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Faksova K, Walsh D, Jiang Y, Griffin J, Phillips A, Gentile A, Kwong JC, Macartney K, Naus M, Grange Z, Escolano S, Sepulveda G, Shetty A, Pillsbury A, Sullivan C, Naveed Z, Janjua NZ, Giglio N, Perälä J, Nasreen S, Gidding H, Hovi P, Vo T, Cui F, Deng L, Cullen L, Artama M, Lu H, Clothier HJ, Batty K, Paynter J, Petousis-Harris H, Buttery J, Black S, Hviid A. COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals. Vaccine 2024; 42:2200-2211. [PMID: 38350768 DOI: 10.1016/j.vaccine.2024.01.100] [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] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The Global COVID Vaccine Safety (GCoVS) Project, established in 2021 under the multinational Global Vaccine Data Network™ (GVDN®), facilitates comprehensive assessment of vaccine safety. This study aimed to evaluate the risk of adverse events of special interest (AESI) following COVID-19 vaccination from 10 sites across eight countries. METHODS Using a common protocol, this observational cohort study compared observed with expected rates of 13 selected AESI across neurological, haematological, and cardiac outcomes. Expected rates were obtained by participating sites using pre-COVID-19 vaccination healthcare data stratified by age and sex. Observed rates were reported from the same healthcare datasets since COVID-19 vaccination program rollout. AESI occurring up to 42 days following vaccination with mRNA (BNT162b2 and mRNA-1273) and adenovirus-vector (ChAdOx1) vaccines were included in the primary analysis. Risks were assessed using observed versus expected (OE) ratios with 95 % confidence intervals. Prioritised potential safety signals were those with lower bound of the 95 % confidence interval (LBCI) greater than 1.5. RESULTS Participants included 99,068,901 vaccinated individuals. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across participating sites in the study period. Risk periods following homologous vaccination schedules contributed 23,168,335 person-years of follow-up. OE ratios with LBCI > 1.5 were observed for Guillain-Barré syndrome (2.49, 95 % CI: 2.15, 2.87) and cerebral venous sinus thrombosis (3.23, 95 % CI: 2.51, 4.09) following the first dose of ChAdOx1 vaccine. Acute disseminated encephalomyelitis showed an OE ratio of 3.78 (95 % CI: 1.52, 7.78) following the first dose of mRNA-1273 vaccine. The OE ratios for myocarditis and pericarditis following BNT162b2, mRNA-1273, and ChAdOx1 were significantly increased with LBCIs > 1.5. CONCLUSION This multi-country analysis confirmed pre-established safety signals for myocarditis, pericarditis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis. Other potential safety signals that require further investigation were identified.
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Affiliation(s)
- K Faksova
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
| | - D Walsh
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - Y Jiang
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - J Griffin
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - A Phillips
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - A Gentile
- Department of Epidemiology, Ricardo Gutierrez Children Hospital, Buenos Aires University, Argentina
| | - J C Kwong
- ICES, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine and the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - K Macartney
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia; The University of Sydney, Australia
| | - M Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Z Grange
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - S Escolano
- Université Paris-Saclay, UVSQ, Inserm, CESP, High Dimensional Biostatistics for Drug Safety and Genomics, Villejuif, France
| | - G Sepulveda
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - A Shetty
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - A Pillsbury
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - C Sullivan
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - Z Naveed
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Z Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Giglio
- Department of Epidemiology, Ricardo Gutierrez Children Hospital, Buenos Aires University, Argentina
| | - J Perälä
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - S Nasreen
- ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - H Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia; The University of Sydney, Australia
| | - P Hovi
- Department of Public Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - T Vo
- Faculty of Social Sciences, Tampere University, Finland
| | - F Cui
- School of Public Health, Peking University, China
| | - L Deng
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - L Cullen
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - M Artama
- Faculty of Social Sciences, Tampere University, Finland
| | - H Lu
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - H J Clothier
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - K Batty
- Auckland UniServices Limited at University of Auckland, New Zealand
| | - J Paynter
- School of Population Health, University of Auckland, New Zealand
| | - H Petousis-Harris
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; School of Population Health, University of Auckland, New Zealand
| | - J Buttery
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia
| | - S Black
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; School of Population Health, University of Auckland, New Zealand
| | - A Hviid
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Howlett DC, Drinkwater KJ, Mahmood N, Salman L, Griffin J, Javaid MK, Retnasingam G, Marzoug A, Greenhalgh R. Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit. Clin Radiol 2023; 78:e1041-e1047. [PMID: 37838545 DOI: 10.1016/j.crad.2023.09.004] [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: 07/26/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/16/2023]
Abstract
AIM To describe a UK-wide re-audit of the 2019 Royal College of Radiologists (RCR) audit evaluating patient-related data and organisational infrastructure in the radiological reporting of vertebral fragility fractures (VFFs) on computed tomography (CT) studies and to assess the impact of a series of RCR interventions, initiated to raise VFF awareness, on reporting practice and outcomes. MATERIALS AND METHODS Patient specific and organisational questionnaires largely replicated those utilised in 2019. The patient questionnaire involved retrospective analysis of between 50 and 100 consecutive, non-traumatic CT studies which included the thoracolumbar spine. All RCR radiology audit leads were invited to participate. Data collection commenced from 1 April 2022. RESULTS Data were supplied by 129/194 (67%) departments. One thousand five hundred and eighty-six of 7,316 patients (21.7%) had a VFF on auditor review. Overall improvements were demonstrated in key initial/provisional reporting results; comment on spine/bone (93.2%, 14.4% improvement, p<0.0002); fracture severity assessment (34.7%, 8.5% improvement, p=0.0007); use of recommended terminology (67.8%, 7.5% improvement, p=0.0034); recommendations for further management (11.7%, 9.1% improvement, p<0.0002). CONCLUSIONS The 2022 national re-audit confirms improvements in diagnostic performance and practice in VFF reporting. Continuing work is required to build on this improvement and to further embed best practice.
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Affiliation(s)
- D C Howlett
- Department of Radiology, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - K J Drinkwater
- Directorate of Education and Professional Practice, Royal College of Radiologists, London, UK.
| | - N Mahmood
- Department of Radiology, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - L Salman
- Department of Radiology, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - J Griffin
- The Royal Osteoporosis Society, Bath, UK
| | - M K Javaid
- The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK
| | - G Retnasingam
- Department of Radiology St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
| | - A Marzoug
- Department of Radiology, Ninewells Hospital, Dundee, UK
| | - R Greenhalgh
- Department of Radiology, London North West University Healthcare NHS Trust, Harrow, UK
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3
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Paskins Z, Moult A, Corp N, Bastounis A, Davis S, Narayanasamy MJ, Griffin J, Gittoes N, Leonardi-Bee J, Langley T, Bishop S, Sahota O. Research priorities regarding the use of bisphosphonates for osteoporosis: a UK priority setting exercise. Osteoporos Int 2023; 34:1711-1718. [PMID: 37294333 DOI: 10.1007/s00198-023-06806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Worldwide, many people who would benefit from osteoporosis drugs are not offered or receiving them, resulting in an osteoporosis care gap. Adherence with bisphosphonates is particularly low. This study aimed to identify stakeholder research priorities relating to bisphosphonate treatment regimens for prevention of osteoporotic fractures. METHODS A three-step approach based on the James Lind Alliance methodology for identification and prioritisation of research questions was used. Research uncertainties were gathered from a large programme of related research studies about bisphosphonate regimens and from recent published international clinical guidelines. Clinical and public stakeholders refined the list of uncertainties into research questions. The third step prioritised the questions using a modified nominal group technique. RESULTS In total, 34 draft uncertainties were finalised into 33 research questions by stakeholders. The top 10 includes questions relating to which people should be offered intravenous bisphosphonates first line (1); optimal duration of treatment (2); the role of bone turnover markers in treatment breaks (3); support patient need for medicine optimisation (4); support primary care practitioner need regarding bisphosphonates (5); comparing zoledronate given in community vs hospital settings (6); ensuring quality standards are met (7); the long-term model of care (8); best bisphosphonate for people aged under 50 (9); and supporting patient decision-making about bisphosphonates (10). CONCLUSION This study reports, for the first time, topics of importance to stakeholders in the research of bisphosphonate osteoporosis treatment regimens. These findings have implications for research into implementation to address the care gap and education of healthcare professionals. Using James Lind Alliance methodology, this study reports prioritised topics of importance to stakeholders in the research of bisphosphonate treatment in osteoporosis. The priorities address how to better implement guidelines to address the care gap, understanding patient factors influencing treatment selection and effectiveness, and how to optimise long-term care.
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Affiliation(s)
- Zoe Paskins
- School of Medicine, Keele University, David Weatherall Building, Newcastle-Under-Lyme, ST5 5BG, UK.
- Haywood Academic Rheumatology Centre, Haywood Hospital, High Lane, Burslem, Stoke-On-Trent, ST6 7AG, UK.
| | - Alice Moult
- School of Medicine, Keele University, David Weatherall Building, Newcastle-Under-Lyme, ST5 5BG, UK
| | - Nadia Corp
- School of Medicine, Keele University, David Weatherall Building, Newcastle-Under-Lyme, ST5 5BG, UK
| | - Anastasios Bastounis
- Faculty of Medicine & Health Sciences, University of Nottingham, City Hospital, Nottingham, NG5 1PB, UK
| | - Sarah Davis
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | | | - Jill Griffin
- Royal Osteoporosis Society (ROS), St James House, The Square, Lower Bristol Road, BA2 3BH, UK
| | - Neil Gittoes
- Centre for Endocrinology, Diabetes and Metabolism, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Tessa Langley
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Simon Bishop
- Nottingham University Business School, University of Nottingham, Nottingham, NG8 1BB, UK
| | - Opinder Sahota
- Department of Healthcare of Older People, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
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4
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Sutherland D, Flynn S, Kurzeja O, Griffin J, Hastings R. Family-systems interventions for families of people with an intellectual disability or who are autistic: a systematic review. J Intellect Disabil Res 2023; 67:1003-1028. [PMID: 37532456 DOI: 10.1111/jir.13068] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Family-systems interventions have been proposed as one way of supporting families of people with an intellectual disability (ID) or who are autistic. This systematic review aimed to summarise what family-systems interventions have been studied with this population, what evidence there is for their effectiveness and families' experiences of the interventions. METHODS The review was preregistered on PROSPERO (CRD42022297516). We searched five electronic databases, identified 6908 records and screened 72 full texts. Study quality was evaluated using the Mixed Methods Appraisal Tool, and a narrative synthesis was used. RESULTS We identified 13 eligible articles with 292 participating families. Most studies reported positive effects of the interventions on wellbeing and family relationships, and families reported positive experiences. However, research quality was poor and there are no any sufficiently powered randomised controlled trials demonstrating family-systems interventions' effectiveness for this population. CONCLUSIONS There is a need for higher-quality research to establish whether family-systems interventions are beneficial for families of people who have an ID or who are autistic.
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Affiliation(s)
- D Sutherland
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - S Flynn
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - O Kurzeja
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - J Griffin
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - R Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, Australia
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5
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Bishop S, Narayanasamy MJ, Paskins Z, Corp N, Bastounis A, Griffin J, Gittoes N, Leonardi-Bee J, Langley T, Sahota O. Clinicians' views of prescribing oral and intravenous bisphosphonates for osteoporosis: a qualitative study. BMC Musculoskelet Disord 2023; 24:770. [PMID: 37770860 PMCID: PMC10540377 DOI: 10.1186/s12891-023-06865-1] [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: 03/20/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Bisphosphonate medications, including alendronate, ibandronate and risedronate administered orally and zoledronate, administered intravenously, are commonly prescribed for the treatment of osteoporosis based on evidence that, correctly taken, bisphosphonates can improve bone strength and lead to a reduction in the risk of fragility fractures. However, it is currently unclear how decisions to select between bisphosphonate regimens, including intravenous regimen, are made in practice and how clinicians support patients with different treatments. METHODS This was an interpretivist qualitative study. 23 semi-structured telephone interviews were conducted with a sample of general practitioners (GPs), secondary care clinicians, specialist experts as well as those providing and leading novel treatments including participants from a community intravenous (IV) zoledronate service. Data analysis was undertaken through a process of iterative categorisation. RESULTS The results report clinicians varying experiences of making treatment choices, as well as wider aspects of osteoporosis care. Secondary care and specialist clinicians conveyed some confidence in making treatment choices including on selecting IV treatment. This was aided by access to diagnostic testing and medication expertise. In contrast GPs reported a number of challenges in prescribing bisphosphonate medications for osteoporosis and uncertainty about treatment choice. Results also highlight how administering IV zoledronate was seen as an opportunity to engage in broader care practices. CONCLUSION Approaches to making treatment decisions and supporting patients when prescribing bisphosphonates for osteoporosis vary in practice. This study points to the need to co-ordinate osteoporosis treatment and care across different care providers.
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Affiliation(s)
- Simon Bishop
- Nottingham University Business School, University of Nottingham, Nottingham, NG5 1PB, UK.
| | | | - Zoe Paskins
- School of Medicine, Keele University, David Weatherall Building, Newcastle-Under-Lyme, UK
- ST5 5BG and Haywood Academic Rheumatology Centre, Haywood Hospital, High Lane, Burslem, Stoke-On-Trent, ST6 7AG, UK
| | - Nadia Corp
- School of Primary, Community and Social Care, Keele University, Newcastle-Under-Lyme, ST5 5BG, UK
| | - Anastasios Bastounis
- Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, NG5 1PB, UK
| | - Jill Griffin
- Royal Osteoporosis Society (ROS), St James House, The Square, Lower Bristol Road, Bath, BA2 3BH, UK
| | - Neil Gittoes
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Jo Leonardi-Bee
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Tessa Langley
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Opinder Sahota
- Department of Healthcare of Older People, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH, UK
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6
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Baji P, Patel R, Judge A, Johansen A, Griffin J, Chesser T, Griffin XL, Javaid MK, Barbosa EC, Ben-Shlomo Y, Marques EMR, Gregson CL. Organisational factors associated with hospital costs and patient mortality in the 365 days following hip fracture in England and Wales (REDUCE): a record-linkage cohort study. Lancet Healthy Longev 2023; 4:e386-e398. [PMID: 37442154 DOI: 10.1016/s2666-7568(23)00086-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Hip fracture care delivery varies between hospitals, which might explain variations in patient outcomes and health costs. The aim of this study was to identify hospital-level organisational factors associated with long-term patient outcomes and costs after hip fracture. METHODS REDUCE was a record-linkage cohort study in which national databases for all patients aged 60 years and older who sustained a hip fracture in England and Wales were linked with hospital metrics from 18 organisational data sources. Multilevel models identified organisational factors associated with the case-mix adjusted primary outcomes: cumulative all-cause mortality, days spent in hospital, and inpatient costs over 365 days after hip fracture. FINDINGS Between April 1, 2016, and March 31, 2019, 178 757 patients with an index hip fracture were identified from 172 hospitals in England and Wales. 126 278 (70·6%) were female, 52 479 (29·4%) were male, and median age was 84 years (IQR 77-89) in England and 83 years (77-89) in Wales. 365 days after hip fracture, 50 354 (28·2%) patients had died. Patients spent a median 21 days (IQR 11-41) in hospital, incurring costs of £14 642 (95% CI 14 600-14 683) per patient, ranging from £10 867 (SD 5880) to £23 188 (17 223) between hospitals. 11 organisational factors were independently associated with mortality, 24 with number of days in hospital, and 25 with inpatient costs. Having all patients assessed by an orthogeriatrician within 72 h of admission was associated with a mean cost saving of £529 (95% CI 148-910) per patient and a lower 365-day mortality (odds ratio 0·85 [95% CI 0·76-0·94]). Consultant orthogeriatrician attendance at clinical governance meetings was associated with cost savings of £356 (95% CI 188-525) and 1·47 fewer days (95% CI 0·89-2·05) in the hospital in the 365 days after hip fracture per patient. The provision of physiotherapy to patients on weekends was associated with a cost saving of £676 (95% CI 67-1285) per patient and with 2·32 fewer days (0·35-4·29) in hospital in the 365 days after hip fracture. INTERPRETATION Multiple, potentially modifiable hospital-level organisational factors associated with important clinical outcomes and inpatient costs were identified that should inform initiatives to improve the effectiveness and efficiency of hip fracture services. FUNDING Versus Arthritis.
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Affiliation(s)
- Petra Baji
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Corvinus University of Budapest, Budapest, Hungary.
| | - Rita Patel
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew Judge
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; NIHR Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Antony Johansen
- Division of Population Medicine, School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, UK; National Hip Fracture Database, Royal College of Physicians, London, UK
| | | | - Tim Chesser
- Department of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Xavier L Griffin
- Barts Bone and Joint Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Estela C Barbosa
- Violence and Society Centre, School of Policy and Global Affairs, City University of London, London, UK; UKPRP VISION Consortium, London, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Elsa M R Marques
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Older People's Unit, Royal United Hospital NHS Foundation Trust Bath, Bath, UK
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7
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Chung A, Ashok D, Avinashi V, Barkey J, Bortolin K, Burnett D, Chen B, Critch J, Drouin É, Griffin J, Hulst J, Marcon M, Martinez A, Persad R, Sherlock M, Huynh H. A150 MODERATE AGREEMENT IN ENDOSCOPIC DISEASE SCORING OF PEDIATRIC EOSINOPHILIC ESOPHAGITIS AMONG PEDIATRIC GASTROENTEROLOGISTS IN CANADA. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991383 DOI: 10.1093/jcag/gwac036.150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Endoscopy is an important tool in assessing the severity of gastrointestinal diseases including Eosinophilic Esophagitis (EoE). Agreement regarding endoscopy outcomes is important when using tools such as the Endoscopic Reference Score for EoE (EREFS). Purpose Our goal was to determine interrater and intrarater agreement of EREFS among Canadian pediatric gastroenterologists. Method Survey-based study of interrater and intrarater reliability amongst pediatric gastroenterologists with interest in pediatric EoE. Participants were sourced from the Canadian Pediatric EoE Network. Participants were asked how many years of training they’ve had with endoscopy for pediatric EoE and their comfort in disease scoring for pediatric EoE. Pediatric EoE cases were identified from the pediatric EoE registry at the Stollery Children’s Hospital with an endoscopic video associated with each case. Participants were asked to score each video using the EREFS questionnaire for the proximal, middle and distal segments of the esophagus. 15 endoscopic videos were evaluated, with 3 cases provided each week over a period of 5 weeks. Additional data included ratings of the video quality and endoscopy quality. Of 15 cases, 12 were unique cases, distributed evenly in severity between no active disease to severe disease. 3 cases were repeated to assess intrarater reliability. The maximum grade of the proximal, middle and distal segments of the esophagus for each component endoscopic finding (edema, rings, exudates, furrows, strictures) were used for reliability calculations. Fleiss Kappa was calculated for all EREFS items and for each component endoscopic finding. Cohen’s Kappa was calculated to assess intrarater reliability. Result(s) Fifteen participants were recruited for the study. The participants had a median of 12 years (IQR: 7, 19) of clinical experience in endoscopy for pediatric EoE. The majority of participants were “comfortable” (i.e., 4 on 5-point scale) with EREFS scoring for pediatric EoE. Fleiss Kappa for all EREFS items was 0.481. For each component endoscopic finding (edema, rings, exudates, furrows, strictures), Fleiss Kappa was 0.365, 0.293, 0.548, 0.263, 0.445 respectively. Cohen’s Kappa had a median of 0.620 (IQR: 0.593, 0.704). The majority of raters rated video quality and endoscopy quality as “good” (i.e., 4 on 5-point scale). Conclusion(s) There is moderate interrater reliability in EREFS scoring for pediatric EoE. Interrater reliability was between fair to moderate for each component endoscopic finding. Intrarater reliability was good. This study shows there is room for improvement in disease scoring for pediatric EoE. This could be in the form of additional training, expert-defined conventions, or centralized reading which have reduced variability in endoscopic reporting for adult GI disease in past studies and could be used in a follow-up study to attempt to improve agreement. Additionally, incorporating EREFS into routine clinical practice may increase agreement amongst endoscopists. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- A Chung
- University of Alberta, Edmonton
| | - D Ashok
- University of Western Ontario, London,Canadian Pediatric EoE Network, -
| | - V Avinashi
- Canadian Pediatric EoE Network, -,BC Children's Hospital, Vancouver
| | - J Barkey
- Canadian Pediatric EoE Network, -,University of Ottawa, Ottawa
| | - K Bortolin
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - D Burnett
- Canadian Pediatric EoE Network, -,Dalhousie University, Halifax,University of Saskatchewan, Saskatoon
| | - B Chen
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
| | - J Critch
- Canadian Pediatric EoE Network, -,Memorial University, St. John's
| | - É Drouin
- Canadian Pediatric EoE Network, -,Université de Montréal, Montreal
| | - J Griffin
- Canadian Pediatric EoE Network, -,University of Manitoba, Winnipeg, Canada
| | - J Hulst
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - M Marcon
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - A Martinez
- Canadian Pediatric EoE Network, -,BC Children's Hospital, Vancouver
| | - R Persad
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
| | - M Sherlock
- Canadian Pediatric EoE Network, -,McMaster University, Hamilton, -
| | - H Huynh
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
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8
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Griffin J, Lockard A, Gutschall M, Belcher B. Assessing Body Measurements, Nutritional Behaviors, And Sleep Behaviors Following Implementation of Mhealth in Appalachian State University College Students. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.085] [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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9
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Thavarajah V, Akman G, Carmona Echeverria L, Griffin J, Freeman A, Haider A, Shaw G, Narashima Sridhar A, Kelly J, Pye H, Crompton J, Enica A, Whitaker H, Okoli U, Cheema U, Heavey S. 120P The compartment-specific spatial transcriptomic landscape of 3D cultured Gleason 7 prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.121] [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: 11/01/2022] Open
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10
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Okoli U, Akman G, Thavarajah V, Carmona Echeverria L, Griffin J, Ohayi R, Freeman A, Haider A, Shaw G, Sridhar A, Kelly J, Simpson B, Pye H, Crompton J, Whitaker H, Cheema U, Heavey S. 99P The transcriptional atlas of co-targeted PIM/PI3K/mTOR ex-vivo patient-derived prostate cancer as revealed by spatial transcriptomics. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.100] [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: 11/01/2022] Open
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11
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Patel R, Judge A, Johansen A, Marques EMR, Griffin J, Bradshaw M, Drew S, Whale K, Chesser T, Griffin XL, Javaid MK, Ben-Shlomo Y, Gregson CL. Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study. Age Ageing 2022; 51:6679179. [PMID: 36041740 PMCID: PMC9427326 DOI: 10.1093/ageing/afac183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/23/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Despite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across the United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the months following hip fracture. METHODS We examined a national record-linkage cohort of 178,757 patients aged ≥60 years who sustained a hip fracture in England and Wales in 2016-19. Patient-level hospital admissions datasets, National Hip Fracture Database and mortality data were linked to metrics from 18 hospital-level organisational-level audits and reports. Multilevel models identified organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality and emergency 30-day readmission. RESULTS Across hospitals mean LOS ranged from 12 to 41.9 days, mean 30-day mortality from 3.7 to 10.4% and mean readmission rates from 3.7 to 30.3%, overall means were 21.4 days, 7.3% and 15.3%, respectively. In all, 22 organisational factors were independently associated with LOS; e.g. a hospital's ability to mobilise >90% of patients promptly after surgery predicted a 2-day shorter LOS (95% confidence interval [CI]: 1.2-2.6). Ten organisational factors were independently associated with 30-day mortality; e.g. discussion of patient experience feedback at clinical governance meetings and provision of prompt surgery to >80% of patients were each associated with 10% lower mortality (95%CI: 5-15%). Nine organisational factors were independently associated with readmissions; e.g. readmissions were 17% lower if hospitals reported how soon community therapy would start after discharge (95%CI: 9-24%). CONCLUSIONS Receipt of hip fracture care should be reliable and equitable across the country. We have identified multiple, potentially modifiable, organisational factors associated with important patient outcomes following hip fracture.
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Affiliation(s)
- Rita Patel
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew Judge
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK,NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Antony Johansen
- Division of Population Medicine, School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, UK,National Hip Fracture Database, Royal College of Physicians, London, UK
| | - Elsa M R Marques
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Jill Griffin
- Clinical & Operations Directorate, Royal Osteoporosis Society, Bath, UK
| | - Marianne Bradshaw
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Drew
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Whale
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Tim Chesser
- Department of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Xavier L Griffin
- Barts Bone and Joint Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK,Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Celia L Gregson
- Address correspondence to: Celia L. Gregson, Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK. Tel: +44 7815102351.
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12
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Drew S, Fox F, Gregson CL, Patel R, Judge A, Johansen A, Marques EMR, Barbosa EC, Griffin J, Bradshaw M, Whale K, Chesser T, Griffin XL, Javaid MK, Ben-Shlomo Y, Gooberman-Hill R. 995 MULTIPLE ORGANISATIONAL FACTORS IMPROVE MULTI-DISCIPLINARY CARE DELIVERY TO PATIENTS WITH HIP FRACTURES: A QUALITATIVE STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.045] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Hip fractures are devastating injuries which incur high healthcare costs. Despite national standards and guidelines, there is substantial variation in hospital delivery of hip fracture care and in patient outcomes. This study aimed to understand organisational processes that facilitate successful delivery of hip fracture services.
Method
Forty qualitative interviews were conducted with healthcare professionals involved in delivering hip fracture care at four English hospitals. Interview data were supplemented with documentary analysis of 23 anonymised British Orthopaedic Association hospital-initiated peer-review reports of services. Data were analysed thematically, with themes transposed onto key components of the care pathway.
Results
We identified multiple aspects of service organisation that facilitated good care delivery. At admission, standardisation of training in nerve block administration impacted care delivery. During hospital stays, service delivery was improved by integrated, shared-care between orthopaedics and orthogeriatrics, and by strategies to improve trauma list efficiency. Adequately staffed orthogeriatric services and the ‘right’ skills and seniority mix were important to holistic care provision. Placing patients on designated hip fracture wards concentrated staff expertise. Collaborative working was achieved through multi-disciplinary team (MDT) meetings between key staff, protocols and care pathways that defined roles and responsibilities, MDT documentation, ‘joined-up’ IT systems within hospitals and with primary care, and shared working spaces such as shared offices and onwards. Trauma and hip fracture coordinators organised care processes and provided a valuable central point of contact within teams. Nominated leads, representing diverse specialties, worked together in MDT planning meetings to develop joint protocols, establish audit priorities, and agree shared goals. Routine, comprehensive monitoring and evaluation of service delivery, with findings shared throughout the MDT, was beneficial.
Conclusion
Our study has characterised potentially modifiable elements of successful hip fracture service delivery. Findings are intended to help services overcome organisational barriers towards delivery of high-quality hip fracture services.
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Affiliation(s)
| | | | | | | | | | - A Johansen
- Cardiff University and University Hospital of Wales
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13
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Patel R, Judge A, Johansen A, Marques EMR, Barbosa EC, Griffin J, Bhimjiyani A, Bradshaw M, Whale K, Drew, Gooberman-Hill R, Chesser T, Griffin XL, Javaid MK, Ben-Shlomo Y, Gregson CL. 946 MULTIPLE ORGANISATIONAL FACTORS ARE ASSOCIATED WITH ADVERSE PATIENT OUTCOMES POST HIP FRACTURE IN HOSPITALS IN ENGLAND & WALES. Age Ageing 2022. [DOI: 10.1093/ageing/afac124.004] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Older adults who sustain a hip fracture require complex multidisciplinary care, which can challenge organisational structures within hospitals. Despite standards and guidelines, substantial variation remains in hip fracture care delivery across the UK. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the post injury period.
Method
A cohort of 178,757 patients aged 60+ years in England and Wales (2016–19) who sustained a hip fracture was examined. Patient-level Hospital Episodes Statistics, National Hip Fracture Database, and mortality data were linked to metrics from 18 hospital-level organisational audits/reports/series. Multilevel models determined the organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality, and emergency 30-day readmission.
Results
Overall LOS was mean 21 days (standard deviation, 20); 13,126 (7.3%) died within 30-days; and 25,239 (15.3%) were readmitted. 25 organisational factors independently predicted LOS: for example, a hospital’s ability to promptly mobilise ≥90% of patients was associated with a 2-day (95%CI:1.3–2.7) shorter LOS, and hospitals where all patients received orthogeriatric assessment within 72 hours of admission had mean 1.5-day (95%CI:0.6–2.3) shorter LOS. Ten organisational factors independently predicted 30-day mortality: providing prompt surgery (≤36 hours from admission) to >80% patients was associated with the same 10% reduction in mortality (95%CI:4–15%), as was discussion of ‘patient experience’ feedback at clinical governance meetings (95%CI:5–15%). Nine organisational factors independently predicted readmission: knowledge of time from discharge to start of community therapy was associated with 17% (95%CI:9–24%) lower readmission rates. Organisational delivery of clinical governance, surgery, and physiotherapy were associated with all outcomes.
Conclusion
Multiple, potentially modifiable, organisational factors are associated with important patient outcomes post-hip fracture. These factors, if causal, indicate auditable components of hospital care where interventions can be targeted to reduce variability in hip fracture care delivery, to improve patient outcomes.
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Affiliation(s)
| | | | - A Johansen
- Cardiff University and University Hospital of Wales
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14
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Uriel M, Oren D, Yopes M, Clerkin K, Raikhelkar J, Fried J, Griffin J, Gaine M, Restaino S, Lee S, Choe J, Jennings D, Topkara V, Takeda K, Naka Y, Majure D, Yuzefpolskaya M, Colombo P, Latif F, Uriel N, Sayer G, Habal M. The Efficacy and Safety of Belatacept in Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Tao A, Raikhelkar J, Griffin J, Benvenuto L, Fried J, Topkara V, Takeda K, Restaino S, Latif F, Yuzefpolskaya M, Colombo P, Uriel N, Sayer G, Clerkin K. Impact of Pre-Heart Transplant Pulmonary Function Tests on Post-Transplant Pulmonary Outcomes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.802] [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: 10/18/2022] Open
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16
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Golob S, Uriel M, Batra J, Gaine M, Clerkin K, Raikhelkar J, Fried J, Griffin J, Restaino S, Lee S, Majure D, Yuzefpolskaya M, Colombo P, Latif F, Pereira M, Choe J, Jennings D, Sayer G, Uriel N. Use of Letermovir for Cytomegalovirus (CMV) Prophylaxis in Orthotopic Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1380] [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: 10/18/2022] Open
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17
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Gaine M, Bae D, Oh D, Lotan D, Atanda A, Oren D, Latif F, Yuzefpolskaya M, Habal M, Griffin J, Majure D, Colombo P, Jennings D, Choe J, Clerkin K, Fried J, Raikhelkar J, Lee S, Restaino S, Sayer G, Uriel N. Characteristics and Outcomes of Recipients of Heart Transplant with Coronarvirus Disease 2019 Who Received Casirivimab Plus Imdevimab Infusion. J Heart Lung Transplant 2022. [PMCID: PMC8988630 DOI: 10.1016/j.healun.2022.01.1401] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose Heart transplant (HT) recipient are at increased risk of adverse outcomes following COVID-19 infection and may benefit from monoclonal antibody infusion to mitigate progression to clinically severe disease. The aim of this study is to describe the outcomes of HT patients who experienced mild to moderate coronavirus disease 2019 (COVID-19), with subsequent administration of casirivimab plus imdevimab administration. Methods A retrospective review of all HT recipients who were infected with COVID-19, and subsequently infused with monoclonal antibodies in a large academic medical center between January 1, 2021 to September 1, 2021. Results 14 HT patients were included in the analysis. The median age was 57.5 (interquartile range [IQR], 41.5-64) years, 10 (71%) were men, and median time from HT was 3.48 (IQR, 1.00-11.82) years. Comorbid conditions included hypertension in 6 patients (43%), diabetes in 4 (29%), and chronic kidney disease in 6 (43%). Eight patients (57%) were previously vaccinated, predominantly with the Pfizer-BioNTech vaccine. Three participants (21%) were admitted after clinical progression of COVID-19. Among patients managed at the study institution, mycophenolate mofetil was discontinued in two patients (14%) and calcineurin inhibitor was maintained at previous levels in all fourteen patients (100%). Of the admitted patients, 1 was treated with high dose corticosteroids alone and 2 were treated with corticosteroids plus remdesivir. No patient required intubation. All 3 patients were discharged home and no patients in this cohort died. Conclusion In this single-center case series, HT patients with mild-moderate COVID-19 who were treated with monoclonal antibody infusion had a hospitalization rate of 21% and 100% survival. Further studies are required to optimize management of COVID-19 infection in the HT population.
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18
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Mir MC, Marchioni M, Zargar H, Zargar-Shoshtari K, Fairey AS, Mertens LS, Dinney CP, Krabbe LM, Cookson MS, Jacobsen NE, Griffin J, Montgomery JS, Vasdev N, Yu EY, Xylinas E, McGrath JS, Kassouf W, Dall'Era MA, Sridhar SS, Aning J, Shariat SF, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Grivas P, Stephenson AJ, Shah JB, van Rhijn BW, Spiess PE, Daneshmand S, Black PC. Corrigendum to "Nomogram Predicting Bladder Cancer-specific Mortality After Neoadjuvant Chemotherapy and Radical Cystectomy for Muscle-invasive Bladder Cancer: Results of an International Consortium" [Eur Urol Focus 2021;7:1347-54]. Eur Urol Focus 2022; 8:1559. [PMID: 35181282 DOI: 10.1016/j.euf.2022.01.009] [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: 11/30/2022]
Affiliation(s)
- Maria Carmen Mir
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Fundacion Instituto Valenciano Oncologia, Valencia, Spain.
| | - Michele Marchioni
- Departmentof Medical, Oral and Biotechnological Sciences, Urology Unit, University "G. d'Annunzio", Chieti-Pescara, Italy
| | - Homi Zargar
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | - K Zargar-Shoshtari
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A S Fairey
- University of Alberta, Edmonton, Alberta, Canada
| | - Laura S Mertens
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C P Dinney
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - L M Krabbe
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, University of Münster, Münster, Germany
| | - M S Cookson
- Department of Urology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - N E Jacobsen
- University of Alberta, Edmonton, Alberta, Canada
| | - J Griffin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - J S Montgomery
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - N Vasdev
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - E Y Yu
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - E Xylinas
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France
| | - J S McGrath
- Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - W Kassouf
- Department of Surgery (Division of Urology), McGill University Health Center, Montreal, Canada
| | - M A Dall'Era
- Department of Urology, University of California at Davis, Davis Medical Center, Sacramento, CA, USA
| | - S S Sridhar
- Princess Margaret Hospital, Toronto, Ontario, Canada
| | - J Aning
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK; Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - S F Shariat
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; UT Southwestern, Dallas, TX, USA; Charles University, Prag, Czech Republic; University of Jordan, Amman, Jordan
| | - J L Wright
- Department of Urology, University of Washington, Seattle, WA, USA
| | - A C Thorpe
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - T M Morgan
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - J M Holzbeierlein
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - T J Bivalacqua
- Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S North
- Cross Cancer Institute, Edmonton, AB, Canada; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - D A Barocas
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Y Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - P Grivas
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - A J Stephenson
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, RUSH University, Chicago, IL, USA
| | - J B Shah
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA; Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - B W van Rhijn
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - P E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - S Daneshmand
- USC/Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - P C Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
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Argiro A, Rosenblum H, Griffin J, Batra J, Cappelli F, Burkhoff D, Maurer M, Olivotto I. Sex related differences in exercise performance in patients with hypertrophic cardiomyopathy: hemodynamic insights through non-invasive pressure volume analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1558] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Women with HCM have worse cardiopulmonary exercise performance compared to men. We used non-invasive pressure-volume (PV) analysis to delineate sex related hemodynamic differences in HCM.
Methods
PV loops were constructed from echocardiograms using left ventricular (LV) volumes indexed to body surface area, Doppler estimates of LV end-diastolic pressure and blood pressure. The end-systolic PV relationship (ESPVR) and end-diastolic PV relationship (EDPVR) were derived from validated single-beat techniques. The area between the ESPVR and EDPVR (isovolumetric PV area), was indexed to an LV end-diastolic pressure of 30mmHg (PVAiso30), as the integrated metric of LV function. LV volume at an end-diastolic pressure of 30mmHg (V30) indexed ventricular capacity.
Results
202 patients were included, 56 women. Women were older (51 vs 44 yrs, p=0.012) and had reduced exercise capacity (5.6 vs 6.9 METs, p<0.001). Only 32 patients (16%) had a peak gradient >30mmHg at rest with no sex differences. Women had significantly lower indexed PVAiso30 (6577 vs 7767 mmHg·mL/m2, p<0.001) driven by reduced ventricular capacitance (V30 54 vs 62 ml/m2, p<0.001). In multivariable linear regression indexed V30 was an independent predictor of exercise capacity.
Conclusion
Impaired exercise capacity in women with HCM appears strongly related to abnormalities in passive diastolic properties, suggesting a unique pathophysiology compared to men, and a potential difference in viable therapeutic molecular targets
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Argiro
- Careggi University Hospital (AOUC), Cardiomyopathy Unit, Heart, Lung and Vessels Department, Florence, Italy
| | - H Rosenblum
- Columbia University Irving Medical Center-NYP Hospital, Division of Cardiology, Department of Medicine, New York, United States of America
| | - J Griffin
- Columbia University Irving Medical Center-NYP Hospital, Division of Cardiology, Department of Medicine, New York, United States of America
| | - J Batra
- Columbia University Irving Medical Center-NYP Hospital, Division of Cardiology, Department of Medicine, New York, United States of America
| | - F Cappelli
- Careggi University Hospital (AOUC), Cardiomyopathy Unit, Heart, Lung and Vessels Department, Florence, Italy
| | - D Burkhoff
- Cardiovascular Research Foundation, New York, United States of America
| | - M Maurer
- Columbia University Irving Medical Center-NYP Hospital, Division of Cardiology, Department of Medicine, New York, United States of America
| | - I Olivotto
- Careggi University Hospital (AOUC), Cardiomyopathy Unit, Heart, Lung and Vessels Department, Florence, Italy
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Booth S, Danek A, Farris A, Nunnery D, Griffin J. Implementing a Video Intervention to Improve Food Security and Promote Weight Loss in a Rural, Low-Income Population. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.254] [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: 10/20/2022]
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21
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Bergstrom T, Bass L, Daglish J, Moorman V, Griffin J, Barrett M. Complex pastern injuries involving the scutum medium in ten horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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)
- T. Bergstrom
- Department of Clinical Sciences Colorado State University Fort Collins Colorado USA
| | - L. Bass
- Department of Clinical Sciences Colorado State University Fort Collins Colorado USA
| | - J. Daglish
- Department of Clinical Sciences Colorado State University Fort Collins Colorado USA
| | - V. Moorman
- Department of Clinical Sciences Colorado State University Fort Collins Colorado USA
| | - J. Griffin
- Department of Large Animal Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Texas A&M University College Station Texas USA
| | - M. Barrett
- Environmental and Radiological Health Science Colorado State University Fort Collins Colorado USA
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22
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Patel R, Drew S, Johansen A, Chesser T, Javaid MK, Griffin XL, Jones T, Griffin J, Bradshaw M, Whale K, Barbosa EC, Marques EMR, Ben-Shlomo Y, Gooberman-Hill R, Judge A, Gregson CL. REducing unwarranted variation in the Delivery of high qUality hip fraCture services in England and Wales (REDUCE): protocol for a mixed-methods study. BMJ Open 2021; 11:e049763. [PMID: 34011603 PMCID: PMC8137248 DOI: 10.1136/bmjopen-2021-049763] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Substantial variation in the delivery of hip fracture care, and patient outcomes persists between hospitals, despite established UK national standards and guidelines. Patients' outcomes are partly explained by patient-level risk factors, but it is hypothesised that organisational-level factors account for the persistence of unwarranted variation in outcomes. The mixed-methods REducing unwarranted variation in the Delivery of high qUality hip fraCture services in England and Wales (REDUCE) study, aims to determine key organisational factors to target to improve patient care. METHODS AND ANALYSIS Quantitative analysis will assess the outcomes of patients treated at 172 hospitals in England and Wales (2016-2019) using National Hip Fracture Database data combined with English Hospital Episodes Statistics; Patient Episode Database for Wales; Civil Registration (deaths) and multiple organisational-level audits to characterise each service provider. Statistical analyses will identify which organisational factors explain variation in patient outcomes, and typify care pathways with high-quality consistent patient outcomes. Documentary analysis of 20 anonymised British Orthopaedic Association hospital-initiated peer-review reports, and qualitative interviews with staff from four diverse UK hospitals providing hip fracture care, will identify barriers and facilitators to care delivery. The COVID-19 pandemic has posed a major challenge to the resilience of services and interviews will explore strategies used to adapt and innovate. This system-wide understanding will inform the development, in partnership with key national stakeholders, of an 'Implementation Toolkit' to inform and improve commissioning and delivery of hip fracture services. ETHICS AND DISSEMINATION This study was approved: quantitative study by London, City and East Research Ethics Committee (20/LO/0101); and qualitative study by Faculty of Health Sciences University of Bristol Research Ethics Committee (Ref: 108284), National Health Service (NHS) Health Research Authority (20/HRA/71) and each NHS Trust provided Research and Development approval. Findings will be disseminated through scientific conferences, peer-reviewed journals and online workshops.
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Affiliation(s)
- Rita Patel
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Drew
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Antony Johansen
- Division of Population Medicine, School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, UK
- National Hip Fracture Database, Royal College of Physicians, London, UK
| | - Tim Chesser
- Department of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Xavier L Griffin
- Division of Orthopaedics, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Tim Jones
- Clinical & Operations Directorate, Royal Osteoporosis Society, Bath, UK
| | - Jill Griffin
- Clinical & Operations Directorate, Royal Osteoporosis Society, Bath, UK
| | - Marianne Bradshaw
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Whale
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Estela Capelas Barbosa
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elsa M R Marques
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachael Gooberman-Hill
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Andrew Judge
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Berdunov V, Millen S, Paramore A, Reynia S, Fryer N, Griffin J, Georges N. 61P Estimating the cost of adjuvant chemotherapy in ER+/HER2- early breast cancer and distant recurrence of breast cancer in the UK. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.075] [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: 11/16/2022] Open
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Yopes M, Clerkin K, Fried J, Griffin J, Raikhelkar J, Topkara V, Kim A, Habal M, Latif F, Restaino S, Yuzefpolskaya M, Farr M, Colombo P, Sayer G, Uriel N. Continuous Intermittent Intravenous Immunoglobulin in Heart Transplant Recipients with Elevated Donor-Specific Antibody Levels. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.836] [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: 10/21/2022] Open
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Slomovich S, Raikhelkar J, Fried J, Griffin J, Clerkin K, Roth Z, Kim A, Farr M, Topkara V, Latif F, Axsom K, Yuzefpolskaya M, Colombo P, Takeda K, Naka Y, Uriel N, Sayer G. The Utility of Televisits in Patients with a Left Ventricular Assist Device. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1130] [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: 10/21/2022] Open
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Golob S, Batra J, Godfrey S, Slomovich S, Fried J, Clerkin K, Griffin J, Takeda K, Naka Y, Topkara V, Habal M, Latif F, Restaino S, Farr M, Yuzefpolskaya M, Colombo P, Sayer G, Uriel N, Raikhelkar J. Clinical Characteristics and Outcomes of Cancer Survivors Undergoing Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.777] [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: 10/21/2022] Open
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Bell J, Takeda K, Haythe J, Szabolcs M, Griffin J, Geskin L, Fanek T, Gaine M, Axsom K. Behcet's Disease Unmasked after Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1295] [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: 10/21/2022] Open
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Smith T, Gorder K, Rudick S, O'Brien T, Liebing K, Riley R, Kong J, Griffin J, Shreenivas S, Raymond T, Answini G, Egnaczyk G, Chung E. Implementing an Algorithm for Mechanical Support in Cardiogenic Shock Improves Survival. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.536] [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: 10/21/2022] Open
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Slomovich S, Roth Z, Clerkin K, Kleet A, Walraven O, Kim A, Colombo P, Raikhelkar J, Griffin J, Farr M, Yuzefpolskaya M, Fried J, Latif F, Restaino S, Topkara V, Uriel N, Sayer G. Remote Monitoring of Heart Transplant Recipients during the COVID-19 Pandemic. J Heart Lung Transplant 2021. [PMCID: PMC7979368 DOI: 10.1016/j.healun.2021.01.1800] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose The COVID-19 pandemic created significant challenges in monitoring heart transplant (HT) recipients for rejection due to efforts to minimize contact with the hospital setting. The aim of this study was to evaluate the safety and efficacy of transitioning HT patients to home phlebotomy and a monitoring protocol based on gene expression profiling (GEP) and donor derived cell free DNA (ddcfDNA). Methods A single-center cohort study that prospectively enrolled consecutive HT patients who were transitioned to a remote monitoring protocol employing home phlebotomy and non-invasive surveillance for rejection. Patients were enrolled starting at 2 months post-HT. Positive GEP values were defined as ≥32 (up to 6 months post-HT) and ≥34 (> 6 months post-HT). A positive ddcfDNA score was defined as >0.12%. A positive biopsy was defined as grade ≥1B/1R Results 246 HT patients were enrolled and followed for a minimum of 3 months. Mean age was 56±14, 71.5% were male, and median time from transplant was 2.7 years. The average distance of patients from the hospital was 25.6 miles. 359 blood tests were drawn for detection of GEP and ddcfDNA and 102 biopsies performed (Figure). Among 32 patients who had negative results on both tests and had a biopsy, 0 had a positive biopsy. Of 25 patients who had positive results on both tests and had a biopsy, 3 (12%) had a positive biopsy. The biopsy positivity rate in patients who were GEP+/ddcfDNA- was 6% and in patients who were GEP-/ddcfDNA+ was 8%. None of the positive biopsies were associated with hemodynamic compromise. 15 (6%) of patients were admitted due to allograft rejection during the study period. There were no deaths. Conclusion Using a remote monitoring protocol with home phlebotomy and noninvasive rejection surveillance was feasible and safe in HT recipients. In this cohort, the combination of negative GEP and ddcfDNA scores was accurate at predicting a lack of allograft rejection.
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Bortolin KA, Ashok D, Avinashi V, Barkey J, Burnett D, Critch J, Drouin E, Griffin J, Huynh H, Marcon P, Martinez A, Persad R, Sherlock M, Waterhouse C, Hulst JM. A14 WIDE VARIATION IN CLINICAL MANAGEMENT OF PAEDIATRIC EOSINOPHILIC ESOPHAGITIS: A CANADIAN EXPERIENCE. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Eosinophilic esophagitis (EoE) is a chronic disorder treated by food elimination diet (FED), topical steroids and/or proton-pump inhibitors (PPI). Serial endoscopies and biopsies assess response to therapy. EoE management has evolved as guidelines are updated.
Aims
To identify practice variation among Canadian paediatric gastroenterologists (PG) who care for children with EoE.
Methods
An online survey using REDCap about decision-making in children with EoE was distributed to PG in Canada in November 2020.
Results
62 PG completed the survey (response rate 69%, 62/94). The majority work in academic centres (92%). 3 centers indicated an accrual of >50 new patients per year; 9/16 centres have >100 patients in follow-up. An EoE Clinic is present in 5 centres.
Diagnosis: Familiarity with the 2018 AGREE and 2020 AGA EoE guidelines was found to be 57% and 67% respectively. Criteria required to diagnose EoE according to current guidelines were correctly indicated by 42% of PG. (Figure 1).
Endoscopy: The majority of PG (95%) adhere to guidelines in terms of required number and location of biopsies for the initial diagnosis. Ideal timing of repeat endoscopy after change in therapy in patients who are not in histological remission was 8–12 weeks by 67% of PG, timing in stable patients on maintenance therapy varied (33% only if patient is symptomatic). 25% used the EREFS Score in reporting endoscopic findings.
Therapy: Improvement of symptoms was the highest ranked goal (64%), followed by remission of histologic findings (30%). A treatment algorithm was in place in 4 centers. The majority routinely assess adherence to therapy (73%) and consult a dietitian for FED (77%). Most (87%) do not consult an allergist for initial management. Preferred choices of 1st-line therapy varied among PG (Figure 2). When FED was selected, 32% of PG started with 1 food, 32% started with 2 foods, most frequently excluding dairy, followed by wheat. 14 (26%) start with ≥6 FED. Prescription of budesonide slurry was consistent among PG with doses of 1 and 2 mg/day in children <10 and >10 years, respectively.
Conclusions
The is the first Canadian study to assess the variation in management of children with EoE by PG. Overall, PG demonstrated good adherence to the guidelines in terms of initial diagnosis, but differences in maintenance therapy choice and timing of endoscopies. The results highlight a need for standardized management algorithms to deliver uniform care to this growing group. Grounding these guidelines in evidence will warrant a significant investment in further paediatric EoE research.
Funding Agencies
None
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Affiliation(s)
- K A Bortolin
- The Hospital for Sick Children, Toronto, ON, Canada
| | - D Ashok
- Pediatrics, Western University, London, ON, Canada
| | - V Avinashi
- BC Children’s Hospital, Vancouver, BC, Canada
| | - J Barkey
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - D Burnett
- Pediatrics, Dalhousie University, Edmonton, AB, Canada
| | - J Critch
- Memorial University, St. John’s,, Canada
| | - E Drouin
- Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - J Griffin
- Pediatric Gastroenterology, University of Manitoba, Winnipeg, MB, Canada
| | - H Huynh
- Alberta Health Services, Edmonton, AB, Canada
| | - P Marcon
- The Hospital for Sick Children, Toronto, ON, Canada
| | - A Martinez
- Pediatrics, Dalhousie University, Edmonton, AB, Canada
| | - R Persad
- Alberta Health Services, Edmonton, AB, Canada
| | - M Sherlock
- McMaster Children’s Hospital, Hamilton, ON, Canada
| | | | - J M Hulst
- The Hospital for Sick Children, Toronto, ON, Canada
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Howlett D, Drinkwater K, Griffin J, Javaid K. Improving outcomes for patients with osteoporotic vertebral fragility fractures: the role of the radiologist. Clin Radiol 2020; 75:811-812. [DOI: 10.1016/j.crad.2020.07.020] [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] [Received: 07/06/2020] [Accepted: 07/09/2020] [Indexed: 12/01/2022]
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van Dijk L, Wahid K, Ahmed S, Elgohari B, McCoy L, Sharafi S, Ventura J, Placide J, Jones E, Dearmas A, Rock S, Winkleman A, Drummey R, Cooksey L, Fahim J, Griffin J, Perez-Martinez I, Mohamed A, Fuller C. Big Data Statistical Learning Improves Survival Prediction For Head And Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mir MC, Marchioni M, Zargar H, Zargar-Shoshtari K, Fairey AS, Mertens LS, Dinney CP, Krabbe LM, Cookson MS, Jacobsen NE, Griffin J, Montgomery JS, Vasdev N, Yu EY, Xylinas E, McGrath JS, Kassouf W, Dall'Era MA, Sridhar SS, Aning J, Shariat SF, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Grivas P, Stephenson AJ, Shah JB, van Rhijn BW, Spiess PE, Daneshmand D, Black PC. Nomogram Predicting Bladder Cancer-specific Mortality After Neoadjuvant Chemotherapy and Radical Cystectomy for Muscle-invasive Bladder Cancer: Results of an International Consortium. Eur Urol Focus 2020; 7:1347-1354. [PMID: 32771446 DOI: 10.1016/j.euf.2020.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/16/2020] [Revised: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) is associated with improved overall and cancer-specific survival. The post-NAC pathological stage has previously been reported to be a major determinant of outcome. OBJECTIVE To develop a postoperative nomogram for survival based on pathological and clinical parameters from an international consortium. DESIGN, SETTING, AND PARTICIPANTS Between 2000 and 2015, 1866 patients with MIBC were treated at 19 institutions in the USA, Canada, and Europe. Analysis was limited to 640 patients with adequate follow-up who had received three or more cycles of NAC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A nomogram for bladder cancer-specific mortality (BCSM) was developed by multivariable Cox regression analysis. Decision curve analysis was used to assess the model's clinical utility. RESULTS AND LIMITATIONS A total of 640 patients were identified. Downstaging to non-MIBC (ypT1, ypTa, and ypTis) occurred in 271 patients (42 %), and 113 (17 %) achieved a complete response (ypT0N0). The 5-yr BCSM was 47.2 % (95 % confidence interval [CI]: 41.2-52.6 %). On multivariable analysis, covariates with a statistically significant association with BCSM were lymph node metastasis (hazard ratio [HR] 1.90 [95% CI: 1.4-2.6]; p < 0.001), positive surgical margins (HR 2.01 [95 % CI: 1.3-2.9]; p < 0.001), and pathological stage (with ypT0/Tis/Ta/T1 as reference: ypT2 [HR 2.77 {95 % CI: 1.7-4.6}; p < 0.001] and ypT3-4 [HR 5.9 {95 % CI: 3.8-9.3}; p < 0.001]). The area under the curve of the model predicting 5-yr BCSM after cross validation with 300 bootstraps was 75.4 % (95 % CI: 68.1-82.6 %). Decision curve analyses showed a modest net benefit for the use of the BCSM nomogram in the current cohort compared with the use of American Joint Committee on Cancer staging alone. Limitations include the retrospective study design and the lack of central pathology. CONCLUSIONS We have developed and internally validated a nomogram predicting BCSM after NAC and radical cystectomy for MIBC. The nomogram will be useful for patient counseling and in the identification of patients at high risk for BCSM suitable for enrollment in clinical trials of adjuvant therapy. PATIENT SUMMARY In this report, we looked at the outcomes of patients with muscle-invasive bladder cancer in a large multi-institutional population. We found that we can accurately predict death after radical surgical treatment in patients treated with chemotherapy before surgery. We conclude that the pathological report provides key factors for determining survival probability.
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Affiliation(s)
- Maria Carmen Mir
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Fundacion Instituto Valenciano Oncologia, Valencia, Spain.
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Urology Unit, University "G. d'Annunzio", Chieti-Pescara, Italy
| | - Homi Zargar
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | - K Zargar-Shoshtari
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A S Fairey
- University of Alberta, Edmonton, Alberta, Canada
| | - Laura S Mertens
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C P Dinney
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - L M Krabbe
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, University of Münster, Münster, Germany
| | - M S Cookson
- Department of Urology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - N E Jacobsen
- University of Alberta, Edmonton, Alberta, Canada
| | - J Griffin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - J S Montgomery
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - N Vasdev
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - E Y Yu
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - E Xylinas
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France
| | - J S McGrath
- Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - W Kassouf
- Department of Surgery (Division of Urology), McGill University Health Center, Montreal, Canada
| | - M A Dall'Era
- Department of Urology, University of California at Davis, Davis Medical Center, Sacramento, CA, USA
| | - S S Sridhar
- Princess Margaret Hospital, Toronto, Ontario, Canada
| | - J Aning
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK; Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - S F Shariat
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; UT Southwestern, Dallas, TX, USA; Charles University, Prag, Czech Republic; University of Jordan, Amman, Jordan
| | - J L Wright
- Department of Urology, University of Washington, Seattle, WA, USA
| | - A C Thorpe
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - T M Morgan
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - J M Holzbeierlein
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - T J Bivalacqua
- Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S North
- Cross Cancer Institute, Edmonton, AB, Canada; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - D A Barocas
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Y Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - P Grivas
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - A J Stephenson
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, RUSH University, Chicago, IL, USA
| | - J B Shah
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA; Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - B W van Rhijn
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - P E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - D Daneshmand
- USC/Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - P C Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
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Griffin J, Macgregor B, Greene N, Partridge CR, Bryson J, Schoof RA. Letter to the Editor regarding Davis B, McDermott S, McCarter M, Ortaglia A. 2019. Population-based mortality data suggests remediation is modestly effective in two Montana Superfund counties. Environ. Geochem. Health. Environ Geochem Health 2020; 42:1229-1233. [PMID: 31673915 DOI: 10.1007/s10653-019-00438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Affiliation(s)
- J Griffin
- Butte Resident, Butte-Silver Bow County, MT, USA
| | - B Macgregor
- Butte Resident, Butte-Silver Bow County, MT, USA
| | - N Greene
- U.S. Environmental Protection Agency Region 8, Denver, CO, USA
| | - C R Partridge
- U.S. Environmental Protection Agency Region 8, Denver, CO, USA
| | - J Bryson
- , Atlantic Richfield, Butte, MT, USA
| | - R A Schoof
- Ramboll US Corporation, 901 Fifth Avenue, Suite 2820, Seattle, WA, 98164, USA.
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Marshall D, DeFilippis E, Truby L, Malick A, Butler C, Griffin J, Clerkin K, Fried J, Raikhelkar J, Yuzefpolskaya M, Colombo P, Sayer G, Takeda K, Takayama H, Naka Y, Farr M, Uriel N, Topkara V. Increased Right Ventricular Assist Device (RVAD) Utilization in Patients with HeartMate 3 Left Ventricular Assist Device (LVAD) in the Post-Approval Era. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.226] [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: 10/24/2022] Open
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Jennings D, Truby L, Fried J, Clerkin K, Griffin J, Raikhelkar J, Axsom K, Lin E, Haythe J, Yuzefpolskaya M, Colombo P, Sayer G, Farr M, Takayama H, Takeda K, Naka Y, Uriel N, Topkara V. Impact of Heart Failure Drug Therapy on GI Bleeding Rates in LVAD Recipients: An INTERMACS Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Batra J, Marshall D, Jennings D, Truby L, DeFilippis E, Malick A, Butler C, Griffin J, Masoumi A, Clerkin K, Raikhelkar J, Fried J, Yuzefpolskaya M, Colombo P, Sayer G, Takayama H, Takeda K, Naka Y, Farr M, Topkara V, Uriel N. Elevated Serum C-reactive Protein (CRP) Level Predicts Increased Post-Implant Mortality in Patients Undergoing HeartMate 3 LVAD Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.228] [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: 10/24/2022] Open
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Brereton PA, Robb P, Sargent CM, Crews HM, Wood R, Caputi A, Carrington J, Chetaneau B, Cohen S, Davies RW, Davis WS, Dix E, Ennion; RA, Furniss S, Gardner JW, Griffin J, Hampton I, Harrison N, Heide C, Hollywood F, Hopkins J, Liddle P, Meagher J, Osborne PY, Piatt T, Postlethwaite K, Procter J, Reynolds EB, Robinson J, Smith M, Sparkes S, Stangroom SG, Stevens R, Sutton P, Swain S, Turnbull J, Vidal JP, Waller JM, Zaiger K. Determination of Lead in Wine by Graphite Furnace Atomic Absorption Spectrophotometry: Interlaboratory Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.6.1287] [Citation(s) in RCA: 3] [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: 11/14/2022]
Abstract
Abstract
An interlaboratory study of a graphite furnace atomic absorption spectrophotometry (GFAAS) method for the determination of lead in wine was conducted. Seventeen laboratories from France, United States, and the United Kingdom, using a variety of GFAAS instruments, took part in the study. The method incorporated a novel matrix-matching procedure to minimize matrix effects between standards and samples. Six wine test materials were prepared and sent to participants as 12 blind duplicate or split level samples. There was good agreement between results obtained from participants and target values (24–279 μg/L) obtained with an inductively coupled plasma-mass spectrometry method. The precision of the GFAAS method was well within the range predicted by the Horwitz equation for the 6 test materials analyzed. Repeatability standard deviations ranged from 3 to 17%. Reproducibility standard deviations were in the range of 10 to 30%. The method is recommended for use for official purposes.
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Affiliation(s)
- Paul A Brereton
- Ministry of Agriculture, Fisheries and Food, CSL Food Science Laboratory, Norwich Research Park, Colney, Norwich, NR4 7UQ, UK
| | - Paul Robb
- Ministry of Agriculture, Fisheries and Food, CSL Food Science Laboratory, Norwich Research Park, Colney, Norwich, NR4 7UQ, UK
| | - Christine M Sargent
- Ministry of Agriculture, Fisheries and Food, CSL Food Science Laboratory, Norwich Research Park, Colney, Norwich, NR4 7UQ, UK
| | - Helen M Crews
- Ministry of Agriculture, Fisheries and Food, CSL Food Science Laboratory, Norwich Research Park, Colney, Norwich, NR4 7UQ, UK
| | - Roger Wood
- Ministry of Agriculture, Fisheries and Food, CSL Food Science Laboratory, Norwich Research Park, Colney, Norwich, NR4 7UQ, UK
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Feldsine PT, Jucker MT, Kaur M, Lienau AH, Kerr DE, Adamson A, Beaupre L, Bishop J, Casasola E, Cote C, Desilets S, D’lima C, Elahimanesh P, Fitzgerald S, Forgey R, Fortin J, Gohil V, Griffin J, Hardin M, Kaur D, Ketrenos J, King A, Kupski B, Luce S, Lucia L, Maeda S, Markun D, Marquez-Gonzalez M, McClendon J, McKessock J, Nelson C, Nguyen T, O’Brien C, Ramos M, Reilly S, Roa N, Schiffelbein Z, Shaffer K, Shepherd D, Sowell S, Trujillo E, Wang S, Williams K. Evaluation of the Assurance GDS® for Salmonella Method in Foods and Environmental Surfaces: Multilaboratory Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/93.1.150] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A multilaboratory collaborative study was conducted to compare the detection of Salmonella by the Assurance GDS® for Salmonella method and the Reference culture methods. Six foods, representing a variety of low microbial and high microbial load foods were analyzed. Seventeen laboratories in the United States and Canada participated in this study. No statistical differences (P < 0.05) were observed between the Assurance GDS for Salmonella and the Reference culture methods for any inoculation level of any food type or naturally contaminated food, except for pasta, for which the Assurance GDS method had a higher number of confirmed test portions for Salmonella compared to the Reference method.
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Affiliation(s)
| | - Markus T Jucker
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Mandeep Kaur
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - David E Kerr
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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40
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Arranz I, Mischke C, Stroka J, Sizoo E, van Egmond H, Neugebauer M, Biselli S, Bonzaaijer G, Breyl I, Brodacz W, Bujara I, Burdaspal P, Cea J, Chan D, Danier J, Debreczeni L, De Girolamo A, De Rechter P, De Saeger S, Dittmar F, Esteves ME, Frohmuth G, González P, Griffin J, Hackenberg R, Hanschmann G, Iversen A, Jaus A, Just P, Lauber U, Legarda T, Li FQ, Meister U, Michelet JY, Michels K, Mrkvilova M, Nordkvist E, Nuotio K, Özkaya Ş, Patel S, Petrová J, Pittet; A, Raditschnig A, Reutter M, Ritscher M, Schenerr H, Slezarova A, Sona T, van Osenbruggen T, Van Peteghem C, Vojsová Y, Wilson P, Wisniewska-Dmytrow H, Woese K. Liquid Chromatographic Method for the Quantification of Zearalenone in Baby Food and Animal Feed: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.6.1598] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
An interlaboratory trial for determination of zearalenone (ZON) in baby food and animal feed was conducted. The study involved 39 participants in 16 European Union member states, as well as Turkey, Uruguay, and China, representing a cross-section of industry, and official food control and research institutes. The method is based on immunoaffinity column cleanup followed by high-performance liquid chromatography using fluorimetry (HPLC-Fl). The test portion of the sample is extracted with methanolwater (75 + 25, v/v). The sample extract is filtered, diluted, and passed over an immunoaffinity column. ZON is eluted with methanol. The separation and determination of ZON is performed by reversed-phase HPLC-Fl with an excitation wavelength of 274 nm and an emission wavelength of 446 nm. Test portions of the samples were spiked at levels of 20 and 30 g/kg ZON in baby food and at levels of 100 and 150 g/kg ZON in animal feed. Mean recoveries from each participant ranged from 78 to 119 with an average value of 92 for baby food and from 51 to 122 with an average value of 74 for animal feed. Based on results for spiked samples (blind duplicates at 2 levels), as well as naturally contaminated samples (blind duplicates at 3 levels), the relative standard deviation for repeatability (RSDr) in baby food ranged from 2.8 to 9.0. For animal feed, this value ranged from 5.7 to 9.5. The relative standard deviation for reproducibility (RSDR) in baby food ranged from 8.2 to 13.3, and for animal feed this value ranged from 15.5 to 21.4. The Horwitz ratio (HorRat) in baby food ranged from 0.3 to 0.4, and for animal feed this value ranged from 0.6 to 0.9. The method showed acceptable within-and between-laboratory precision for each matrix, as required by European legislation.
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Affiliation(s)
- Isabel Arranz
- Institute for Reference Materials and Measurements, European CommissionJoint Research Center, Food Safety and Quality Unit, Retieseweg 111, B-2440 Geel, Belgium
| | - Carsten Mischke
- Institute for Reference Materials and Measurements, European CommissionJoint Research Center, Food Safety and Quality Unit, Retieseweg 111, B-2440 Geel, Belgium
| | - Joerg Stroka
- Institute for Reference Materials and Measurements, European CommissionJoint Research Center, Food Safety and Quality Unit, Retieseweg 111, B-2440 Geel, Belgium
| | - Eric Sizoo
- National Institute for Public Health and the Environment, Laboratory for Food and Residue Analysis, PO Box 1, 3720 Bilthoven, The Netherlands
| | - Hans van Egmond
- National Institute for Public Health and the Environment, Laboratory for Food and Residue Analysis, PO Box 1, 3720 Bilthoven, The Netherlands
| | - Michael Neugebauer
- University of Bonn, Pharmaceutical Chemistry, An der Immenburg 4, D-53121 Bonn, Germany
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MacDonald SJ, Anderson S, Brereton P, Wood R, Damant A, Aletrari M, Alonso S, Burdaspal P, Darroch J, Donnelly C, Durand T, Felguerias I, French R, Griffin J, Heide C, Herry M, Hollywood F, Howe A, Ioannou-Kakouri E, Johnson T, Kernaghan I, Krska R, Nisbet J, Pettersson H, Procter J, Rawcliffe P, Smith A, Smith W, Stangroom S, Stevens C, Swanson W, Sweet P, Thomas M, Waller J, Welsh P. Determination of Zearalenone in Barley, Maize and Wheat Flour, Polenta, and Maize-Based Baby Food by Immunoaffinity Column Cleanup with Liquid Chromatography: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/88.6.1733] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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
An interlaboratory study was performed on behalf of the UK Food Standards Agency to evaluate the effectiveness of an affinity column cleanup liquid chromatography (LC) method for the determination of zearalenone (ZON) in a variety of cereals and cereal products at proposed European regulatory limits. The test portion is extracted with acetonitrile:water. The sample extract is filtered, diluted, and applied to an affinity column. The column is washed, and ZON is eluted with acetonitrile. ZON is quantified by reversed-phase LC with fluorescence detection. Barley, wheat and maize flours, polenta, and a maize-based baby food naturally contaminated, spiked, and blank (very low level) were sent to 28 collaborators in 9 European countries and 1 collaborator in New Zealand. Participants were asked to spike test portions of all samples at a ZON concentration equivalent to 100 μg/kg. Average recoveries ranged from 91–111%. Based on results for 4 artificially contaminated samples (blind duplicates) and 1 naturally contaminated sample (blind duplicate), the relative standard deviation for repeatability (RSDr) ranged from 6.9–35.8%, and the relative standard deviation for reproducibility (RSDR) ranged from 16.4–38.2%. The method showed acceptable within- and between-laboratory precision for all 5 matrixes, as evidenced by HorRat values <1.7.
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Affiliation(s)
- Susan J MacDonald
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Sharron Anderson
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Paul Brereton
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Roger Wood
- Food Standards Agency, Aviation House, 125 Kingsway, London, WC2B 6NH, United Kingdom
| | - Andrew Damant
- Food Standards Agency, Aviation House, 125 Kingsway, London, WC2B 6NH, United Kingdom
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42
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MacDonald SJ, Anderson S, Brereton P, Wood R, Barrett G, Brodie C, Burdaspal PA, Conley D, Cooper J, Darroch J, Donnelly C, Embrey N, Ennion RA, Felguerias I, Griffin J, Kitching M, Knight S, Lanham J, Legarda TM, Lenartowicz P, Luis E, Lundie JC, Möller T, Norwood D, Novo R, Nyberg M, O’Donnell C, Panzarini G, Pascale M, Patel S, Paulsch W, Payne N, Rawcliffe P, Reid K, Rizzo A, Rothin A, Saari L, Stangroom SG, Swanson W, Sweet P, Thomas T, Trani R, Turpin E, van Egmond HP, Walker M, Watkins JD, Williams C. Determination of Ochratoxin A in Currants, Raisins, Sultanas, Mixed Dried Fruit, and Dried Figs by Immunoaffinity Column Cleanup with Liquid Chromatography: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.6.1164] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
An interlaboratory study was performed on behalf of the Food Standards Agency to evaluate the effectiveness of an affinity column cleanup liquid chromatographic (LC) method for the determination of ochratoxin A in a variety of dried fruit at European regulatory limits. To ensure homogeneity before analysis, laboratory samples are normally slurried with water in the ratio of 5 parts fruit to 4 parts water, and test materials in this form were used in the study. The test portion was extracted with acidified methanol. The extract was filtered, diluted with phosphate-buffered saline, and applied to an affinity column. The column was washed and ochratoxin A was eluted with methanol. Ochratoxin A was quantified by reversed-phase LC. The use of post-column pH shift to enhance the fluorescence of ochratoxin A by the addition of 1.1M ammonia solution to the column eluant is optional. Determination was by fluorescence. Currants, sultanas, raisins, figs, and mixed fruit (comprising dried pineapple, papaya, sultanas, prunes, dates, and banana chips), both naturally contaminated and blank (very low level), were sent to 24 collaborators in 7 European countries. Participants were asked to spike test portions of all test samples at a level equivalent to 5 ng/g ochra toxin A. Average recoveries ranged from 69 to 74%. Based on results for 5 naturally contaminated test samples (blind duplicates) the relative standard deviation for repeatability (RSDr) ranged from 4.9 to 8.7%, and the relative standard deviation for reproducibility (RSDR)rangedfrom14to28%. The method showed acceptable within-and be-tween-laboratory precision for all 5 matrixes, as evidenced by HORRAT values <1.3.
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Affiliation(s)
- Susan J MacDonald
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Sharron Anderson
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Paul Brereton
- Central Science Laboratory, Sand Hutton, York, YO41 1LZ, United Kingdom
| | - Roger Wood
- Food Standards Agency, Aviation House, 125 Kingsway, London, WC2B 6NH, United Kingdom
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43
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Skarbaliene J, Russell W, Griffin J, Eriksson PO. PT01.2: ZP7570: A Novel GLP-1/GLP-2 Dual Acting Peptide with Potential as the Next Generation Therapy for Short Bowel Syndrome. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32542-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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44
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Haslam S, Parsons A, Omylinska-Thurston J, Nair K, Harlow J, Lewis J, Thurston S, Griffin J, Dubrow-Marshall L, Karkou V. Arts for the Blues - a new creative psychological therapy for depression: a pilot workshop report. Perspect Public Health 2019; 139:137-146. [PMID: 30950682 DOI: 10.1177/1757913919826599] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Research over the last decade has identified both strengths and limitations in the use of routinely prescribed psychological therapies for depression. More recently, a focus on how creative art therapies and 'arts on prescription' are developing a growing recognition of their potential additional therapeutic mechanisms for depression. AIM In an attempt to develop a new therapeutic intervention for depression, this research aligned both the evidence base surrounding the arts on prescription movement, collating these with client-reported helpful factors and preferences for therapeutic interventions. METHODS We developed a framework for a new pluralistic 'meta-approach' of therapy for depression, based on; an interdisciplinary thematic synthesis of active ingredients, considered specific features implemented in therapy, and client-reported helpful factors considered to be the broad features or experiences in therapy from both talking therapies and creative approaches. This framework contributed to the development of a pilot workshop entitled Arts for the Blues - A New Creative Psychological Therapy for Depression. An outline of, and evaluation from this workshop is presented in this article. Workshop participants were recruited via a voluntary workshop taking place at a North West Higher Education Institution Arts and Health conference ( N = 15). RESULTS The workshop was evaluated using quantitative measures, with results indicating around a 70% overall satisfaction, followed up with qualitative commentary around areas of good practice and areas for development. These included the positive reflection on the application of creative arts and the multimodal nature of the approach, while others reflected on the potential overwhelming nature of utilising multimodal methods for individuals with depression. CONCLUSION Overall feedback from the pilot workshop is discussed in relation to prior research, giving credence to the potential for incorporating arts into therapy.
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Affiliation(s)
- S Haslam
- Senior Lecturer in Mental Health, Edge Hill University, St Helens Road, Ormskirk L39 4QP, UK
| | - A Parsons
- Lecturer in Psychology, University of Salford, Salford, UK
| | - J Omylinska-Thurston
- Counselling Psychologist, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - K Nair
- Counsellor, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - J Harlow
- Senior Lecturer in Child Health, Edge Hill University, Ormskirk, UK
| | - J Lewis
- Research Assistant, Edge Hill University, Ormskirk, UK
| | - S Thurston
- Reader, University of Salford, Salford, UK
| | - J Griffin
- Senior Lecturer, Edge Hill University, Ormskirk, UK
| | - L Dubrow-Marshall
- Psychology Programme Leader and Lecturer, University of Salford, Salford, UK
| | - V Karkou
- Professor of Dance, Arts and Wellbeing, Edge Hill University, Ormskirk, UK
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45
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Avery A, Griffin J, Stokes J, Coulton R, Pallister C, Lavin J. The benefits of non-surgical weight management on weight and glycaemic control in people with complex type 2 diabetes: A primary care service evaluation of clinical outcomes at 12 months. Endocrinol Diabetes Metab 2019; 2:e00045. [PMID: 31008360 PMCID: PMC6458457 DOI: 10.1002/edm2.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/02/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 01/08/2023] Open
Abstract
Optimizing diabetes management in patients with complex type 2 diabetes (T2DM) and obesity presents challenges. This study evaluates weight and HbA1c at 12 months (primary outcomes) and blood pressure, lipids, medication and lifestyle changes (secondary outcomes) in patients referred by a diabetes specialist (DSN) to the weight management intervention (Slimming World). Patients attended up to 12 or 24 funded weekly group sessions. The DSN recorded baseline and 12-month primary and secondary outcome data. A post-intervention questionnaire explored the lifestyle changes made. 69 patients achieved a mean weight loss of 5.5 (5.16) %, reduction in BMI [37.7(6.11) to 35.9 (6.30) kg/m2, P < 0.001] and HbA1c levels [62.8 (12.85) to 55.0 (13.02) mmol/mol, P < 0.001] at 12 months. 81.2% reduced their HbA1c levels. Small reductions were observed in SBP, DBP and triglycerides, and six patients reduced their diabetes medications. Twenty patients completed the questionnaire: unhealthy snacking reduced (P < 0.001) and going for walks increased (P < 0.001) with fewer people avoiding moderate activity (P < 0.05). Despite being a chronic, progressive condition, referral to a community-based programme was successful in supporting patients with established T2DM improve their diet and activity levels, lose weight and improve their glycaemic control 12 months later with a small number able to reduce their medication.
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Affiliation(s)
- Amanda Avery
- Nutrition, Health & Research teamSlimming WorldAlfretonUK
| | | | | | - Rosie Coulton
- Nutrition, Health & Research teamSlimming WorldAlfretonUK
| | | | - Jacquie Lavin
- Nutrition, Health & Research teamSlimming WorldAlfretonUK
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46
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Pritchard L, Wilson S, Griffin J, Pearce G, Murray IA, Lewis S. Prevalence of reduced bone mineral density in adults with coeliac disease - are we missing opportunities for detection in patients below 50 years of age? Scand J Gastroenterol 2018; 53:1433-1436. [PMID: 30513012 DOI: 10.1080/00365521.2018.1543447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE There are little data on the prevalence of reduced bone mineral density (BMD) in young adult patients with coeliac disease; guidelines do not support routine investigation of these patients. We assessed the prevalence of reduced BMD in our patients by age. PATIENTS AND METHODS Prospective observational study of 260 coeliac patients having DXA one year after commencing gluten-free diet. Nonparametric tests and regression were used. RESULTS Median age was 51years, BMI 24 and 85 (32.7%) were male. Reduced BMD was associated with increasing age (p < .001), female sex (p = .005), low BMI (p < .001) and previous fracture (p < .01); 49% of all patients and all patients under 20 years old had reduced BMD. The median age of patients with BMI <20 kgm2 was 56 (27, 70) years with the majority of younger patients having normal BMI. CONCLUSIONS Low BMD is a common finding in young patients with coeliac disease, yet routine assessment of BMD is not currently supported by national guidelines. Early identification may improve motivation to comply with GFD and allow adequate calcium and vitamin D supplementation to reduce risk of fracture later in life.
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Affiliation(s)
- Lucy Pritchard
- a Department of Nutrition and Dietetics , Derriford Hospital , Plymouth , UK
| | - Sophia Wilson
- a Department of Nutrition and Dietetics , Derriford Hospital , Plymouth , UK
| | - Jill Griffin
- b Department of Radiology , Derriford Hospital , Plymouth , UK
| | | | - Iain A Murray
- c Department of Gastroenterology , Musgrove Park Hospital , Taunton , UK.,d Department of Gastroenterology , Royal Cornwall Hospitals NHS Trust , Treliske , UK
| | - Stephen Lewis
- e Department of Gastroenterology , Derriford Hospital , Plymouth , UK
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47
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Griffin J, Bangerter L, Havyer R, Comer M, Biggar V, Frangiosa T. ENGAGING FAMILY CAREGIVERS TO IMPROVE HEALTH CARE DELIVERY: ESTABLISHING CLINICAL BEST PRACTICES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.461] [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: 11/12/2022] Open
Affiliation(s)
| | - L Bangerter
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery
| | | | - M Comer
- Geoffrey Beene Foundation Alzheimer’s Initiative
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48
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Mathew J, Griffin J, Alamaniotis M, Kanarachos S, Fitzpatrick M. Prediction of welding residual stresses using machine learning: Comparison between neural networks and neuro-fuzzy systems. Appl Soft Comput 2018. [DOI: 10.1016/j.asoc.2018.05.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [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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49
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Fabbri M, Finney Rutten L, Manemann S, Boyd C, Wolff J, Chamberlain A, Weston S, Yost K, Griffin J, Killian J, Roger V. P902Patient-centered communication and outcomes in heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p902] [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)
- M Fabbri
- Mayo Clinic, Rochester, United States of America
| | | | - S Manemann
- Mayo Clinic, Rochester, United States of America
| | - C Boyd
- Johns Hopkins University of Baltimore, Baltimore, United States of America
| | - J Wolff
- Johns Hopkins University of Baltimore, Baltimore, United States of America
| | | | - S Weston
- Mayo Clinic, Rochester, United States of America
| | - K Yost
- Mayo Clinic, Rochester, United States of America
| | - J Griffin
- Mayo Clinic, Rochester, United States of America
| | - J Killian
- Mayo Clinic, Rochester, United States of America
| | - V Roger
- Mayo Clinic, Rochester, United States of America
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50
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Maredza M, Petrou S, Dritsaki M, Achten J, Griffin J, Lamb SE, Parsons NR, Costa ML. A comparison of the cost-effectiveness of intramedullary nail fixation and locking plate fixation in the treatment of adult patients with an extra-articular fracture of the distal tibia: economic evaluation based on the FixDT trial. Bone Joint J 2018; 100-B:624-633. [PMID: 29701091 DOI: 10.1302/0301-620x.100b5.bjj-2017-1329.r2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to compare the cost-effectiveness of intramedullary nail fixation and 'locking' plate fixation in the treatment of extra-articular fractures of the distal tibia. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom National Health Service (NHS) and personal social services (PSS), based on evidence from the Fixation of Distal Tibia Fractures (UK FixDT) multicentre parallel trial. Data from 321 patients were available for analysis. Costs were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Cost-effectiveness was reported in terms of incremental cost per quality adjusted life year (QALY) gained, and net monetary benefit. Sensitivity analyses were conducted to test the robustness of cost-effectiveness estimates. Results Mean NHS and PSS costs were significantly lower for patients treated with an intramedullary nail than for those treated with a locking plate (-£970, 95% confidence interval (CI) -1685 to -256; p = 0.05). There was a small increase in QALYs gained in the nail fixation group (0.01, 95% CI -0.03 to 0.06; p = 0.52). The probability of cost-effectiveness for nail fixation exceeded 90% at cost-effectiveness thresholds as low as £15 000 per additional QALY. The cost-effectiveness results remained robust to several sensitivity analyses. Conclusion This trial-based economic evaluation suggests that nail fixation is a cost-effective alternative to locking plate fixation. Cite this article: Bone Joint J 2018;100-B:624-33.
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Affiliation(s)
- M Maredza
- Clinical Trials Unit, Warwick Medical School, The University of Warwick, Coventry, UK
| | - S Petrou
- Clinical Trials Unit, Warwick Medical School, The University of Warwick
| | - M Dritsaki
- Oxford Trauma,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - J Achten
- Oxford Trauma,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - J Griffin
- Clinical Trials Unit, Warwick Medical School, The University of Warwick, Gibbet Hill Campus, Coventry, UK
| | - S E Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - N R Parsons
- Clinical Trials Unit, Warwick Medical School, The University of Warwick
| | - M L Costa
- Oxford Trauma,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, and Clinical Trials Unit, Warwick Medical School, The University of Warwick, Coventry, UK and University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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