. RESULTS A total of 200 systematic reviews met the inclusion criteria. We identified spin in 38% (n=76) of the abstracts. The most common type of spin found was type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention), occurring 40 times; the least common was type 2 (title claims or suggests a beneficial effect of the experimental intervention not supported by the findings), which was not present in any included abstracts. We found that abstracts pertaining to pharmacologic interventions were 3.84 times more likely to contain spin. The likelihood of an article containing spin has decreased annually (adjusted odds ratio 0.91, 95% CI 0.84-0.99). No significant correlation between funding source or other study characteristics and the presence of spin was identified. CONCLUSIONS We have found that spin is fairly common in the abstracts of systematic reviews of melanoma treatments, but the prevalence of spin in these abstracts has been declining from 1992-2020.
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Affiliation(s)
- Ross Nowlin
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alexis Wirtz
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - David Wenger
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Ryan Ottwell
- Department of Internal Medicine, University of Oklahoma College of Community Medicine, Tulsa, OK, United States
- Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, MI, United States
| | - Courtney Cook
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Wade Arthur
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Brigitte Sallee
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jarad Levin
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Drew Wright
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, United States
| | - Meghan Sealey
- Department of Statistics, Oklahoma State University, Stillwater, OK, United States
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, OK, United States
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
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Jerome GJ, Fink T, Brady T, Young DR, Dickerson FB, Goldsholl S, Findling RL, Stepanova EA, Scheimann A, Dalcin AT, Terry A, Gennusa J, Cook C, Daumit GL, Wang NY. Physical Activity Levels and Screen Time among Youth with Overweight/Obesity Using Mental Health Services. Int J Environ Res Public Health 2022; 19:ijerph19042261. [PMID: 35206449 PMCID: PMC8871648 DOI: 10.3390/ijerph19042261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022]
Abstract
Youth with mental illness have higher levels of obesity than children in the general population. Both regular physical activity and limited screen time have been recommended to reduce and prevent childhood obesity. This study examines accelerometer-based moderate-vigorous physical activity (MVPA) and screen time among youth with overweight/obesity issues who are receiving mental health care. This study looked at a 12-month weight management randomized clinical trial for overweight/obese youth aged 8-18 years who are receiving mental health services. At baseline, MVPA was assessed using accelerometers, and screen time was self-reported. Among 100 youth, 43% were female, 44% were Black, and 48% were <13 years old. In an adjusted general linear model, higher levels of MVPA were associated with the younger age group (p = 0.012), male participants (p = 0.013), and lower BMI z-scores (p = 0.014). In a separate model, higher screen time was associated with participants who were Black (p = 0.007). Achieving optimal cardiovascular health at the population level requires an understanding of the groups that are most in need of additional assistance. These data reinforce that targeted lifestyle approaches to promote increased physical activity and decreased screen time among overweight/obese youth using mental health services may need additional tailoring for sex, age, and race subgroups.
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Affiliation(s)
- Gerald J. Jerome
- Department of Kinesiology, Towson University, Towson, MD 21252, USA
- Correspondence:
| | - Tyler Fink
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Tammy Brady
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; (T.B.); (A.S.)
| | | | | | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Robert L. Findling
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23284, USA; (R.L.F.); (E.A.S.)
| | - Ekaterina A. Stepanova
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23284, USA; (R.L.F.); (E.A.S.)
| | - Ann Scheimann
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; (T.B.); (A.S.)
| | - Arlene T. Dalcin
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Alison Terry
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Joseph Gennusa
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Courtney Cook
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Gail L. Daumit
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (T.F.); (S.G.); (A.T.D.); (A.T.); (J.G.); (C.C.); (G.L.D.); (N.-Y.W.)
- Department of Biostatistics and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Memiah P, Cook C, Kingori C, Munala L, Howard K, Ayivor S, Bond T. Correlates of intimate partner violence among adolescents in East Africa: a multi-country analysis. Pan Afr Med J 2021; 40:142. [PMID: 34925677 PMCID: PMC8654874 DOI: 10.11604/pamj.2021.40.142.23311] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/04/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction intimate partner violence (IPV) is a global concern not only among adults but also adolescents. It has been reported that 35% of adolescent women have ever experienced IPV - occuring more so in non-industrialized countries. This study sought to understand the correlates associated with experiencing IPV among adolescent women between the ages 15 and 24 in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda. Methods this was a secondary analysis of Demographic and Health Survey (DHS) data on adolescent women aged 15-24 years in five East African countries. IPV was measured as a composite variable of emotional, physical, and sexual violence. Other sociodemographic, income, maternal, sexual, knowledge, behavioral, and partner-related variables were included in the analysis. Results the prevalence of ever experiencing IPV was 45.1% (n=2380). A higher proportion of women who reported experiencing IPV had their first sexual encounter when they were less than 18 years of age (p<0.001). The adjusted odds ratio (aOR) of experiencing IPV increased almost two times for women who were aged 18-24 years (aOR: 1.7; CI: 1.3-2.3), almost four times (aOR 3.8; CI: 1.7-8.3) for those who had two or more children, and two-fold for women who had ever terminated a pregnancy compared to those who had not (aOR 2.2; CI: 1.0-4.9). Additionally, there was a higher odds (aOR: 1.5 (1.0-2.3)) of experiencing IPV if the respondent believed their husband/spouse´s abuse was justified. Conclusion raising early awareness and educating both the young males and females appropriately to mitigate contributing factors to IPV could ensure stable, healthy relationships free of domestic violence in the future.
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Affiliation(s)
- Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore Maryland, United States of America
| | - Courtney Cook
- Biology Department, University of West Florida, Florida, United States of America
| | - Caroline Kingori
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University Grover Center, Athens OH 45701, United States of America
| | - Leso Munala
- Department of Public Health, St. Catherine University, Minnesota, United States of America
| | - Kathryn Howard
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore Maryland, United States of America
| | - Sandra Ayivor
- College of Education and Professional Studies, University of West Florida, Florida, United States of America
| | - Tristi Bond
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore Maryland, United States of America
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Memiah P, Biadgilign S, Kuhlman J, Cook C, Mburia P, Kingori C, Sarpong D, Buluku G, Hawkins M. Allostatic Load, Single, and Dual Chronic Conditions: Evidence from the National Health and Nutrition Examination Survey. Metab Syndr Relat Disord 2021; 20:104-113. [PMID: 34910882 PMCID: PMC8972020 DOI: 10.1089/met.2021.0008] [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: 11/12/2022] Open
Abstract
Background: Allostatic load (AL) is defined as a cumulative burden of chronic stress and life events, which involves the interaction of different physiological systems at varying degrees of activity. AL is suspected of contributing to health disparities among different populations. Suppressed or overactive physiological systems can interrupt AL affecting proper tissue and organ function leading to disease. The objective of our study was to determine the association of AL with dual chronic conditions. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES). For the current analysis, we used the data cycles of 2007–2010, which is the most recent data that collected comprehensive measures of the composite AL outcome variable. Descriptive, bivariate, and multivariable logistic regression, with stepwise forward variable selection method (P < 0.05), were conducted using STATA/IC 15.0. Results: AL levels were high among 20% of the respondents (n = 2179). Having a lower income to poverty ratio, being married, physical inactivity, experiencing sleep problems, and a history of smoking were significantly associated with high AL (P < 0.05). Non-Hispanic blacks [odds ratio (OR): 1.8; 95% confidence interval (CI): 1.6–2.4] and Mexicans and other Hispanics (OR: 1.4; 95% CI: 1.1–1.7) had higher AL compared to Caucasians. Having cardiovascular disease (CVD) (OR: 1.7; 95% CI: 1.4–2.2) and diabetes (OR: 4.7; 95% CI: 3.8–5.7) independently, as well as both CVD and diabetes (OR: 3.1; 95% CI 2.7–3.6), were associated with higher odds of AL. We conducted an age-adjusted regression model that indicated higher odds of elevated AL among females with diabetes independently (OR: 1.4; 95% CI: 1.2–1.9) and with both CVD and diabetes (OR: 1.6; 95% CI: 1.2–2.1) compared to men. Conclusions: Despite the significant impact and association of AL with overall health, there is minimal evidence of its risk factors and linkage to disease burden. Modifiable lifestyle factors were associated with a higher AL. There is a critical need to support ethnic and gender contextual interventions to reduce the burden of AL on chronic conditions.
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Affiliation(s)
- Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sibhatu Biadgilign
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Jamie Kuhlman
- College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Courtney Cook
- Department of Nursing, Fortis Institute, Pensacola, Florida, USA
| | - Piera Mburia
- Department of Public Health, University of Reno, Reno, Arizona, USA
| | - Carol Kingori
- College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Daniel Sarpong
- Centre of for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, Louisiana, USA
| | - Gabriel Buluku
- Department of Medicine, University of Maryland School of Medicine Midtown Campus, Baltimore, Maryland, USA
| | - Marquis Hawkins
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Ottwell R, Heigle B, Reddy AK, Sajjadi N, Wirtz A, Cook C, Howard H, Hartwell M, Vassar M. Correction: The Use of Person-Centered Language in Medical Research Journals Focusing on Psoriasis: Cross-sectional Analysis. JMIR Dermatol 2021; 4:e31902. [PMID: 37632850 PMCID: PMC10501509 DOI: 10.2196/31902] [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: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.2196/28415.].
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Affiliation(s)
- Ryan Ottwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Benjamin Heigle
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Arjun K Reddy
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Nicholas Sajjadi
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alexis Wirtz
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Courtney Cook
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Hannah Howard
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
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Ramirez R, Cook C, Van Meter J. Development and implementation of a trauma team education program in Georgetown, Guyana. Nurse Pract 2021; 46:46-55. [PMID: 34138814 DOI: 10.1097/01.npr.0000753836.44596.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Trauma teams without structured team training demonstrate impaired team dynamics, which can cause delays in patient care, leading to poor patient outcomes. Improving team dynamics leads to better communication, reduced errors, and enhanced patient care. Evidence-based trauma team training was implemented and delivered within a resource-restricted ED.
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Ottwell R, Heigle B, Reddy AK, Sajjadi N, Wirtz A, Cook C, Howard H, Hartwell M, Vassar M. The Use of Person-Centered Language in Medical Research Journals Focusing on Psoriasis: Cross-sectional Analysis. JMIR Dermatol 2021; 4:e28415. [PMID: 37632812 PMCID: PMC10501510 DOI: 10.2196/28415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/18/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Person-centered language places a person's identity before any disability or medical condition they may have. Using person-centered language reduces stigma and improves the patient-physician relationship, potentially optimizing health outcomes. Patients with psoriasis often feel stigmatized due to their chronic skin condition. OBJECTIVE We seek to evaluate the use of person-centered language in psoriasis literature and to explore whether certain article characteristics were associated with non-person-centered language. METHODS We performed a systematic search on PubMed for recently published articles in journals that regularly publish psoriasis studies. After article reduction procedures, randomization, and screening, we reached our target sample of 400 articles. The following non-person-centered language terms were extracted from each article: "Psoriasis Patient," "Psoriasis subject," "Affected with," "Sufferer," "Suffering from," "Burdened with," "Afflicted with," and "Problems with." Screening and data extraction occurred in a masked duplicate fashion. RESULTS Of the 400 included articles, 272 (68%) were not adherent to person-centered language guidelines according to the American Medical Association Manual of Style. The most frequent non-person-centered language term was "Psoriasis Patient," found in 174 (43.5%) articles. The stigmatizing language was associated with the type of article and funding status, with original investigations and funded studies having higher rates of stigmatizing language. CONCLUSIONS Articles about psoriasis commonly use non-person-centered language terms. It is important to shift away from using stigmatizing language about patients with psoriasis to avoid potential untoward influences. We recommend using "patients with psoriasis" or "patient living with psoriasis" to emphasize the importance of person-centered care.
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Affiliation(s)
- Ryan Ottwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Benjamin Heigle
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Arjun K Reddy
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Nicholas Sajjadi
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alexis Wirtz
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Courtney Cook
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Hannah Howard
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
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Cook C, Choi H, Wallace Z. POS1428 VALIDATION OF ANCA-ASSOCIATED VASCULITIS AS THE CAUSE OF END-STAGE RENAL DISEASE IN THE UNITED STATES RENAL DATA SYSTEM. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Glomerulonephritis and other renal manifestations are common in ANCA-associated vasculitis (AAV). Renal involvement in AAV is associated with adverse outcomes, including end-stage renal disease (ESRD) in up to 25% of patients (1). The United States Renal Data System (USRDS), a national registry of ESRD patients, represents a unique nationwide data source for studying AAV patients with ESRD. Prior research has assessed how often patients with ESRD attributed to AAV have biopsy-proven glomerulonephritis in USRDS (2), but the validity of the diagnosis of AAV as the cause of ESRD in the USRDS remains unknown.Objectives:We aim to validate the diagnosis of AAV as the primary cause of ESRD listed in USRDS.Methods:We identified all patients in the Mass General Brigham (MGB) healthcare system with a billing code for advanced chronic kidney disease or end-stage renal disease or procedure code for dialysis or renal transplantation. We identified all MGB patients fulfilling these criteria to records in the USRDS by name, sex, date of birth, and social security number. From this cohort of patients, we identified those with AAV or related diagnoses listed as the primary disease causing ESRD (ICD9: 446.0, 446.4 or ICD10: M31.3X, M31.7). Two authors reviewed medical records to collect information on whether or not a physician had diagnosed AAV, details of AAV history, renal and non-renal biopsies, and antineutrophil cytoplasmic antibody (ANCA) tests. Discrepancies were resolved through consensus. Details regarding initial ESRD onset date were obtained from the USRDS. To calculate the positive predictive value (PPV) for AAV as the primary cause of ESRD a definite physician diagnosis of AAV (a diagnosis confirmed by two physicians based on available data) in the MGB medical record was used as the gold standard. To calculate sensitivity, we linked the Partners (MGB) AAV Cohort to USRDS records using the same methods. A diagnosis code of AAV as the cause of ESRD was considered a true positive and a diagnosis code for other types of nephritis was considered a false negative.Results:We identified 89 USRDS records linked to MGB medical records in which the primary cause of ESRD was attributed to AAV. Of these, 85 were confirmed to be true cases of AAV after medical record review (PPV=96%) (Table 1). Among the cases classified as AAV, 84 (99%) had a positive ANCA test, which was predominantly MPO/P-ANCA (47, 55%); 36 (42%) had a renal biopsy, all of which were supportive of the diagnosis. The majority of cases were identified as AAV by ICD9 or 10 codes for Wegener’s granulomatosis (446.4 or M313.1). Within the Partners (MGB) AAV cohort linked to USRDS records, 33 (55%) of 60 identified cases had AAV listed as the cause of ESRD; in the remainder, ESRD was attributed to non-specific nephritis codes.Table 1.AAV and non-AAV patients in the USRDS with ESRD due to AAV
(N=89)Physician-Diagnosed AAV(N=85)ANCA type n (%)84 (98.8)MPO/P-ANCA+47 (55.3)PR3/C-ANCA+33 (38.8)Renal biopsy n (%)36 (42.4)Pauci-Immune Glomerulonephritis n (%)16 (44%)Non-renal biopsy n (%) Yes10 (11.8) No74 (87.1)Years from AAV diagnosis to ESRD median [IQR]1 [0, 6]Principal diagnosis code (ICD9/ICD10) n (%) Wegener’s granulomatosis (446.4, 446.4B, or M313.1)81 (95.3)Conclusion:We found that the diagnosis of AAV as the primary cause of ESRD in the USRD had a high PPV, suggesting accurate classification of ESRD due to AAV in the USRDS, but that sensitivity was moderate. These findings support the past and future use of the USRDS for research with ESRD attributed to AAV.References:[1]Moiseev S, Novikov P, Jayne D, Mukhin N. End-stage renal disease in ANCA-associated vasculitis. Nephrol Dial Transplant. 2017;32(2):248-53.[2]Layton JB, Hogan SL, Jennette CE, Kenderes B, Krisher J, Jennette JC, et al. Discrepancy between Medical Evidence Form 2728 and renal biopsy for glomerular diseases. Clin J Am Soc Nephrol. 2010;5(11):2046-52.Disclosure of Interests:None declared
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Hsu T, D’silva K, Serling-Boyd N, Wang J, Mueller A, Fu X, Prisco L, Martin L, Vanni K, Zaccardelli A, Cook C, Choi H, Zhang Y, Gravallese E, Wallace Z, Sparks J. POS1174 HYPERINFLAMMATION AND CLINICAL OUTCOMES FOR PATIENTS WITH SYSTEMIC RHEUMATIC DISEASES HOSPITALIZED FOR COVID-19: A COMPARATIVE COHORT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:COVID-19 can induce a hyperinflammatory state resulting in cytokine storm, which can lead to poor outcomes. Patients with systemic rheumatic diseases may be at increased risk for respiratory failure with COVID-19. Therefore, we investigated the relationship between rheumatic disease, hyperinflammation, and clinical outcomes among hospitalized COVID-19 patients.Objectives:To compare laboratory values, hyperinflammation, and clinical outcomes of hospitalized COVID-19 rheumatic patients and matched comparators.Methods:We performed a comparative cohort study of patients with polymerase chain reaction (PCR)-confirmed COVID-19 requiring hospitalization between 3/1/20-7/7/20 at a large health care system. We compared each systemic rheumatic disease case to up to 5 matched (by age, sex, and date of +SARS-CoV-2 PCR) comparators without systemic rheumatic disease. We extracted laboratory values from their hospitalization to compare peaks/troughs of individual laboratory results by case status and derived the COVID-19-associated hyperinflammation score (cHIS), a composite of 6 laboratory domains (0-6, ≥2 indicating hyperinflammation), as previously developed1. We used multivariable logistic regression to estimate ORs for COVID-19 outcomes by hyperinflammation and case status.Results:We identified 57 hospitalized rheumatic disease cases (mean age 67 years, 67% female) and 232 matched comparators hospitalized with PCR-confirmed COVID-19. Among cases, 26 (46%) had rheumatoid arthritis and 14 (25%) had systemic lupus erythematosus. Most cases (34, 60%) had active rheumatic disease. At baseline, 15 (27%) of cases were treated with biologic DMARDs, and 32 (56%) were using glucocorticoids. We analyzed 39,900 total laboratory results (median 85 per patient). Cases had higher peak neutrophil-to-lymphocyte ratio (9.6 vs 7.8, p=0.02), LDH (421 vs 345 U/L, p=0.04), creatinine (1.2 vs 1.0 mg/dL, p=0.01), and BUN (31 vs 23 mg/dL, p=0.03) than comparators but similar peak CRP (149 vs 116 mg/L, p=0.11, Figure 1). Cases had higher peak median cHIS (3 vs 2, p=0.01). Peak cHIS ≥2 had higher odds of intensive care unit (ICU) admission (OR 3.45, 95%CI 1.98-5.99), mechanical ventilation (OR 66.0, 95%CI 9.0-487.8), and mortality (OR 16.4, 95%CI 4.8-56.4) compared to cHIS <2 (Table 1). Cases had increased risk of ICU admission (OR 2.0, 95%CI 1.1-3.7) and mechanical ventilation (OR 2.7, 95%CI 1.4-5.2) than comparators.Table 1.Associations of peak cHIS and systemic rheumatic disease with COVID-19 hospitalization outcomesIntensive care unit admissionMechanical ventilationDeath%Adjusted OR (95%CI)%Adjusted OR (95%CI)%Adjusted OR (95%CI)Hospitalization outcomes by hyperinflammation on cHIS1cHIS <2 (n=112)21%1.0 (Ref)1%1.0 (Ref)3%1.0 (Ref)cHIS ≥2 (n=177)48%3.5 (2.0-6.0)37%66.2 (9.0-487.8)27%16.4 (4.8-56.4)Hospitalization outcomes by rheumatic disease statusComparators (n=232)30%1.0 (Ref)19%1.0 (Ref)16%1.0 (Ref)Rheumatic cases (n=57)51%1.87 (1.03-3.40)39%2.46 (1.30-4.67)21%1.32 (0.61-2.88)Matching factors: age, sex, and date of +PCR.1Adjusted for age, sex, and case status.2Adjusted for race, smoking, comorbidities, and body mass index.cHIS, COVID-19-associated hyperinflammation score; CI, confidence interval; OR, odds ratio; PCR, polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.Conclusion:Patients with systemic rheumatic disease hospitalized for COVID-19 had higher risk for hyperinflammation, kidney injury, and mechanical ventilation than non-rheumatic comparators. We validated the cHIS in our cohort, which was strongly associated with poor COVID-19 outcomes. These findings highlight that hospitalized patients with rheumatic diseases may be vulnerable to poor COVID-19 outcomes.References:[1]Webb BJ et al. Clinical criteria for COVID-19-associated hyperinflammatory syndrome. Lancet Rheumatol. 2020 Dec;2(12):e754-e763.Disclosure of Interests:Tiffany Hsu: None declared, Kristin D’Silva: None declared, Naomi Serling-Boyd: None declared, Jiaqi Wang: None declared, Alisa Mueller: None declared, Xiaoqing Fu: None declared, Lauren Prisco: None declared, Lily Martin: None declared, Kathleen Vanni: None declared, Alessandra Zaccardelli: None declared, Claire Cook: None declared, Hyon Choi Consultant of: Dr. Choi reports consultancy fees from Takeda, Selecta, GlaxoSmithKline, and Horizon, Grant/research support from: Dr. Choi reports research support from AstraZeneca., Yuqing Zhang: None declared, Ellen Gravallese: None declared, Zachary Wallace Consultant of: Dr. Wallace reports consulting fees from Viela Bio and MedPace., Grant/research support from: Dr. Wallace reports research support from Bristol-Myers Squibb and Principia., Jeffrey Sparks Consultant of: Dr. Sparks reports consultancy fees from Bristol-Myers Squibb, Gilead, Inova, Janssen, Optum, and Pfizer., Grant/research support from: Dr. Sparks reports research support from Amgen and Bristol-Myers Squibb.
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Lin V, Patel R, Wirtz A, Mannem D, Ottwell R, Arthur W, Cook C, Howard H, Wright D, Hartwell M, Vassar M. Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions. Dermatology 2021; 237:496-505. [PMID: 34000718 DOI: 10.1159/000515299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/21/2020] [Accepted: 12/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spin - the misrepresentation of a study's results - has been identified in abstracts of studies focused on a variety of disorders from multiple fields of medicine. OBJECTIVES This study's primary objective was to evaluate the abstracts of systematic reviews and meta-analyses focused on the treatment of atopic dermatitis for the nine most severe forms of spin. METHODS We systematically searched Embase and MEDLINE for systematic reviews of atopic dermatitis therapies. Screening and data extraction occurred in a masked, duplicate fashion. Each included study was evaluated for the nine most severe types of spin and other study characteristics. RESULTS Our searches retrieved 2,456 studies, of which 113 were included for data extraction. Spin was found in 74.3% of our included studies (84/113). Spin type 6 occurred most frequently (68/113, 60.2%). Spin types 1, 2, and 9 were not identified. All industry-funded systematic reviews contained spin in their abstract. The presence of spin was not associated with any specific study characteristics, including the methodological quality of the study. CONCLUSIONS Severe forms of spin were found in the majority of abstracts for systematic reviews of atopic dermatitis treatments. Steps should be taken to prevent spin to improve the quality of reporting in abstracts.
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Affiliation(s)
- Vanessa Lin
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Raahi Patel
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Arkansas Colleges of Health Education, Fort Smith, Arkansas, USA
| | - Alexis Wirtz
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Arkansas Colleges of Health Education, Fort Smith, Arkansas, USA
| | - Deepika Mannem
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Arkansas Colleges of Health Education, Fort Smith, Arkansas, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Courtney Cook
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - Drew Wright
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, New York, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Hoang N, Cook C, Downing M, Rickstrew J, Siscos S, Rajpara A. Asymptomatic Discolored Lesions on the Groin. Cutis 2021; 107:E23-E25. [PMID: 33956618 DOI: 10.12788/cutis.0216] [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: 11/20/2022]
Affiliation(s)
- Nguyen Hoang
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
| | - Courtney Cook
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
| | - Malia Downing
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
| | - Jace Rickstrew
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
| | - Spyros Siscos
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
| | - Anand Rajpara
- Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division of Dermatology, University of Kansas Medical Center, Kansas City. Dr. Cook is from the Oklahoma State University Center for Health Sciences, Tulsa
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Khattab MH, Weaver M, Cook C, Kinder N, Vassar M. Public Speaker Characteristics at Meetings of the Dermatologic and Ophthalmic Drug Advisory Committee and the Ophthalmic Devices Panel. Am J Ophthalmol 2021; 223:28-32. [PMID: 33166500 DOI: 10.1016/j.ajo.2020.09.043] [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] [Received: 08/05/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE We investigated meetings of the Dermatologic and Ophthalmic Drug Advisory Committee (DODAC) and the Ophthalmic Devices Panel (ODP) of the Food and Drug Administration (FDA) to determine whether a relationship exists between receipt of industry payments by speakers of the Open Public Hearing (OPH) portion and the nature of their recommendations regarding treatment approval. DESIGN Cross-sectional study. METHODS We reviewed publicly available transcripts of all DODAC and ODP meetings from February 2009 to December 2019. For each meeting, information about each public speaker including presence of conflict of interest (COI) and whether their testimony regarding the drug or device was positive, negative, or neutral toward treatment approval was extracted in a blinded fashion using a pilot-tested Google Form. RESULTS Of the 86 speakers, 66 (76.7%) included a COI disclosure statement and 41 (47.7%) disclosed a COI. Regarding classification of the speakers' testimonies, 70 (81.4%) of 86 were positive, 9 (10.5%) of 86 were negative, and 7 (8.1%) of 86 were neutral. Each one of the 41 speakers with a COI gave a positive testimony. Speakers who disclosed a COI were significantly more likely to give a positive testimony than speakers who did not (P < .001). CONCLUSION We recommend the DODAC and ODP require full disclosure of COI information and introduce stricter policies to manage COIs, allowing the committee to fully understand the context of the public speakers' comments, including the possible influence of COI on these comments.
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Affiliation(s)
- Mostafa H Khattab
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
| | - Michael Weaver
- Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA
| | - Courtney Cook
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Nicholas Kinder
- Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Grubbs V, Jaar BG, Cavanaugh KL, Ephraim PL, Ameling JM, Cook C, Greer RC, Boulware LE. Impact of pre-dialysis nephrology care engagement and decision-making on provider and patient action toward permanent vascular access. BMC Nephrol 2021; 22:60. [PMID: 33593328 PMCID: PMC7885501 DOI: 10.1186/s12882-021-02264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While catheters are often thought the result of emergency hemodialysis (HD) initiation among patients with little or no pre-dialysis nephrology care, the role of patient level of engagement in care and modality decision-making have not been fully explored. METHODS This is a retrospective medical record review of adults (age 18-89 years) who received care in academically affiliated private practice, public hospital, or Veterans Administration settings prior to initiating HD with a catheter between 10/1/2011 and 9/30/2012. Primary predictors were level of patient engagement in nephrology care within 6 months of HD initiation and timing of modality decision-making. Primary outcomes were provider action (referral) and any patient action (evaluation by a vascular surgeon, vein mapping or vascular surgery) toward [arteriovenous fistula or graft, (AVF/AVG)] creation. RESULTS Among 92 incident HD patients, 66% (n = 61) initiated HD via catheter, of whom 34% (n = 21) had ideal engagement in care but 42% (n = 25) had no documented decision. Providers referred 48% (n = 29) of patients for AVF/AVG, of whom 72% (n = 21) took any action. Ideal engagement in care predicted provider action (adjusted OR 13.7 [95% CI 1.08, 175.1], p = 0.04), but no level of engagement in care predicted patient action (p > 0.3). Compared to patients with no documented decision, those with documented decisions within 3, 3-12, or more than 12 months before initiating dialysis were more likely to have provider action toward AVF/AVG (adjusted OR [95% CI]: 9.0 [1.4,55.6], p = 0.2, 37.6 [3.3423.4] p = 0.003, and 4.8 [0.8, 30.6], p = 0.1, respectively); and patient action (adjusted OR [95% CI]: 18.7 [2.3, 149.0], p = 0.006, 20.4 [2.6, 160.0], p = 0.004, and 6.2 [0.9, 44.0], p = 0.07, respectively). CONCLUSIONS Timing of patient modality decision-making, but not level of engagement in pre-dialysis nephrology care, was predictive of patient and provider action toward AVF/AVG Interventions addressing patients' psychological preparation for dialysis are needed.
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Affiliation(s)
- Vanessa Grubbs
- Division of Nephrology, San Francisco/ San Francisco General Hospital Renal Center, University of California, Box 1341, 1001 Potrero Avenue, Bldg 100, Room 342, San Francisco, CA, 94110, USA.
| | - Bernard G Jaar
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.,Nephrology Center of Maryland, Baltimore, MD, USA
| | - Kerri L Cavanaugh
- Division of Nephrology & Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Patti L Ephraim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Jessica M Ameling
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.,Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Courtney Cook
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Raquel C Greer
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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Memiah P, Kamau A, Opanga Y, Muhula S, Nyakeriga E, Humwa F, Cook C, Kingori C, Muriithi J. Using Friendship Ties to Understand the Prevalence of, and Factors Associated With, Intimate Partner Violence Among Adolescents and Young Adults in Kenya: Cross-Sectional, Respondent-Driven Survey Study. Interact J Med Res 2020; 9:e19023. [PMID: 33382380 PMCID: PMC7808892 DOI: 10.2196/19023] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/18/2020] [Accepted: 10/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background Optimization of innovative approaches is required for estimating the intimate partner violence (IPV) burden among adolescents and young adults (AYA). Further investigation is required to identify risk and protective factors associated with IPV among AYA. There remain significant gaps in understanding these factors among this vulnerable population. Objective The goal of our study was to determine the prevalence of IPV among an urban population of AYA and to identify factors associated with IPV among AYA. Methods A cross-sectional study design utilizing respondent-driven sampling was adopted. The study was conducted among 887 AYA, aged 15 to 24 years, residing in Nairobi, Kenya. Data were collected through a phone-based survey using the REACH (Reaching, Engaging Adolescents and Young Adults for Care Continuum in Health)-AYA app. Questions on behavioral and psychosocial factors were adopted from different standardized questionnaires. Descriptive, bivariate, and multivariable statistics were used to describe the characteristics of the study sample. Results Of the 887 participants, a higher proportion were male (540/887, 60.9%) compared to female (347/887, 39.1%). The prevalence of IPV was 22.3% (124/556). IPV was associated with being unsure if it was okay for a boy to hit his girlfriend, living in a home with physical violence or abuse, and being bullied (P=.005). The likelihood of experiencing IPV was higher among respondents whose friends and family members used alcohol (odds ratio [OR] 1.80, 95% CI 1.09-2.98) and among those who had repeated a class at school in the past two years (OR 1.90, 95% CI 1.11-3.23). Respondents who visited a health facility or doctor for reproductive health services were 2 times more likely to experience IPV (OR 2.23, 95% CI 1.40-3.70). Respondents who had used illicit drugs were 2 times more likely to experience IPV (OR 4.31, 95% CI 2.64-7.04). The probability of experiencing IPV decreased by 63% (OR 0.37, 95% CI 0.16-0.85) among respondents who refused to have sex with someone who was not prepared to use a condom. Conclusions IPV remains a significant public health priority because of its impact to society. Our results are in congruence with other similar studies. Efforts toward incorporating appropriate IPV core measures into the comprehensive care package for every AYA seeking health services should be explored. Programs need to address constellations of risk and protective factors linked to IPV in an effort to prevent its occurrence.
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Affiliation(s)
- Peter Memiah
- University of Maryland School of Medicine, Baltimore, MD, United States
| | | | | | | | | | - Felix Humwa
- University of California, San Francisco, Nairobi, Kenya
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Bindernagel R, Cook C, Wayant C, Jellison S, Vassar M. Assessing the quality of intervention reporting in dermatology randomized controlled trials using the TIDieR checklist. Br J Dermatol 2020; 183:1114-1115. [PMID: 32628774 DOI: 10.1111/bjd.19382] [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] [Received: 08/26/2019] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/01/2022]
Affiliation(s)
- R Bindernagel
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - C Cook
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - C Wayant
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - S Jellison
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - M Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Cook C, Ottwell R, Rogers T, Checketts J, Musuvathy S, Vassar M. Evaluation of the Level of Evidence Supporting the Recommendations Constituting the American Academy of Dermatology Clinical Practice Guidelines: Cross-Sectional Analysis. JMIR Dermatol 2020. [DOI: 10.2196/17370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Clinical practice guidelines are evidence-based recommendations used by physicians to improve patient care. These guidelines provide the physician with an assessment of the benefits and harms of a treatment and its alternatives. Therefore, it is essential that the clinical practice guidelines be based on the strongest available evidence. Numerous studies in a variety of different fields of medicine have demonstrated that recommendations supported by weak evidence are a common theme in clinical practice guidelines. A clinical guideline based solely on weak evidence has the capability to reduce the quality of care provided by physicians.
Objective
Our primary objective is to evaluate the levels of evidence supporting the recommendations constituting the American Academy of Dermatology clinical practice guidelines.
Methods
Using a cross-sectional study design, authors SM and RO located all current clinical practice guidelines on the American Academy of Dermatology website on June 10, 2017, and December 11, 2019. Each recommendation and its corresponding evidence rating were extracted in a duplicate and blinded fashion. A consensus meeting was planned a priori to resolve disagreements in extractions or stratifications.
Results
In total, 6 clinical guidelines and their subsections were screened and 899 recommendations were identified. Our final data set included 841 recommendations, as 58 recommendations contained no level of evidence and were excluded from calculations. Many recommendations were supported by a moderate level of evidence and therefore received a B rating (346/841, 41.1%). Roughly one-third of the recommendations were supported by a strong level of evidence and were given an A rating (n=307, 36.5%). The clinical practice guideline with the highest overall strength of evidence was regarding the treatment of acne, which had 17 of 35 (48.6%) recommendations supported by strong evidence and only 2 (5.7%) supported by weak evidence. The clinical practice guideline with the fewest recommendations supported by strong evidence was melanoma (13/63, 20.6%).
Conclusions
Clinical practice guidelines that lack strong supporting evidence could negatively affect patient care, and dermatologists should be mindful that not all recommendations are supported by the strongest level of evidence. An increased quantity of quality research needs to be performed in the field of dermatology to improve the evidence supporting the American Academy of Dermatology clinical practice guidelines.
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Liu Y, Cook C, Haririchian P, Ricardo-Gonzalez R, North J, Charruyer A, Ghadially R, Cho R, Cheng J. 095 Single-cell Profiling Reveals a Highly Specific, Compartmentalized Functional Response in the Cutaneous Immune System. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Daumit GL, Dalcin AT, Dickerson FB, Miller ER, Evins AE, Cather C, Jerome GJ, Young DR, Charleston JB, Gennusa JV, Goldsholl S, Cook C, Heller A, McGinty EE, Crum RM, Appel LJ, Wang NY. Effect of a Comprehensive Cardiovascular Risk Reduction Intervention in Persons With Serious Mental Illness: A Randomized Clinical Trial. JAMA Netw Open 2020; 3:e207247. [PMID: 32530472 PMCID: PMC7293000 DOI: 10.1001/jamanetworkopen.2020.7247] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Persons with serious mental illness have a cardiovascular disease mortality rate more than twice that of the overall population. Meaningful cardiovascular risk reduction requires targeted efforts in this population, who often have psychiatric symptoms and cognitive impairment. OBJECTIVE To determine the effectiveness of an 18-month multifaceted intervention incorporating behavioral counseling, care coordination, and care management for overall cardiovascular risk reduction in adults with serious mental illness. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted from December 2013 to November 2018 at 4 community mental health outpatient programs in Maryland. The study recruited adults with at least 1 cardiovascular disease risk factor (hypertension, diabetes, dyslipidemia, current tobacco smoking, and/or overweight or obesity) attending the mental health programs. Of 398 participants screened, 269 were randomized to intervention (132 participants) or control (137 participants). Data collection staff were blinded to group assignment. Data were analyzed on the principle of intention to treat, and data analysis was performed from November 2018 to March 2019. INTERVENTIONS A health coach and nurse provided individually tailored cardiovascular disease risk reduction behavioral counseling, collaborated with physicians to implement appropriate risk factor management, and coordinated with mental health staff to encourage attainment of health goals. Programs offered physical activity classes and received consultation on serving healthier meals; intervention and control participants were exposed to these environmental changes. MAIN OUTCOMES AND MEASURES The primary outcome was the change in the risk of cardiovascular disease from the global Framingham Risk Score (FRS), which estimates the 10-year probability of a cardiovascular disease event, from baseline to 18 months, expressed as percentage change for intervention compared with control. RESULTS Of 269 participants randomized (mean [SD] age, 48.8 [11.9] years; 128 men [47.6%]), 159 (59.1%) had a diagnosis of schizophrenia or schizoaffective disorder, 67 (24.9%) had bipolar disorder, and 38 (14.1%) had major depressive disorder. At 18 months, the primary outcome, FRS, was obtained for 256 participants (95.2%). The mean (SD) baseline FRS was 11.5% (11.5%) (median, 8.6%; interquartile range, 3.9%-16.0%) in the intervention group and 12.7% (12.7%) (median, 9.1%; interquartile range, 4.0%-16.7%) in the control group. At 18 months, the mean (SD) FRS was 9.9% (10.2%) (median, 7.7%; interquartile range, 3.1%-12.0%) in the intervention group and 12.3% (12.0%) (median, 9.7%; interquartile range, 4.0%-15.9%) in the control group. Compared with the control group, the intervention group experienced a 12.7% (95% CI, 2.5%-22.9%; P = .02) relative reduction in FRS at 18 months. CONCLUSIONS AND RELEVANCE An 18-month behavioral counseling, care coordination, and care management intervention statistically significantly reduced overall cardiovascular disease risk in adults with serious mental illness. This intervention provides the means to substantially reduce health disparities in this high-risk population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02127671.
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Affiliation(s)
- Gail L. Daumit
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Arlene T. Dalcin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | | | - Edgar R. Miller
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - A. Eden Evins
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Corinne Cather
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Gerald J. Jerome
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Kinesiology, Towson University, Towson, Maryland
| | - Deborah R. Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Jeanne B. Charleston
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joseph V. Gennusa
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stacy Goldsholl
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Courtney Cook
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ann Heller
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emma E. McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rosa M. Crum
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lawrence J. Appel
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Abstract
Botryomycosis is a rare bacterial infection which is most commonly caused by Staphylococcus aureus. It usually affects the skin but can also involve the viscera. The cutaneous form typically presents as ulcerated plaques or nodules that evolve over months to years to form discharging sinuses. As opposed to the norm for this uncommon infection, our case had a relatively acute presentation. A 44-year-old male with a history of relapsed mantle cell lymphoma, stem cell transplant and chronic graft versus host disease on immunosuppressive therapy presented with 2-3 week history of sores on his hands. Punch biopsy and subsequent pathological testing confirmed the diagnosis of botryomycosis. The patient was subsequently treated with clindamycin for 30 days and the lesions completely resolved. In this case report, we highlight the acute presentation of this relatively rare and usually chronic infectious disease.
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Affiliation(s)
- Angad Singh
- Kansas University Medical Center, Kansas City, KS, United States
| | - Courtney Cook
- Kansas University Medical Center, Kansas City, KS, United States
| | - Kaitlyn Kollmann
- Kansas University Medical Center, Kansas City, KS, United States
| | - Anand Rajpara
- Kansas University Medical Center, Kansas City, KS, United States
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Nour D, Shun-shin M, Fung M, Howard J, Ahmed Y, Allahwala U, Alzuhairi K, Bhindi R, Chamie D, Cook C, Doi S, Funayama N, Hansen P, Horinaka R, Ishibashi Y, Hijikata N, Kaihara T, Kawase Y, Koga M, Kotecha T, Kuwata S, Manica A, Matsuo H, Nakayama M, Nijjer S, Petraco R, Rajkumar C, Ramrakha P, Ruparelia N, Seligman H, Sen S, Takahashi T, Tanabe Y, Warisawa T, Watanabe A, Weaver J, Yong T, Francis D, Al-Lamee R. 834 How Accurately can Physicians Predict Invasive Physiology Using Coronary Angiography? Results of an International Multi-Centre Survey. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wiffen L, Lodge D, Fox L, Bradley C, Ibrahim W, Bentley K, Cook C, Nutkins K, Brown T, Rupani H, Chauhan A, Bishop L, Hicks A. Patient experience of telephone consultations in the lung cancer pathway. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Urtatiz O, Cook C, Huang JLY, Yeh I, Van Raamsdonk CD. GNAQ Q209L expression initiated in multipotent neural crest cells drives aggressive melanoma of the central nervous system. Pigment Cell Melanoma Res 2019; 33:96-111. [PMID: 31680437 DOI: 10.1111/pcmr.12843] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 07/05/2019] [Revised: 10/08/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022]
Abstract
Primary leptomeningeal melanocytic neoplasms represent a spectrum of rare tumors originating from melanocytes of the leptomeninges, which are the inner two membranes that protect the central nervous system. Like other non-epithelial melanocytic lesions, they bear frequent oncogenic mutations in the heterotrimeric G protein alpha subunits, GNAQ or GNA11. In this study, we used Plp1-creERT to force the expression of oncogenic GNAQQ209L in the multipotent neural crest cells of the ventro-medial developmental pathway, beginning prior to melanocyte cell differentiation. We found that this produces leptomeningeal melanocytic neoplasms, including cranial melanocytomas, spinal melanocytomas, and spinal melanomas, in addition to blue nevus-like lesions in the dermis. GNAQQ209L drove different phenotypes depending upon when during embryogenesis (E9.5, E10.5, or E11.5) it was induced by tamoxifen and which Cre driver (Plp1-creERT, Tyr-creERT2 , or Mitf-cre) was used. Given these differences, we propose that melanocytes go through temporary phases where they become sensitive to the oncogenic effects of GNAQQ209L . R26-fs-GNAQQ209L ; Plp1-creERT mice will be useful for defining biomarkers for potentially aggressive leptomeningeal melanocytomas and for developing new therapeutics for advanced disease.
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Affiliation(s)
- Oscar Urtatiz
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Courtney Cook
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Jenny L-Y Huang
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Iwei Yeh
- Departments of Dermatology and Pathology, University of California at San Francisco, San Francisco, CA, USA
| | - Catherine D Van Raamsdonk
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
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Alferness PL, Wiebe LA, Anderson L, Bennett O, Bosch M, Clark D, Claussen F, Colin T, Cook C, Davis H, Ely V, Graham D, Grazzini R, Hickes H, Holland P, Hom W, Ingram R, Ling Y, Markley B, Peoples G, Pitz G, Robert G, Robinson C, Sen L, Sensue A, South N, Steginsky C, Summer S, Trower T, Wieczorek P, Zheng S. Determination of Glyphosate and Aminomethylphosphonic Acid in Crops by Capillary Gas Chromatography with Mass-Selective Detection: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.3.823] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A collaborative study was conducted to validate a method for the determination of glyphosate and aminomethylphosphonic acid (AMPA) in crops. The analytes are extracted from crops with water, and the crude extracts are then subjected to a cation exchange cleanup. The analytes are derivatized by the direct addition of the aqueous extract into a mixture of heptafluorobutanol and trifluoroacetic anhydride. The derivatized analytes are quantitated by capillary gas chromatography with mass-selective detection (MSD). The collaborative study involved 13 laboratories located in 5 countries 12 laboratories returned valid data sets. The crops tested were field corn grain, soya forage, and walnut nutmeat at concentrations of 0.050, 0.40, and 2.0 mg/kg. The study used a split-level pair replication scheme with blindly coded laboratory samples. Twelve materials were analyzed, including 1 control and 3 split-level pairs for each matrix, 1 pair at each nominal concentration. For glyphosate, the mean recovery was 91%, the average intralaboratory variance, the repeatability relative standard deviation (RSDr), was 11%, and the interlaboratory variance, the reproducibility relative standard deviation (RSDR), was 16%. For AMPA, the mean recovery was 87%, the RSDr was 16%, and the RSDR was 25% at mg/kg levels.
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Affiliation(s)
- Philip L Alferness
- Zeneca Ag Products 1 , Western Research Center, 1200 S 47th St, Richmond, CA
| | - Lawrence A Wiebe
- Zeneca Ag Products 1 , Western Research Center, 1200 S 47th St, Richmond, CA
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Anderson JM, Niemann A, Johnson AL, Cook C, Tritz D, Vassar M. Transparent, Reproducible, and Open Science Practices of Published Literature in Dermatology Journals: Cross-Sectional Analysis. JMIR Dermatol 2019. [DOI: 10.2196/16078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Reproducible research is a foundational component for scientific advancements, yet little is known regarding the extent of reproducible research within the dermatology literature.
Objective
This study aimed to determine the quality and transparency of the literature in dermatology journals by evaluating for the presence of 8 indicators of reproducible and transparent research practices.
Methods
By implementing a cross-sectional study design, we conducted an advanced search of publications in dermatology journals from the National Library of Medicine catalog. Our search included articles published between January 1, 2014, and December 31, 2018. After generating a list of eligible dermatology publications, we then searched for full text PDF versions by using Open Access Button, Google Scholar, and PubMed. Publications were analyzed for 8 indicators of reproducibility and transparency—availability of materials, data, analysis scripts, protocol, preregistration, conflict of interest statement, funding statement, and open access—using a pilot-tested Google Form.
Results
After exclusion, 127 studies with empirical data were included in our analysis. Certain indicators were more poorly reported than others. We found that most publications (113, 88.9%) did not provide unmodified, raw data used to make computations, 124 (97.6%) failed to make the complete protocol available, and 126 (99.2%) did not include step-by-step analysis scripts.
Conclusions
Our sample of studies published in dermatology journals do not appear to include sufficient detail to be accurately and successfully reproduced in their entirety. Solutions to increase the quality, reproducibility, and transparency of dermatology research are warranted. More robust reporting of key methodological details, open data sharing, and stricter standards journals impose on authors regarding disclosure of study materials might help to better the climate of reproducible research in dermatology.
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Doan T, Hinterwirth A, Worden L, Arzika AM, Maliki R, Abdou A, Kane S, Zhong L, Cummings ME, Sakar S, Chen C, Cook C, Lebas E, Chow ED, Nachamkin I, Porco TC, Keenan JD, Lietman TM. Gut microbiome alteration in MORDOR I: a community-randomized trial of mass azithromycin distribution. Nat Med 2019; 25:1370-1376. [PMID: 31406349 DOI: 10.1038/s41591-019-0533-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/25/2019] [Indexed: 01/25/2023]
Abstract
The MORDOR I trial1, conducted in Niger, Malawi and Tanzania, demonstrated that mass azithromycin distribution to preschool children reduced childhood mortality1. However, the large but simple trial design precluded determination of the mechanisms involved. Here we examined the gut microbiome of preschool children from 30 Nigerien communities randomized to either biannual azithromycin or placebo. Gut microbiome γ-diversity was not significantly altered (P = 0.08), but the relative abundances of two Campylobacter species, along with another 33 gut bacteria, were significantly reduced in children treated with azithromycin at the 24-month follow-up. Metagenomic analysis revealed functional differences in gut bacteria between treatment groups. Resistome analysis showed an increase in macrolide resistance gene expression in gut microbiota in communities treated with azithromycin (P = 0.004). These results suggest that prolonged mass azithromycin distribution to reduce childhood mortality reduces certain gut bacteria, including known pathogens, while selecting for antibiotic resistance.
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Affiliation(s)
- T Doan
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA.
- Department of Ophthalmology, University of California, San Francisco, CA, USA.
| | - A Hinterwirth
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - L Worden
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | | | - R Maliki
- The Carter Center, Niamey, Niger
| | - A Abdou
- Ministry of Public Health, Niamey, Niger
- Programme National de Soins Oculaires, Niamey, Niger
| | - S Kane
- The Carter Center, Niamey, Niger
| | - L Zhong
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - M E Cummings
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - S Sakar
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - C Chen
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - C Cook
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - E Lebas
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - E D Chow
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - I Nachamkin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - T C Porco
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - J D Keenan
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - T M Lietman
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
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Ilunga Tshiswaka D, Ibe-Lamberts KD, Fazio M, Morgan JD, Cook C, Memiah P. Determinants of stroke prevalence in the southeastern region of the United States. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0974-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Basham CA, Elias B, Fanning A, Cook C, Orr P. Performance measurement of a Canadian provincial tuberculosis programme: Manitoba, 2008-2012. Int J Tuberc Lung Dis 2019; 22:437-443. [PMID: 29562993 DOI: 10.5588/ijtld.17.0508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Performance measurement assists tuberculosis (TB) programmes in understanding areas of strength and weakness, and planning for improvements. Canada currently does not have a national comprehensive system for the measurement and analysis of TB programme performance. OBJECTIVE To analyse the performance of a Canadian provincial TB programme using measures and targets based on those published by the US Centers for Disease Prevention and Control for 2015. DESIGN Using provincial surveillance data from the Canadian province of Manitoba, we analysed key programme performance outcome measures (treatment completion, early detection, human immunodeficiency virus [HIV] testing, paediatric TB, retreatment, and contact elicitation and assessment) for people diagnosed with TB between 2008 and 2010. RESULTS Significant outcome variation was found between Indigenous and non-Indigenous populations as well as within populations. The reporting rate of HIV testing was low. High rates of paediatric TB among Indigenous populations, particularly in rural areas, were found. Significantly better performance in HIV testing and reporting as well as in contact investigation was found for rural compared with urban Indigenous populations. Foreign-born persons had the lowest contact assessment rate. CONCLUSION This study of TB programme performance in Manitoba demonstrates the viability of the approach in the Canadian context, and could help to identify key areas for TB programme improvement.
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Affiliation(s)
- C A Basham
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia Centre for Disease Control, Vancouver, British Columbia
| | - B Elias
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - A Fanning
- Emeritus, Department of Medicine, University of Alberta, Edmonton, Alberta
| | - C Cook
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - P Orr
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
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Tseng E, Dalcin AT, Jerome GJ, Gennusa JV, Goldsholl S, Cook C, Appel LJ, Maruthur NM, Daumit GL, Wang NY. Effect of a Behavioral Weight Loss Intervention in People With Serious Mental Illness and Diabetes. Diabetes Care 2019; 42:804-809. [PMID: 30765433 PMCID: PMC6489111 DOI: 10.2337/dc18-2201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/21/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Given the high prevalence of obesity and diabetes in patients with serious mental illness (SMI) and the lack of evidence on the effects of weight loss programs in SMI patients with diabetes, we evaluated the effectiveness of a behavioral weight loss intervention among SMI participants with and without diabetes. RESEARCH DESIGN AND METHODS Using data from ACHIEVE, a randomized controlled trial to evaluate the effects of a behavioral weight loss intervention among overweight/obese people with SMI, we assessed and compared weight change from baseline to 18 months in participants with and without diabetes using a longitudinal mixed-effects model. RESULTS Of the 291 trial participants, 82 (28.2%) participants had diabetes (34 and 48 in intervention and control groups, respectively) at baseline. Participants with diabetes were more likely to be taking antipsychotics (31.7% vs. 18.7%, P = 0.02). At 18 months, participants in the control group with diabetes lost 1.2 lb (0.6%) of body weight compared with 0.8 lb (0.7%) among those without diabetes. In the intervention group, participants with diabetes lost 13.7 lb (6.6%) of their initial body weight compared with 5.4 lb (2.9%) for those without diabetes. Corresponding net effects (intervention minus control) were 4.6 lb (2.2%) and 12.5 lb (6.0%) net weight reduction over 18 months in the no diabetes and the diabetes subgroups, respectively. However, the between-group difference in intervention effects was statistically nonsignificant (absolute weight change: P-interaction = 0.08; % weight change: P-interaction = 0.10). CONCLUSIONS A behavioral weight loss intervention is effective among overweight and obese individuals with SMI regardless of their diabetes status.
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Affiliation(s)
- Eva Tseng
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD .,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD
| | - Arlene T Dalcin
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD
| | | | - Joseph V Gennusa
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stacy Goldsholl
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Courtney Cook
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lawrence J Appel
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD.,Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Nisa M Maruthur
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD.,Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Gail L Daumit
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD.,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Nae-Yuh Wang
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.,Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD.,Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.,Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Alexander E, McGinty EE, Wang NY, Dalcin A, Jerome GJ, Miller ER, Dickerson F, Charleston J, Young DR, Gennusa JV, Goldsholl S, Cook C, Appel LJ, Daumit GL. Effects of a behavioural weight loss intervention in people with serious mental illness: Subgroup analyses from the ACHIEVE trial. Obes Res Clin Pract 2019; 13:205-210. [PMID: 30852244 PMCID: PMC7255457 DOI: 10.1016/j.orcp.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/11/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups. METHODS This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups. RESULTS No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined. CONCLUSIONS These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.
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Affiliation(s)
- Eleanore Alexander
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
| | - Emma E McGinty
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Arlene Dalcin
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gerald J Jerome
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Kinesiology, Towson University, Baltimore, MD, 21252, United States
| | - Edgar R Miller
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD 21204, United States
| | - Jeanne Charleston
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91024, United States
| | - Joseph V Gennusa
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Courtney Cook
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
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Memiah P, Opanga Y, Bond T, Cook C, Mwangi M, Fried J, Joseph MA, Owuor K, Mochache V, Machira YW. Is sexual autonomy a protective factor for neonatal, child, and infant mortality? A multi-country analysis. PLoS One 2019; 14:e0212413. [PMID: 30794592 PMCID: PMC6386489 DOI: 10.1371/journal.pone.0212413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/02/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sexual autonomy empowers women to set boundaries, take control of their bodies, prevent sexually transmitted diseases and avoid unplanned pregnancy. A woman's ability to negotiate safer sex is crucial for her survival and that of her child. Sexual autonomy among East African women is vital to the elimination of the deaths of neonates, infants, and children. The aim of our study was to explore the association of sexual autonomy on neonatal, infant, and child mortality. METHODOLOGY This was a secondary analysis of demographic health survey (DHS) data on women of reproductive age (15-49 years) in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda. Data on our outcome variables neonatal, infant, and under-five mortality which were in binary form was extracted from the database. Sexual autonomy was classified as a composite variable of "respondent can refuse sex," "respondent can ask partner to use condom," and "if spouse is justified in asking husband to use condom." Other sociodemographic, maternal, health system and paternal variables were included in the analysis. STATA version 14 was used for analysis. Proportions and frequencies were used to describe the three outcome variables and sociodemographic characteristics. Chi-square tests were used to compare associations between sexual autonomy and categorical variables. Adjusted hazard ratios were used to determine the association between sexual autonomy and independent variables. RESULTS The sampled women were predominantly urban (75%; n = 5758) and poor (48.7%; n = 3702). A majority of those that experienced mortality (neonatal mortality 53.5%, infant mortality 54.3%, under-five mortality 55.7%) were young (under 20) at the time of their first child's birth while their male partners were older. The multivariate analysis supports the beneficial effects of women's sexual autonomy in East Africa. Women who exercised sexual autonomy experienced significantly lower rates of child mortality at all three stages: neonatal (NHR = 0.80, 95% CI: 0.68-0.94, p = 0.006), infant (IHR = 0.82, 95% CI: 0.72-0.93, p = 0.003), and under-five (UHR = 0.84, 95% CI: 0.75-0.94, p = 0.002), net of all other factors. Receiving antenatal care and using contraceptives also contributed significantly to lower child mortality rates. CONCLUSION Our findings suggest that sexual autonomy among East African women is an urgent priority that is crucial to the survival of neonates, infants, and children in East Africa. Women should be informed, empowered, and autonomous concerning their reproductive and sexual health.
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Affiliation(s)
- Peter Memiah
- Department of Public Health, Usha Kundu College of Health, University of West Florida, Pensacola, Florida, United States of America
- * E-mail:
| | | | - Tristi Bond
- Department of Public Health, Usha Kundu College of Health, University of West Florida, Pensacola, Florida, United States of America
| | - Courtney Cook
- Biology Department, University of West Florida, Pensacola, Florida, United States of America
| | - Michelle Mwangi
- Department of Economics, University of Nairobi, Nairobi, Kenya
| | - Jenna Fried
- Psychology Department, University of West Florida, Pensacola, Florida, United States of America
| | - Marie A. Joseph
- Department of Public Health, Usha Kundu College of Health, University of West Florida, Pensacola, Florida, United States of America
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Schultz A, Dahl L, McGibbon E, Brownlie J, Cook C, Elbarouni B, Katz A, Nguyen T, Sawatzky J, Sinclaire M, Throndson K, Fransoo R. DIFFERENCES IN FIVE YEAR OUTCOMES AND FOLLOW-UP CARE POST INDEX CORONARY ANGIOGRAPHY AMONG FIRST NATION PEOPLE AND ALL OTHER MANITOBANS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Ahmad Y, Howard J, Arnold A, Shun-Shin M, Cook C, Petraco R, Sutaria N, Malik I, Mayet J, Francis DP, Sen S. P716PFO closure is superior to medical therapy for cryptogenic stroke: a meta-analysis of randomised controlled trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p716] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Ahmad
- Imperial College London, London, United Kingdom
| | - J Howard
- Imperial College London, London, United Kingdom
| | - A Arnold
- Imperial College London, London, United Kingdom
| | - M Shun-Shin
- Imperial College London, London, United Kingdom
| | - C Cook
- Imperial College London, London, United Kingdom
| | - R Petraco
- Imperial College London, London, United Kingdom
| | - N Sutaria
- Imperial College NHS Healthcare Trust, Cardiolog, London, United Kingdom
| | - I Malik
- City Hospital Birmingham, University of Birmingham Centre for Cardiovascular Medicine, Birmingham, United Kingdom
| | - J Mayet
- Imperial College London, London, United Kingdom
| | - D P Francis
- Imperial College London, London, United Kingdom
| | - S Sen
- Imperial College London, London, United Kingdom
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Wayant C, Moore G, Hoelscher M, Cook C, Vassar M. Adherence to reporting guidelines and clinical trial registration policies in oncology journals: a cross-sectional review. BMJ Evid Based Med 2018; 23:104-110. [PMID: 29653939 DOI: 10.1136/bmjebm-2017-110855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/08/2018] [Indexed: 01/10/2023]
Abstract
Reporting guidelines (RG) aim to improve research transparency and ensure high-quality study reporting. Similarly, clinical trial registration policies aim to reduce bias in results reporting by ensuring prospective registration of all trial outcomes. Failure to adhere to quality standards documented in RGs may result in low-quality and irreproducible research. Herein, we investigate the adherence to common RGs and trial registration policies in 21 oncology journals. We surveyed the Instructions for Authors page for each of the included oncology journals for adherence to common reporting guidelines and trial registration policies. We corresponded with editors to determine accepted study types and cross-referenced this information with a journal's RGs and trial registration policies to calculate the per cent of journals that adhere to a specific guideline or policy. 76.2% (16/21) of oncology journals surveyed adhere to Consolidated Standards of Reporting Trials guidelines for clinical trials while only 33.3% (7/21) adhere to Strengthening the Reporting of Observational Studies in Epidemiology for observational studies. Similarly, 76.2% (16/21) of oncology journals adhere to clinical trial registration policies. We further demonstrate that journal adherence to RGs positively affects author reporting, despite adherence to trial registration policies showing no such benefit. Our results show that oncology journals adhere to RGs and trial registration policies at a higher rate than other specialties, but nonetheless show room for improvement. We conclude that oncology journal adherence to RGs and trial registration policies is encouraging, but nonetheless suboptimal. We recommend the adoption of RGs and trial registration policies by all oncology journals.
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Affiliation(s)
- Cole Wayant
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Gretchan Moore
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mark Hoelscher
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Courtney Cook
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Boulware LE, Ephraim PL, Ameling J, Lewis-Boyer L, Rabb H, Greer RC, Crews DC, Jaar BG, Auguste P, Purnell TS, Lamprea-Monteleagre JA, Olufade T, Gimenez L, Cook C, Campbell T, Woodall A, Ramamurthi H, Davenport CA, Choudhury KR, Weir MR, Hanes DS, Wang NY, Vilme H, Powe NR. Effectiveness of informational decision aids and a live donor financial assistance program on pursuit of live kidney transplants in African American hemodialysis patients. BMC Nephrol 2018; 19:107. [PMID: 29724177 PMCID: PMC5934897 DOI: 10.1186/s12882-018-0901-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/22/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND African Americans have persistently poor access to living donor kidney transplants (LDKT). We conducted a small randomized trial to provide preliminary evidence of the effect of informational decision support and donor financial assistance interventions on African American hemodialysis patients' pursuit of LDKT. METHODS Study participants were randomly assigned to receive (1) Usual Care; (2) the Providing Resources to Enhance African American Patients' Readiness to Make Decisions about Kidney Disease (PREPARED); or (3) PREPARED plus a living kidney donor financial assistance program. Our primary outcome was patients' actions to pursue LDKT (discussions with family, friends, or doctor; initiation or completion of the recipient LDKT medical evaluation; or identification of a donor). We also measured participants' attitudes, concerns, and perceptions of interventions' usefulness. RESULTS Of 329 screened, 92 patients were eligible and randomized to Usual Care (n = 31), PREPARED (n = 30), or PREPARED plus financial assistance (n = 31). Most participants reported interventions helped their decision making about renal replacement treatments (62%). However there were no statistically significant improvements in LDKT actions among groups over 6 months. Further, no participants utilized the living donor financial assistance benefit. CONCLUSIONS Findings suggest these interventions may need to be paired with personal support or navigation services to overcome key communication, logistical, and financial barriers to LDKT. TRIAL REGISTRATION ClinicalTrials.gov [ NCT01439516 ] [August 31, 2011].
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Affiliation(s)
- L. Ebony Boulware
- Division of General Internal Medicine, Duke University School of Medicine, 411 W. Chapel Hill, St Suite 500, Durham, NC 27110 USA
| | - Patti L. Ephraim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
| | - Jessica Ameling
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - LaPricia Lewis-Boyer
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Hamid Rabb
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD USA
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Raquel C. Greer
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Deidra C. Crews
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Bernard G. Jaar
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Priscilla Auguste
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Tanjala S. Purnell
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Julio A. Lamprea-Monteleagre
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Department of Cardiology, University of Washington School of Medicine, Seattle, WA USA
| | - Tope Olufade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
| | - Luis Gimenez
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD USA
- Nephrology Center of Maryland at MedStar Good Samaritan Hospital, Baltimore, MD USA
| | - Courtney Cook
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Tiffany Campbell
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Ashley Woodall
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Hema Ramamurthi
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Cleomontina A. Davenport
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC USA
| | - Kingshuk Roy Choudhury
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC USA
| | - Matthew R. Weir
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD USA
| | - Donna S. Hanes
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD USA
| | - Nae-Yuh Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Helene Vilme
- Division of General Internal Medicine, Duke University School of Medicine, 411 W. Chapel Hill, St Suite 500, Durham, NC 27110 USA
| | - Neil R. Powe
- Department of Medicine, San Francisco General Hospital and University of California, San Francisco, CA USA
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Cook C, Checketts J, Atakpo P, Nelson N, Vassar M. How well are reporting guidelines and trial registration used by dermatology journals to limit bias? A meta-epidemiological study. Br J Dermatol 2018; 178:1433-1434. [DOI: 10.1111/bjd.16135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Cook
- Oklahoma State University Center for Health Sciences; 1111 W. 17th St Tulsa OK 74017 U.S.A
| | - J.X. Checketts
- Oklahoma State University Center for Health Sciences; 1111 W. 17th St Tulsa OK 74017 U.S.A
| | - P. Atakpo
- Oklahoma State University Center for Health Sciences; 1111 W. 17th St Tulsa OK 74017 U.S.A
| | - N. Nelson
- Oklahoma State University Center for Health Sciences; 1111 W. 17th St Tulsa OK 74017 U.S.A
| | - M. Vassar
- Oklahoma State University Center for Health Sciences; 1111 W. 17th St Tulsa OK 74017 U.S.A
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Bowers A, Meyer C, Tritz D, Cook C, Fuller K, Smith C, Diener B, Vassar M. Assessing quality of randomized trials supporting guidelines for laparoscopic and endoscopic surgery. J Surg Res 2018; 224:233-239. [PMID: 29506846 DOI: 10.1016/j.jss.2017.11.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/27/2017] [Accepted: 11/22/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent studies have highlighted the risk of bias and the fragility of results in randomized controlled trials (RCTs). The aim of our study was to evaluate the clinical practice guidelines created by the Society for Gastrointestinal and Endoscopic Surgeons (SAGES) for fragility, statistical power, and risk of bias. MATERIALS AND METHODS We screened the SAGES clinical practice guideline references for qualifying RCTs. RCTs were assessed for risk of bias using the Cochrane Collaboration Risk of Bias tool 2.0. We used the fragility index and fragility quotient to evaluate the robustness of trial results and conducted a power analysis using G*Power to determine if trials were adequately powered. RESULTS Twenty-two (40.7%) of the 54 trials that we assessed were rated as having a high risk of bias, 17 (31.5%) were rated as having a low risk of bias, and 15 (27.8%) were rated as having some concerns. The median fragility index was 2.5 (interquartile range 1-7). The median fragility quotient was 0.021 (interquartile range 0.003-0.045). Mean sample size was 108, and the mean loss to follow-up was eight patients. Eight of 33 trials (24.2%) were found to be underpowered according to the sample size used in the primary outcome. CONCLUSIONS Guidelines created by SAGES are supported by RCTs that are frequently fragile or underpowered or have a high risk of bias. Future RCTs should utilize the Consolidated Standards of Reporting Trials statement, implement strategies to minimize loss to follow-up, and use properly powered sample sizes.
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Affiliation(s)
- Aaron Bowers
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
| | - Chase Meyer
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Daniel Tritz
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Courtney Cook
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Kaleb Fuller
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Caleb Smith
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Brian Diener
- Department of Surgery, Oklahoma State University Medical Center, Tulsa, Oklahoma
| | - Matt Vassar
- College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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