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Carrasco-Labra A, Devji T, Qasim A, Phillips M, Johnston BC, Devasenapathy N, Zeraatkar D, Bhatt M, Jin X, Brignardello-Petersen R, Urquhart O, Foroutan F, Schandelmaier S, Pardo-Hernandez H, Vernooij RW, Huang H, Rizwan Y, Siemieniuk R, Lytvyn L, Patrick DL, Ebrahim S, Furukawa TA, Nesrallah G, Schunemann HJ, Bhandari M, Thabane L, Guyatt GH. Serious reporting deficiencies exist in minimal important difference studies: Current state and suggestions for improvement. J Clin Epidemiol 2022; 150:25-32. [PMID: 35760237 DOI: 10.1016/j.jclinepi.2022.06.010] [Citation(s) in RCA: 5] [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: 10/23/2021] [Revised: 05/30/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate reporting of minimal important difference (MID) estimates using anchor-based methods for patient-reported outcome measures (PROMs), and the association with reporting deficiencies on their credibility. STUDY DESIGN AND SETTING Systematic survey of primary studies empirically estimating MIDs. We searched Medline, EMBASE, PsycINFO, and the Patient-Reported Outcome and Quality of Life Instruments Database until October 2018. We evaluated study reporting, focusing on participants' demographics, intervention(s), characteristics of PROMs and anchors, and MID estimation method(s). We assessed the impact of reporting issues on credibility of MID estimates. RESULTS In 585 studies reporting on 5,324 MID estimates for 526 distinct PROMs, authors frequently failed to adequately report key characteristics of PROMs and MIDs, including minimum and maximum values of PROM scale, measure of variability accompanying the MID estimate and number of participants included in the MID calculation. Across MID estimates (n=5,324), the most serious reporting issues impacting credibility included infrequent reporting of the correlation between the anchor and PROM (66%), inadequate details to judge precision of MID point estimate (13%), and insufficient information about the threshold used to ascertain MIDs (16%). CONCLUSION Serious issues of incomplete reporting in the MID literature threaten the optimal use of MID estimates to inform the magnitude of effects of interventions on PROMs.
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Affiliation(s)
- Alonso Carrasco-Labra
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8; Center for Integrative Global Oral Health, University of Pennsylvania, School of Dental Medicine, Philadelphia, PA, United States. 240 S. 40th Street, 3rd Fl East, Philadelphia, PA 19104.
| | - Tahira Devji
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Anila Qasim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Bradley C Johnston
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8; Departments of Nutrition, Epidemiology and Biostatistics, Texas A&M University, College Station, TX, United States, 373 Olsen Blvd, Cater-Mattil Building, 77843
| | - Niveditha Devasenapathy
- Indian Institute of Public Health, Delhi, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon- 122002, Haryana, India
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Meha Bhatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Xuejing Jin
- School of Public Health, University of Alberta, Edmonton, Alberta. 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Olivia Urquhart
- Evidence Synthesis and Translation Research, Science and Research Institute, American Dental Association, Chicago, Illinois, United States. 211 E Chicago Avenue, Chicago, Illinois, United States
| | - Farid Foroutan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Stefan Schandelmaier
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Hector Pardo-Hernandez
- Iberoamerican Cochrane Centre; Biomedical Research Institute (IIB Sant Pau); CIBERESP, Barcelona, Spain. Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni M. Claret 167 Pavelló 18 planta 0, 08025 Barcelona, Spain
| | - Robin Wm Vernooij
- Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands. Heidelberglaan 100, 3584 CX Utrecht, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - Hsiaomin Huang
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, United States. 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Yamna Rizwan
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada. 50 Stone Rd E, Guelph, ON N1G 2W1, Canada
| | - Reed Siemieniuk
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Donald L Patrick
- Department of Health Services, University of Washington, Seattle, Washington, United States. 1705 NE Pacific St, Seattle, WA 98195
| | - Shanil Ebrahim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan. Yoshidakonoecho, Sakyo Ward, Kyoto, 606-8315, Japan
| | - Gihad Nesrallah
- Nephrology Program, Humber River Regional Hospital, Toronto, Ontario, Canada. 1235 Wilson Ave, Toronto, ON M3M 0B2, Canada
| | - Holger J Schunemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8; Department of Medicine, McMaster University, Hamilton, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8; Department of Surgery, McMaster University, Hamilton, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8; Department of Medicine, McMaster University, Hamilton, Canada. 1280 Main St East, Hamilton, Canada, L8S 4L8
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Siemieniuk RA, Bartoszko JJ, Zeraatkar D, Kum E, Qasim A, Martinez JPD, Izcovich A, Lamontagne F, Han MA, Agarwal A, Agoritsas T, Azab M, Bravo G, Chu DK, Couban R, Devji T, Escamilla Z, Foroutan F, Gao Y, Ge L, Ghadimi M, Heels-Ansdell D, Honarmand K, Hou L, Ibrahim Q, Khamis A, Lam B, Mansilla C, Loeb M, Miroshnychenko A, Marcucci M, McLeod SL, Motaghi S, Murthy S, Mustafa RA, Pardo-Hernandez H, Rada G, Rizwan Y, Saadat P, Switzer C, Thabane L, Tomlinson G, Vandvik PO, Vernooij RW, Viteri-García A, Wang Y, Yao L, Zhao Y, Guyatt GH, Brignardello-Petersen R. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ 2020; 370:m2980. [PMID: 32732190 PMCID: PMC7390912 DOI: 10.1136/bmj.m2980] [Citation(s) in RCA: 484] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To compare the effects of treatments for coronavirus disease 2019 (covid-19). DESIGN Living systematic review and network meta-analysis. DATA SOURCES WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, up to 3 December 2021 and six additional Chinese databases up to 20 February 2021. Studies identified as of 1 December 2021 were included in the analysis. STUDY SELECTION Randomised clinical trials in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. Pairs of reviewers independently screened potentially eligible articles. METHODS After duplicate data abstraction, a bayesian network meta-analysis was conducted. Risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development, and evaluation (GRADE) approach. For each outcome, interventions were classified in groups from the most to the least beneficial or harmful following GRADE guidance. RESULTS 463 trials enrolling 166 581 patients were included; 267 (57.7%) trials and 89 814 (53.9%) patients are new from the previous iteration; 265 (57.2%) trials evaluating treatments with at least 100 patients or 20 events met the threshold for inclusion in the analyses. Compared with standard care, three drugs reduced mortality in patients with mostly severe disease with at least moderate certainty: systemic corticosteroids (risk difference 23 fewer per 1000 patients, 95% credible interval 40 fewer to 7 fewer, moderate certainty), interleukin-6 receptor antagonists when given with corticosteroids (23 fewer per 1000, 36 fewer to 7 fewer, moderate certainty), and Janus kinase inhibitors (44 fewer per 1000, 64 fewer to 20 fewer, high certainty). Compared with standard care, two drugs probably reduce hospital admission in patients with non-severe disease: nirmatrelvir/ritonavir (36 fewer per 1000, 41 fewer to 26 fewer, moderate certainty) and molnupiravir (19 fewer per 1000, 29 fewer to 5 fewer, moderate certainty). Remdesivir may reduce hospital admission (29 fewer per 1000, 40 fewer to 6 fewer, low certainty). Only molnupiravir had at least moderate quality evidence of a reduction in time to symptom resolution (3.3 days fewer, 4.8 fewer to 1.6 fewer, moderate certainty); several others showed a possible benefit. Several drugs may increase the risk of adverse effects leading to drug discontinuation; hydroxychloroquine probably increases the risk of mechanical ventilation (moderate certainty). CONCLUSION Corticosteroids, interleukin-6 receptor antagonists, and Janus kinase inhibitors probably reduce mortality and confer other important benefits in patients with severe covid-19. Molnupiravir and nirmatrelvir/ritonavir probably reduce admission to hospital in patients with non-severe covid-19. SYSTEMATIC REVIEW REGISTRATION This review was not registered. The protocol is publicly available in the supplementary material. READERS' NOTE This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This is the fifth version of the original article published on 30 July 2020 (BMJ 2020;370:m2980), and previous versions can be found as data supplements. When citing this paper please consider adding the version number and date of access for clarity.
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Affiliation(s)
- Reed Ac Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Joint first authors
| | - Jessica J Bartoszko
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Joint first authors
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Joint first authors
| | - Elena Kum
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Anila Qasim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Juan Pablo Díaz Martinez
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Ariel Izcovich
- Servicio de Clinica Médica del Hospital Alemán, Buenos Aires, Argentina
| | - Francois Lamontagne
- Department of Medicine and Centre de recherche du CHU de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Thomas Agoritsas
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Maria Azab
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Gonzalo Bravo
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Derek K Chu
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Rachel Couban
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Tahira Devji
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Zaira Escamilla
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Farid Foroutan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Ted Rogers Center for Heart Research, Toronto General Hospital, ON, Canada
| | - Ya Gao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Long Ge
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
- Joint first authors
| | - Maryam Ghadimi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Kimia Honarmand
- Department of Medicine, Western University, London, ON, Canada
| | - Liangying Hou
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Quazi Ibrahim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Assem Khamis
- Wolfson Palliative Care Research Centre, Hull York Medical School, Hull, UK
| | - Bonnie Lam
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Christian Mansilla
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Mark Loeb
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Anna Miroshnychenko
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Maura Marcucci
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Shelley L McLeod
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharhzad Motaghi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Srinivas Murthy
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Reem A Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, University of Kansas Medical Center, Kansas City, MO, USA
| | - Hector Pardo-Hernandez
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yamna Rizwan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Pakeezah Saadat
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Charlotte Switzer
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - George Tomlinson
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | | | - Robin Wm Vernooij
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Andrés Viteri-García
- Epistemonikos Foundation, Santiago, Chile
- Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Ying Wang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Yunli Zhao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
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Devji T, Carrasco-Labra A, Qasim A, Phillips M, Johnston BC, Devasenapathy N, Zeraatkar D, Bhatt M, Jin X, Brignardello-Petersen R, Urquhart O, Foroutan F, Schandelmaier S, Pardo-Hernandez H, Vernooij RW, Huang H, Rizwan Y, Siemieniuk R, Lytvyn L, Patrick DL, Ebrahim S, Furukawa T, Nesrallah G, Schünemann HJ, Bhandari M, Thabane L, Guyatt GH. Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study. BMJ 2020; 369:m1714. [PMID: 32499297 PMCID: PMC7270853 DOI: 10.1136/bmj.m1714] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To develop an instrument to evaluate the credibility of anchor based minimal important differences (MIDs) for outcome measures reported by patients, and to assess the reliability of the instrument. DESIGN Instrument development and reliability study. DATA SOURCES Initial criteria were developed for evaluating the credibility of anchor based MIDs based on a literature review (Medline, Embase, CINAHL, and PsycInfo databases) and the experience of the authors in the methodology for estimation of MIDs. Iterative discussions by the team and pilot testing with experts and potential users facilitated the development of the final instrument. PARTICIPANTS With the newly developed instrument, pairs of masters, doctoral, or postdoctoral students with a background in health research methodology independently evaluated the credibility of a sample of MID estimates. MAIN OUTCOME MEASURES Core credibility criteria applicable to all anchor types, additional criteria for transition rating anchors, and inter-rater reliability coefficients were determined. RESULTS The credibility instrument has five core criteria: the anchor is rated by the patient; the anchor is interpretable and relevant to the patient; the MID estimate is precise; the correlation between the anchor and the outcome measure reported by the patient is satisfactory; and the authors select a threshold on the anchor that reflects a small but important difference. The additional criteria for transition rating anchors are: the time elapsed between baseline and follow-up measurement for estimation of the MID is optimal; and the correlations of the transition rating with the baseline, follow-up, and change score in the patient reported outcome measures are satisfactory. Inter-rater reliability coefficients (ĸ) for the core criteria and for one item from the additional criteria ranged from 0.70 to 0.94. Reporting issues prevented the evaluation of the reliability of the three other additional criteria for the transition rating anchors. CONCLUSIONS Researchers, clinicians, and healthcare policy decision makers can consider using this instrument to evaluate the design, conduct, and analysis of studies estimating anchor based minimal important differences.
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Affiliation(s)
- Tahira Devji
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Alonso Carrasco-Labra
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Anila Qasim
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Bradley C Johnston
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | | | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Meha Bhatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Xuejing Jin
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Olivia Urquhart
- Center for Evidence Based Dentistry, American Dental Association, Chicago, IL, USA
| | - Farid Foroutan
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Stefan Schandelmaier
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Hector Pardo-Hernandez
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Robin Wm Vernooij
- Department of Research, Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Hsiaomin Huang
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Yamna Rizwan
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Reed Siemieniuk
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Donald L Patrick
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Shanil Ebrahim
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Toshi Furukawa
- Department of Health Promotion and Human Behaviour, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Gihad Nesrallah
- Nephrology Program, Humber River Regional Hospital, Toronto, ON, Canada
- Division of Nephrology, University of Western Ontario, London, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Levy E, Rizwan Y, Thibault L, Lepage G, Brunet S, Bouthillier L, Seidman E. Altered lipid profile, lipoprotein composition, and oxidant and antioxidant status in pediatric Crohn disease. Am J Clin Nutr 2000; 71:807-15. [PMID: 10702177 DOI: 10.1093/ajcn/71.3.807] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Growing evidence supports a role for peroxidation in the pathogenesis of Crohn disease (CD). The activation of inflammatory cells, the release of their mediators, and the excessive production of free radicals may affect circulating lipids. OBJECTIVE We examined the lipid profile, lipoprotein composition, and oxidant-antioxidant status of children with CD. DESIGN We studied 22 pediatric CD patients and 10 healthy control subjects. RESULTS The proportion of saturated and monounsaturated fatty acids in plasma of CD patients was higher but that of polyunsaturated fatty acids was lower than in control subjects. This resulted in higher ratios in CD patients of palmitoleic acid to linoleic acid (P < 0. 05) and of eicosatrienoic acid to arachidonic acid (P < 0.04), 2 established indexes of essential fatty acid deficiency. Hypocholesterolemia was noted in CD patients as a result of lower LDL-cholesterol concentrations than in control subjects (P < 0.02). Plasma apolipoproteins B (P < 0.02) and A-I (P < 0.02) were also lower in CD patients, whereas plasma triacylglycerols were higher (P < 0.005). Lipoprotein composition was altered in CD patients, with relative triacylglycerol depletion and protein enrichment in VLDL. In contrast, intermediate-density lipoprotein of CD patients was characterized by an increased percentage of triacylglycerol and protein (P < 0.005) and a reduced proportion of phospholipids (P < 0. 01). Additional abnormalities were observed in the chemical distribution of HDL(2) and HDL(3) moieties. Lipid peroxidation was documented by higher plasma malondialdehyde concentrations in CD patients (P < 0.05), accompanied by lower retinol concentrations (P < 0.02). CONCLUSION Disturbances in the lipid profile, in lipoprotein concentrations and composition, and in oxidant-antioxidant status occur in CD patients.
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Affiliation(s)
- E Levy
- Gastroenterology-Nutrition Unit, Centre de Recherche, Hôpital Sainte-Justine, Departments of Pediatrics and Nutrition, Université de Montréal, Canada.
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