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Caruana DL, Jiang W, Elaydi A, Grauer JN. Sponsorship of clinical trials related to the spine: Trends over time and comparative analysis of trial characteristics by sponsorship type. N Am Spine Soc J 2024; 17:100296. [PMID: 38130466 PMCID: PMC10733670 DOI: 10.1016/j.xnsj.2023.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
Background Clinical trials are crucial to advance products and procedures related to the spine. ClinicalTrials.gov is an internet-based registry and results database that catalogs trial characteristics, such as intervention types, phase, randomization, and blinding. Sponsorship trends have not been specifically evaluated for spine-related clinical trials, nor have trial characteristics been compared among spine-related trials sponsored by institutions, industries, and federal agencies. The purpose of this cross-sectional analysis of spine-related clinical trials was to characterize the types and trends of sponsorship for spine-related clinical trials, and compare trial characteristics among trials sponsored by institutions, industries, and federal agencies. Methods ClinicalTrials.gov was queried for clinical trials started from the launch of ClinicalTrials.gov (February 29, 2000) through December 31, 2022, using the term "spine." Trial characteristics were abstracted, including start year, intervention type, phase, randomization, and blinding. Univariate and multivariate analyses were performed to determine associations between sponsorship type and other trial characteristics. Results A total of 4,484 clinical trials were identified, of which 78 trials were excluded due to incomplete reporting of trial registration data. From 2000 through 2022, the number of spine-related trials initiated annually markedly increased (from 21 to 453, representing an increase of 2,057%). This was predominantly driven by an increase in the number of institutionally sponsored trials. Relative to trials with institutional sponsorship, industry sponsorship was independently associated with different intervention types, phases of study, lack of randomization, and lack of blinding. Relative to trials with institutional sponsorship, federal sponsorship was independently associated with intervention type, and phase of study. Conclusions From 2000 through 2022, the number of spine-related clinical trials initiated annually markedly increased, driven by an increase in institutionally sponsored trials. Specific trial characteristics were more or less likely for industrially or federally sponsored trials relative to institutionally sponsored trials suggesting the types of clinical trials are shifting over time.
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Affiliation(s)
- Dennis L Caruana
- Department of Orthopaedics & Rehabilitation, Yale School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, United States
| | - Will Jiang
- Department of Orthopaedics & Rehabilitation, Yale School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, United States
| | - Ali Elaydi
- Department of Orthopaedics & Rehabilitation, Yale School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, United States
| | - Jonathan N Grauer
- Department of Orthopaedics & Rehabilitation, Yale School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, United States
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Symons T, Davis JS. Creating concise and readable patient information sheets for interventional studies in Australia: are we there yet? Trials 2022; 23:794. [PMID: 36131293 PMCID: PMC9490706 DOI: 10.1186/s13063-022-06712-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Participant information sheets and consent forms (PICFs) used in interventional studies are often criticised for being hard to read and understand. We assessed the readability and its correlates of a broad range of Australian PICFs. Methods We analysed the participant information sheet portion of 248 PICFs. Readability scores were measured using three formulae: the Flesch Reading Ease, the Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook (SMOG). We investigated how various features (including sponsor type and PICF type) correlated with PICF length and readability and examined compliance with other measures known to improve readability. Results For a sample of 248 PICFs, the mean (standard deviation) Flesch Reading Ease score was 49.3 (5.7) and for the Flesch-Kincaid Grade Level 11.4 (1.1). The mean (SD) SMOG score was 13.2 (0.9). The median document length was 3848 words (8 pages). Commercial PICFs were more than twice as long as non-commercial, but statistically more readable (p = 0.03) when analysed using the SMOG formula. Subgroup analyses indicated that PICFs for self-consenters were statistically more readable than those for proxy consenters. The use of tables, but not the use of illustrations was associated with better readability scores. Conclusions The PICFs in our sample are long and complex, and only 3 of the 248 achieved the recommended readability score of grade 8 or below. The broader use of best practice principles for writing health information for consumers and the development of more context-sensitive templates could improve their utility.
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Affiliation(s)
- Tanya Symons
- Department of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, Australia
| | - Joshua S Davis
- Menzies School of Health Research, and Charles Darwin University, Casuarina, Northern Territory, Australia. .,Department of Infectious Diseases, John Hunter Hospital, Newcastle, Australia.
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Patel K, Cobourne MT, Pandis N, Seehra J. Are orthodontic randomised controlled trials justified with a citation of an appropriate systematic review? Prog Orthod 2021; 22:48. [PMID: 34918200 PMCID: PMC8677858 DOI: 10.1186/s40510-021-00395-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 01/06/2023] Open
Abstract
Background A systematic review of the evidence should be undertaken to support the justification for undertaking a clinical trial. The aim of this study was to examine whether reports of orthodontic Randomised Clinical Trials (RCTs) cite prior systematic reviews (SR) to explain the rationale or justification of the trial. Study characteristics that predicated the citation of SR in the RCT report were also explored. Material and methods Orthodontic RCTs published between 1st January 2010 to 31st December 2020 in seven orthodontic journals were identified. All titles and abstracts were screened independently by two authors. Descriptive statistics and associations were assessed for the study characteristics. Logistic regression was used to identify predicators of SR inclusion in the trial report. Results 301 RCTs fulfilling the eligibility criteria were assessed. 220 SRs were available of which 74.5% (N = 164) were cited, and 24.5% (N = 56) were not included but were available in the literature within 12 months of trial commencement. When a SR was not included in the introduction or no SR was available within 12 months of trial commencement, interventional studies were commonly cited. The continent of the corresponding author predicated the possibility of inclusion of a SR in the introduction (OR 0.36; 95% CI 0.18–0.71; p = 0.003). Conclusions A quarter of orthodontic RCTs (24.5%) included in this study did not cite a SR in the introduction section to justify the rationale of the trial when a relevant SR was available. To reduce research waste and optimal usage of resources, researchers should identify or conduct a systematic review of the evidence to support the rationale and justification of the trial.
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Affiliation(s)
- Kishan Patel
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - Martyn T Cobourne
- Centre for Craniofacial Development and Regeneration, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, SE1 9RT, UK
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - Jadbinder Seehra
- Centre for Craniofacial Development and Regeneration, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, SE1 9RT, UK.
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Seehra J, Liu C, Pandis N. Citation of prior systematic reviews in reports of randomized controlled trials published in dental speciality journals. J Dent 2021; 109:103658. [PMID: 33836249 DOI: 10.1016/j.jdent.2021.103658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/17/2021] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the extent to which reports of dental Randomised Clinical Trials (RCTs) cite prior systematic reviews (SR) to explain the rationale or justification of the trial. Study characteristics that predicated the citation of SR in the RCT report were explored. METHODS An electronic database search was undertaken to identify dental RCTs published between 1st January 2014 and 31st December 2019. All titles and abstracts were screened independently by two authors. Descriptive statistics and associations were calculated for the study characteristics. Logistic regression was used to identify predicators of SR inclusion in the trial report. RESULTS 682 RCTs were analysed. 312 SRs were available of which 62.5 % were cited and 37.5 % were not included but were available in the literature within 12 months of trial commencement. An association between inclusion of SR and trial registration (P = 0.046) was detected. For the inclusion of a SR, authors based in Asia or other had lower odds than those based in Europe (OR: 0.53; 95 % CI:0.34,0.82; p = 0.005). Every unit increase in journal impact factor increased the odds of SR inclusion (OR: 1.23; 95 %: 1.06, 1.43; p = 0.006). CONCLUSIONS A relatively high proportion of dental RCTs (37.5 %) did not cite a SR in the introduction section to justify the rationale of the trial when a relevant SR was available. Trials conducted by a corresponding author based in Europe and published in journals with an increasing impact factor were also more likely to cite a SR. CLINICAL SIGNIFICANCE Further progress is required to minimise research waste and ensure resources are channelled towards clinically useful trials which have an appropriate rationale and justification.
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Affiliation(s)
- Jadbinder Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, United Kingdom.
| | - Catherine Liu
- Department of Oral and Maxillofacial Surgery, Queen's Hospital, Barking, Romford, United Kingdom
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland
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Jayawardena R, Swarnamali H, Ranasinghe P, Misra A. Health effects of coconut oil: Summary of evidence from systematic reviews and meta-analysis of interventional studies. Diabetes Metab Syndr 2021; 15:549-555. [PMID: 33689936 DOI: 10.1016/j.dsx.2021.02.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Systemic review (SR) and meta-analysis (MA) of interventional studies are considered as the highest level of evidence for clinical decision making. Therefore, we systematically summarized all high-quality evidence on the usage of coconut oil for health-related benefits from SRs and MA. METHODS PubMed®, Web of science®, SciVerse Scopus®, and EMBASE® databases were systematically searched to select SRs and SRs with MA of interventional studies reporting health-related clinical outcomes of coconut oil. Similar studies were grouped based on their respective clinical areas. A methodological quality appraisal was conducted for all included SRs and SRs with MA using the Critical Appraisal Checklist for Systematic Reviews. RESULTS A total of seven papers were selected for inclusion in this review, consisting of three MA and one SR on cardio-metabolic health, one SR on oral health, and one SR and one MA each on skin health. Coconut oil significantly increases serum total cholesterol, low-density- and high-density- lipoprotein cholesterol levels compared to poly- and mono-unsaturated oils. Limited studies showed that topical use of coconut oil helps in the prevention and treatment of atopic dermatitis and oil pulling for the prevention of dental caries. All four studies on cardiometabolic health and the SR on oral health had a high score in the quality assessment, SR with MA on skin health fulfilled high-quality scoring whereas the SR on the same topic had a low-quality scoring. CONCLUSIONS In summary, consistent and strong evidence shows that coconut oil has an adverse effect on the lipids parameters associated with cardio-metabolic health, with limited studies to conclude the effects of atopic dermatitis and oil pulling.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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Browne JL, Korsun N, Casas L, Rodriguez I, Valero B, Rincon A, Pascual MA. "Are changes in breast density during the menstrual cycle relevant? To what?". Breast Cancer Res Treat 2020; 183:451-8. [PMID: 32666266 DOI: 10.1007/s10549-020-05788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Cancers can be hidden by high breast density (BDen)- the masking effect (ME). BDen is also a modifiable and highly prevalent breast cancer risk (BCR) factor. The purposes of this study were to determine how much glandular volume (GVol), breast volume (BVol) and their ratio: BDen change during the menstrual cycle, and if these changes could affect ME or be relevant to results of interventional studies aiming to diminish BCR using these parameters as surrogates. METHODS We retrieved GVol, BVol and BDen data values obtained from 39,997 right mammograms performed with photon counting technique of 19,904 premenopausal women who reported their first day of last menses (FDLM). Many women had more than one study included over the years (with a different FDLM) but were not studied longitudinally. We segregated women by age (yearly), divided the menstrual cycle in 4 weeks, and assigned results with respect to the FDLM. RESULTS All parameters vary cyclically, with higher values in week 4 (GVol and BDen) or week 1 (BVol). Mean inter-week differences were very small for the three parameters, and diminished with age. However, especially in the youngest women, inter-week differences could be more than 10% for BDen, 15% for GVol, and 50% for BVol. CONCLUSION Small inter-week mean differences almost certainly rule out relevant changes to ME directly attributable to BDen. However, the possibility of large differences during the menstrual cycle in younger women, who are the ideal targets of interventional studies to diminish BCR, might distort results and should be accounted for.
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de la O V, Zazpe I, Martínez JA, Santiago S, Carlos S, Zulet MÁ, Ruiz-Canela M. Scoping review of Paleolithic dietary patterns: a definition proposal. Nutr Res Rev 2021; 34:78-106. [PMID: 32482184 DOI: 10.1017/S0954422420000153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The Paleolithic diet (PaleoDiet) is an allegedly healthy dietary pattern inspired by the consumption of wild foods and animals assumed to be consumed in the Paleolithic era. Despite gaining popularity in the media, different operational definitions of this Paleolithic nutritional intake have been used in research. Our hypothesis is that specific components used to define the PaleoDiet may modulate the association of this diet with several health outcomes. We comprehensively reviewed currently applied PaleoDiet scores and suggested a new score based on the food composition of current PaleoDiet definitions and the theoretical food content of a staple dietary pattern in the Paleolithic age. In a PubMed search up to December 2019, fourteen different PaleoDiet definitions were found. We observed some common components of the PaleoDiet among these definitions although we also found high heterogeneity in the list of specific foods that should be encouraged or banned within the PaleoDiet. Most studies suggest that the PaleoDiet may have beneficial effects in the prevention of cardiometabolic diseases (type 2 diabetes, overweight/obesity, CVD and hyperlipidaemias) but the level of evidence is still weak because of the limited number of studies with a large sample size, hard outcomes instead of surrogate outcomes and long-term follow-up. Finally, we propose a new PaleoDiet score composed of eleven food items, based on a high consumption of fruits, nuts, vegetables, fish, eggs and unprocessed meats (lean meats); and a minimum content of dairy products, grains and cereals, and legumes and practical absence of processed (or ultra-processed) foods or culinary ingredients.
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Zeeneldin AA, Taha FM. The Egyptian clinical trials' registry profile: Analysis of three trial registries (International Clinical Trials Registry Platform, Pan-African Clinical Trials Registry and clinicaltrials.gov). J Adv Res 2015; 7:37-45. [PMID: 26843968 PMCID: PMC4703417 DOI: 10.1016/j.jare.2015.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 05/05/2014] [Revised: 11/21/2014] [Accepted: 01/11/2015] [Indexed: 10/26/2022] Open
Abstract
Registering clinical trials (CTs) in public domains enhances transparency, increases trust in research, improves participation and safeguards against publication bias. This work was done to study the profile of clinical research in Egypt in three CT registries with different scopes: the WHO International CT Registry Platform (ICTRP), the continental Pan-African CT Registry (PACTR) and the US clinicaltrials.gov (CTGR). In March 2014, ICTRP, PACTR and CTGR were searched for clinical studies conducted in Egypt. It was found that the number of studies conducted in Egypt (percentage) was 686 (0.30%) in ICTRP, 56 (11.3%) in PACTR and 548 (0.34%) in CTGR. Most studies were performed in universities and sponsored by university/organization, industry or individual researchers. Inclusion of adults from both genders predominated. The median number of participants per study in the three registries ranged between 63 and 155. The conditions researched differed among the three registries and study purpose was mostly treatment followed by prevention. Endpoints were mostly efficacy followed by safety. Observational:Interventional studies (i.e. clinical trials) represented 15.5%:84.5% in ICTRP, 0%:100% in PACTR and 16.4%:83.6% in CTGR. Most interventions were drugs or procedures. Observational studies were mostly prospective and cohort studies. Most CTs were phase 3 and tested drugs or procedures. Parallel group assignment and random allocation predominated. Blinding was implemented in many of trials and was mostly double-blind. We conclude that CTs from Egypt in trial registries are apparently low and do not accurately reflect clinical research conducted in Egypt or its potential. Development of an Egyptian CT registry is eagerly needed. Registering all Egyptian CTs in public domains is highly recommended.
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Affiliation(s)
- Ahmed A Zeeneldin
- Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Fatma M Taha
- Unit of Biochemistry and Molecular Biology, the Medical Biochemistry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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