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Liu H, Yang H, Guo X, Bai Y, SiRi G. Clinical benefits of therapeutic drug monitoring of vancomycin therapy in patients with postoperative intracerebral hemorrhage: a retrospective cohort study. Eur J Hosp Pharm 2024; 31:240-246. [PMID: 36207132 DOI: 10.1136/ejhpharm-2022-003455] [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: 06/30/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the clinical efficacy and safety of conducting therapeutic drug monitoring (TDM) of vancomycin in patients with postoperative intracerebral haemorrhage. METHODS We conducted a retrospective analysis of 435 patients who experienced postoperative cerebral haemorrhage and were treated with vancomycin in the Department of Neurosurgery of Inner Mongolia Autonomous Region People's Hospital from January 2017 to December 2021. Patients were then matched using the propensity score matching method in a ratio of 1:1. Ninety-two pairs of cases were successfully matched, and the data before and after performing vancomycin TDM were analysed. RESULTS After PSM, the baseline data of the two groups were balanced. There were no significant differences in the 14-day mortality and length of hospital stay (p>0.05) between the two groups. Compared with the non-TDM group, the TDM group had a higher proportion of patients with normal white blood cells (83.7% vs 56.5%, p=0.000), neutrophil count (57.6% vs 25.0%, p=0.000) and attaining desirable reductions of 80% in procalcitonin (65.2% vs 10.9%, p=0.000) and C-reactive protein (78.3% vs 41.3%, p=0.000) levels. At US$15.82 per additional TDM, TDM significantly promoted patient outcomes, as seen in improvements in the proportion of patients attaining desirable levels of white blood cells, neutrophil count, procalcitonin and C-reactive protein. CONCLUSIONS Vancomycin TDM is a safe and effective approach for the treatment of patients with postoperative intracerebral haemorrhage. The empirical use of TDM of vancomycin significantly improved normal values of white blood cells and neutrophil count, achieved desirable reductions of 80% in procalcitonin and C-reactive protein, and reduced nephrotoxicity in patients with postoperative intracerebral haemorrhage.
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Affiliation(s)
- Huanhuan Liu
- Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Hongxin Yang
- Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China
| | - Xiaobin Guo
- Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China
| | - Yingchun Bai
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Guleng SiRi
- Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China
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McCallum L, Lip S, Rostron M, Hanna R, Bin Pg Md Salimin N, Nichol S, Padmanabhan S. OPTIMA-BP: empOwering PaTients in MAnaging Blood Pressure - protocol for a randomised parallel group study comparing use of Kvatchii web-based patient education portal as an addition to home blood pressure monitoring. Open Heart 2024; 11:e002535. [PMID: 38429056 PMCID: PMC10910568 DOI: 10.1136/openhrt-2023-002535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/01/2023] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION Hypertension is the leading modifiable risk factor for cardiovascular disease and is implicated in half of all strokes and myocardial infarctions. One-third of the adults in Scotland have hypertension yet only a quarter of them have their blood pressure (BP) controlled to target (<140/90 mm Hg). Empowering patients to have a better understanding of their condition and becoming actively involved in the monitoring and management of hypertension may lead to improved patient satisfaction, improved BP control and health outcomes and reduction in the use of primary/secondary care hypertension clinics. METHODS AND ANALYSIS OPTIMA-BP is a randomised parallel group pilot study comparing the use of home BP monitoring accompanied by access to the web-based cardiovascular educational portal (Kvatchii) and home BP monitoring (HBPM) alone in 200 patients with hypertension attending the Glasgow Blood Pressure Clinic, Queen Elizabeth University Hospital, Glasgow. Consented participants will be asked to complete surveys on lifestyle factors, medication adherence, quality of life and hypertension knowledge, understanding and home monitoring. The intervention group will be asked to complete a survey to help evaluate the Kvatchii portal. At 6 and 12 months, the surveys will be repeated via the CASTOR EDC. Both groups will input their HBPM results at 2-month intervals into a CASTOR-EDC survey. OPTIMA-BP will follow-up with participants over 12 months with the study running over 24 months. The primary outcome is HBPM systolic BP area under the curve between baseline and 6 months ETHICS AND DISSEMINATION: OPTIMA-BP was approved by the North of Scotland Research Ethics Committee 2 (22/NS/0095). Current protocol version 1.2 date 6 June 2023. Written informed consent will be provided by all study participants. Study findings will be submitted to international peer-reviewed journals and will be presented at national and international scientific meetings. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT05575453. Registered 12 October 2022. https://clinicaltrials.gov/ct2/show/NCT05575453.
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Affiliation(s)
- Linsay McCallum
- NHS Greater Glasgow and Clyde, Glasgow, UK
- Institute of Cardiovascular and Metabolic Science, University of Glasgow, Glasgow, UK
| | - Stefanie Lip
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
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Cobey KD, Alayche M, Saba S, Barnes NY, Ebrahimzadeh S, Alarcón E, Hibbert B, Moher D. Cardiology researchers' practices and perceived barriers to open science: an international survey. Open Heart 2024; 11:e002433. [PMID: 38233041 PMCID: PMC10806507 DOI: 10.1136/openhrt-2023-002433] [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: 08/25/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE Open science is a movement and set of practices to conduct research more transparently. Implementing open science will significantly improve public access and supports equity. It also has the potential to foster innovation and reduce duplication through data and materials sharing. Here, we survey an international group of researchers publishing in cardiovascular journals regarding their perceptions and practices related to open science. METHODS We identified the top 100 'Cardiology and Cardiovascular Medicine' subject category journals from the SCImago journal ranking platform. This is a publicly available portal that draws from Scopus. We then extracted the corresponding author's name and email from all articles published in these journals between 1 March 2021 and 1 March 2022. Participants were sent a purpose-built survey about open science. The survey contained primarily multiple choice and scale-based questions for which we report count data and percentages. For the few text-based responses we conducted thematic content analysis. RESULTS 198 participants responded to our survey. Participants had a mean response of 6.8 (N=197, SD=1.8) on a 9-point scale with endpoints, not at all familiar (1) and extremely familiar (9), when indicating how familiar they were with open science. When asked about where they obtained open science training, most participants indicated this was done on the job self-initiated while conducting research (n=103, 52%), or that they had no formal training with respect to open science (n=72, 36%). More than half of the participants indicated they would benefit from practical support from their institution on how to perform open science practices (N=106, 54%). A diversity of barriers to each of the open science practices presented to participants were acknowledged. Participants indicated that funding was the most essential incentive to adopt open science. CONCLUSIONS It is clear that policy alone will not lead to the effective implementation of open science. This survey serves as a baseline for the cardiovascular research community's open science performance and perception and can be used to inform future interventions and monitoring.
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Affiliation(s)
- Kelly D Cobey
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Mohsen Alayche
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Saba
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Nana Yaa Barnes
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Health Sciences University of Ottawa, Ottawa, Ontario, Canada
| | | | - Emilio Alarcón
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - David Moher
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Zimba O, Gasparyan AY. Designing, Conducting, and Reporting Survey Studies: A Primer for Researchers. J Korean Med Sci 2023; 38:e403. [PMID: 38084027 PMCID: PMC10713437 DOI: 10.3346/jkms.2023.38.e403] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Survey studies have become instrumental in contributing to the evidence accumulation in rapidly developing medical disciplines such as medical education, public health, and nursing. The global medical community has seen an upsurge of surveys covering the experience and perceptions of health specialists, patients, and public representatives in the peri-pandemic coronavirus disease 2019 period. Currently, surveys can play a central role in increasing research activities in non-mainstream science countries where limited research funding and other barriers hinder science growth. Planning surveys starts with overviewing related reviews and other publications which may help to design questionnaires with comprehensive coverage of all related points. The validity and reliability of questionnaires rely on input from experts and potential responders who may suggest pertinent revisions to prepare forms with attractive designs, easily understandable questions, and correctly ordered points that appeal to target respondents. Currently available numerous online platforms such as Google Forms and Survey Monkey enable moderating online surveys and collecting responses from a large number of responders. Online surveys benefit from disseminating questionnaires via social media and other online platforms which facilitate the survey internationalization and participation of large groups of responders. Survey reporting can be arranged in line with related recommendations and reporting standards all of which have their strengths and limitations. The current article overviews available recommendations and presents pointers on designing, conducting, and reporting surveys.
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Affiliation(s)
- Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
| | - Armen Yuri Gasparyan
- Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK
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Ebrahimi H, Castro DV, Feng MI, Prajapati SR, Lee KO, Chan EH, Paul T, Sehgal I, Patel J, Li X, Zengin ZB, Meza L, Mercier BD, Hsu J, Govindarajan A, Chawla N, Dizman N, Bergerot CD, Rock A, Liu S, Tripathi A, Dorff T, Pal SK, Chehrazi-Raffle A. Examining Exclusion Criteria in Advanced Prostate Cancer Clinical Trials: An Assessment of recommendations From the American Society Of Clinical Oncology and Friends of Cancer Research. Clin Genitourin Cancer 2023; 21:e467-e473. [PMID: 37301665 DOI: 10.1016/j.clgc.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Eligibility criteria illustrate the characteristics of the study population and promote the safety of participants. However, overreliance on restrictive eligibility criteria may limit the generalizability of outcomes. As a result, the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) issued statements to curtail these challenges. In this study, we aimed to assess restrictiveness in eligibility criteria across advanced prostate cancer clinical trials. MATERIALS AND METHODS We identified all phase I, II, and III advanced prostate cancer clinical trials between June 30, 2012, and June 30, 2022, through Clinicaltrials.gov. We evaluated whether a clinical trial excluded, conditionally included, or did not report 4 common criteria: brain metastases, prior or concurrent malignancies, HIV infection, and hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. Performance status (PS) criteria were recorded based on the Eastern Cooperative Oncology Group (ECOG) scale. RESULTS Out of 699 clinical trials within our search strategy, 265 (37.9%) trials possessed all the required data and were included in our analysis. The most common excluded condition of our interest was brain metastases (60.8%), followed by HIV positivity (46.4%), HBV/HCV positivity (46.0%), and concurrent malignancies (15.5%). Additionally, 50.9% of clinical trials only included patients with ECOG PS 0 to 1. HIV and HBV/HCV infection were exclusion criteria of 22 (80.8%) and 19 (73.1%) immunotherapy trials, respectively. CONCLUSION Patients with brain metastases, prior or concurrent malignancies, HIV infection, HBV/HCV infection, or low-functioning PS were overly restricted from participating in advanced prostate clinical trials. Advocating for broader criteria may ameliorate generalizability.
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Affiliation(s)
- Hedyeh Ebrahimi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Daniela V Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Matthew I Feng
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sweta R Prajapati
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Kyle O Lee
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Elyse H Chan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Trishita Paul
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Ishaan Sehgal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Jalen Patel
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Xiaochan Li
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Benjamin D Mercier
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Neal Chawla
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA; Department of Internal Medicine, Yale University School of Medicine, Yale New Haven Hospital, New Haven, CT
| | - Cristiane D Bergerot
- Centro de Câncer de Brasília (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | - Adam Rock
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sandy Liu
- Department of Medical Oncology, City of Hope Orange County Medical Center, Irvine, CA
| | - Abhishek Tripathi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Tanya Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Alexander Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
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Mahdi Salehi M, Maragha T, Brondani M. Application of the Life Grid in Oral Health Research: A Scoping Review. Community Dent Health 2023; 40:187-194. [PMID: 37655484 DOI: 10.1922/cdh_00088salehi08] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
AIM The life grid is a retrospective interview-based tool used to enhance recall of past events. This scoping review examines the use of the life grid in oral health research and its applications. METHODS Using the Joanna Briggs Institute framework, Medline (Ovid), CINAHL, PsycInfo, ERIC, MedEdPortal, Web of Science Core Collection, ProQuest, and Google Scholar were searched with "life grid" and "oral" as initial keywords. Then, two reviewers screened the records independently. Studies published until April 21, 2022, were added, regardless of language. Data were summarised narratively and in a comprehensive table focused on seven main areas. RESULTS A total of 22 studies were included from 724 initially identified records. The life grid was used in different forms, in various qualitative, longitudinal, and cross-sectional studies with participants of different ages. Eight studies used the life grid at the beginning of the interview, four during the process, and one at the end. The ability to reduce recall bias, increase data reliability, establish rapport with participants, and ensure information accuracy were among the most commonly cited benefits of using the life grid in oral health research, particularly in oral cancer research. CONCLUSIONS The life grid is a flexible tool used in a variety of structures and applications in oral health research. Positive impacts have been reported by both researchers and participants. This review highlights the potential of the life grid as a data collection and interview tool in oral health research and dental education.
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Affiliation(s)
- M Mahdi Salehi
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - T Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - M Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
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Allemang-Trivalle A, Leducq S, Maruani A, Giraudeau B. Designs used in published therapeutic studies of rare superficial vascular anomalies: a systematic literature search. BMC Med Res Methodol 2023; 23:196. [PMID: 37648985 PMCID: PMC10466846 DOI: 10.1186/s12874-023-02017-0] [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: 04/07/2022] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Rare superficial vascular anomalies represent a wide range of diseases. Their management is difficult given the broad spectrum and the lack of clinical trials assessing treatment efficacy. A randomized clinical trial of vascular anomalies is difficult because of the rarity of the diseases and is enhanced by the population of interest often being children. Therefore, suitable designs are needed. We conducted a methodological systematic literature search to identify designs implemented for investigating the treatment of rare superficial vascular anomalies. METHODS We conducted a literature search on January 25, 2021, of the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov and European Union Clinical Trials Register databases. This systematic methodological literature search was registered at the Prospective Register of Systematic Reviews (PROSPERO: CRD42021232449). Randomized and non-randomized studies were included if they met the following criteria: were prospective studies of rare superficial vascular anomaly therapies, dealt with humans (adults and children) and were published in English from 2000. We excluded case reports/case series reporting fewer than 10 patients, reviews, retrospective studies, animal studies, studies of systemic or common vascular anomalies and non-therapeutic studies. We did not assess risk of bias in the included studies because our review was a methodological one focused on the design used. The review provided a descriptive analysis of relevant features of eligible research studies. RESULTS From 2046 articles identified, we included 97 studies (62 reports and 35 ongoing studies): 25 randomized controlled studies, 7 non-randomized comparative studies, 64 prospective cohorts and 1 case series. Among the 32 comparative studies included, 21 used a parallel-group design. The 11 other studies used different designs such as cross-over, randomized placebo phase, delayed-start, within-person, or challenge-dechallenge-rechallenge or used a historical control group or an observational run-in period. CONCLUSIONS Our systematic literature search highlights the lack of randomized control trials in superficial vascular anomalies due to the rarity of patients and their heterogeneity. New designs are emerging and can overcome the limitations of testing treatments in parallel groups.
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Affiliation(s)
- Aude Allemang-Trivalle
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France.
- INSERM CIC1415, CHRU de Tours, Tours, France.
| | - Sophie Leducq
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), CHRU de Tours, Tours, France
| | - Annabel Maruani
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- INSERM CIC1415, CHRU de Tours, Tours, France
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), CHRU de Tours, Tours, France
| | - Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- INSERM CIC1415, CHRU de Tours, Tours, France
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Amorin-Woods LG, Woods BL, Mullings BL, Vindigni D, Losco BE. Future Research by the Australian Chiropractic Profession: Analysis of Comments and Suggestions From a Nationwide Survey of Academics and Practitioners. J Manipulative Physiol Ther 2023:S0161-4754(23)00028-3. [PMID: 37422749 DOI: 10.1016/j.jmpt.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 04/13/2023] [Accepted: 05/15/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The purpose of this study was to identify and compare the research priorities of Australian practicing chiropractors and academics across listed research domains and to seek their views on existing chiropractic research strategies. Concurrent objectives were to gain insight into the perspectives on characteristics of research and solicit ideas and suggestions for future research from both groups. METHODS This study used a mixed-method research design to collect data using an online survey portal. Australian chiropractic academics (n = 220) and practicing chiropractors who were also members of a nationally representative, practice-based research network database (n = 1680) were invited to participate. Data were collected (February 19, 2019, to May 24, 2019). The free-text data were analyzed primarily via semantic coding and verbatim referential units in cases where the category was an exact match for the textual data. Content analyses of the qualitative data were presented in a tabulated and narrative manner as identified domains. Selected representative examples were provided verbatim. RESULTS The response rate for the survey was 44% for full-time equivalent academics, 8% for casuals and part-time chiropractic academics, and 21.5% for Australian Chiropractic Research Network database chiropractic practitioners. Open-text data comprised a narrower focus on musculoskeletal (MSK) conditions and opposition or reservations by academics and some practitioners toward the research agenda of those espousing traditional concepts and terminology. Comments from both groups illustrate the strongly held views that characterize divergent factions of the chiropractic profession. Some practitioners were highly critical of the narrow focus and epistemological paradigm of Australian university-based research, while others were strongly supportive of the traditional focus of the Australian Spinal Research Foundation. Australian academics at the 4 university-based programs held the view that MSK and spinal pain, for which some evidence already exists, should be the priority of future research, building on what is known. Practitioners believed that future research should be directed toward expanded areas such as basic science, younger populations, and non-MSK conditions. Respondents were sharply divided on attitudes toward traditional chiropractic terminology, concepts, and philosophy and the utility of future research on these topics. CONCLUSION Our qualitative findings suggest there is a division in the Australian chiropractic profession regarding research direction and priorities. This divide exists between academics and researchers and within field practitioners. This study highlights the attitudes, opinions, and perceptions of important stakeholder groups, which should be considered by decision-makers when formulating research policy, strategy, and prioritization of funding.
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Affiliation(s)
- Lyndon G Amorin-Woods
- School of Allied Health, Murdoch University Chiropractic Clinic, Perth, Western Australia, Australia.
| | - Beau L Woods
- Australian Chiropractic College, Adelaide, South Australia, Australia; Private practice, Perth, Western Australia, Australia
| | - Benjamin L Mullings
- School of Allied Health, Murdoch University Chiropractic Clinic, Perth, Western Australia, Australia
| | - Dein Vindigni
- School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Barrett E Losco
- School of Allied Health, Murdoch University Chiropractic Clinic, Perth, Western Australia, Australia
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Bradshaw TJ, Huemann Z, Hu J, Rahmim A. A Guide to Cross-Validation for Artificial Intelligence in Medical Imaging. Radiol Artif Intell 2023; 5:e220232. [PMID: 37529208 PMCID: PMC10388213 DOI: 10.1148/ryai.220232] [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: 10/27/2022] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 08/03/2023]
Abstract
Artificial intelligence (AI) is being increasingly used to automate and improve technologies within the field of medical imaging. A critical step in the development of an AI algorithm is estimating its prediction error through cross-validation (CV). The use of CV can help prevent overoptimism in AI algorithms and can mitigate certain biases associated with hyperparameter tuning and algorithm selection. This article introduces the principles of CV and provides a practical guide on the use of CV for AI algorithm development in medical imaging. Different CV techniques are described, as well as their advantages and disadvantages under different scenarios. Common pitfalls in prediction error estimation and guidance on how to avoid them are also discussed. Keywords: Education, Research Design, Technical Aspects, Statistics, Supervised Learning, Convolutional Neural Network (CNN) Supplemental material is available for this article. © RSNA, 2023.
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Emary PC, Stuber KJ, Mbuagbaw L, Oremus M, Nolet PS, Nash JV, Bauman CA, Ciraco C, Couban RJ, Busse JW. Quality of Reporting Using Good Reporting of A Mixed Methods Study Criteria in Chiropractic Mixed Methods Research: A Methodological Review. J Manipulative Physiol Ther 2023; 46:152-161. [PMID: 38142381 DOI: 10.1016/j.jmpt.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/25/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE The purpose of this review was to examine the reporting in chiropractic mixed methods research using Good Reporting of A Mixed Methods Study (GRAMMS) criteria. METHODS In this methodological review, we searched MEDLINE, Embase, CINAHL, and the Index to Chiropractic Literature from the inception of each database to December 31, 2020, for chiropractic studies reporting the use of both qualitative and quantitative methods or mixed qualitative methods. Pairs of reviewers independently screened titles, abstracts, and full-text studies, extracted data, and appraised reporting using the GRAMMS criteria and risk of bias with the Mixed Methods Appraisal Tool (MMAT). Generalized estimating equations were used to explore factors associated with reporting using GRAMMS criteria. RESULTS Of 1040 citations, 55 studies were eligible for review. Thirty-seven of these 55 articles employed either a multistage or convergent mixed methods design, and, on average, 3 of 6 GRAMMS items were reported among included studies. We found a strong positive correlation in scores between the GRAMMS and MMAT instruments (r = 0.78; 95% CI, 0.66-0.87). In our adjusted analysis, publications in journals indexed in Web of Science (adjusted odds ratio = 2.71; 95% CI, 1.48-4.95) were associated with higher reporting using GRAMMS criteria. Three of the 55 studies fully adhered to all 6 GRAMMS criteria, 4 studies adhered to 5 criteria, 10 studies adhered to 4 criteria, and the remaining 38 adhered to 3 criteria or fewer. CONCLUSION Our findings suggest that reporting in chiropractic mixed methods research using GRAMMS criteria was poor, particularly among studies with a higher risk of bias.
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Affiliation(s)
- Peter C Emary
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada; Chiropractic Department, D'Youville University, Buffalo, New York; Private practice, Langs Community Health Centre, Cambridge, Ontario, Canada.
| | - Kent J Stuber
- Parker University Research Center, Parker University, Dallas, Texas; Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Lawrence Mbuagbaw
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada; Centre for the Development of Best Practices in Health, Yaundé, Cameroon; Division of Global Health, Stellenbosch University, Stellenbosch, South Africa; Division of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Mark Oremus
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Paul S Nolet
- Care and Public Health Research Institute (CAPHRI) School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Jennifer V Nash
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Craig A Bauman
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
| | | | - Rachel J Couban
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
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11
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Johnson CD, Green BN. Education Descriptive Reports: How to Publish Pragmatic Studies in Education. J Chiropr Humanit 2022; 29:15-21. [PMID: 35935806 PMCID: PMC9344319 DOI: 10.1016/j.echu.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The purpose of this article is to describe the contents of an education descriptive report and to provide a useful publication format for educators in the health professions. DISCUSSION The education descriptive report is a pragmatic, empirical study that can contribute to the literature. Education descriptive reports describe an event or situation in an education setting, the resulting outcomes, and what new information can be learned. These reports may use quantitative, qualitative, or mixed methods and may be from organizational, academic, instructional, programmatic, or other educational perspectives. CONCLUSION The education descriptive report gives educators in the health professions a mechanism to introduce their scholarly efforts and observations in education environments in a manner that is consistent with the academic literature. This article describes the structure of an education descriptive report and includes a helpful template for academic authors to develop their own report so they may publish observational, reflective, and hypothesis-generating articles.
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12
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Fink MA, Kades K, Bischoff A, Moll M, Schnell M, Küchler M, Köhler G, Sellner J, Heussel CP, Kauczor HU, Schlemmer HP, Maier-Hein K, Weber TF, Kleesiek J. Deep Learning-based Assessment of Oncologic Outcomes from Natural Language Processing of Structured Radiology Reports. Radiol Artif Intell 2022; 4:e220055. [PMID: 36204531 PMCID: PMC9530771 DOI: 10.1148/ryai.220055] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/20/2022] [Accepted: 07/07/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE To train a deep natural language processing (NLP) model, using data mined structured oncology reports (SOR), for rapid tumor response category (TRC) classification from free-text oncology reports (FTOR) and to compare its performance with human readers and conventional NLP algorithms. MATERIALS AND METHODS In this retrospective study, databases of three independent radiology departments were queried for SOR and FTOR dated from March 2018 to August 2021. An automated data mining and curation pipeline was developed to extract Response Evaluation Criteria in Solid Tumors-related TRCs for SOR for ground truth definition. The deep NLP bidirectional encoder representations from transformers (BERT) model and three feature-rich algorithms were trained on SOR to predict TRCs in FTOR. Models' F1 scores were compared against scores of radiologists, medical students, and radiology technologist students. Lexical and semantic analyses were conducted to investigate human and model performance on FTOR. RESULTS Oncologic findings and TRCs were accurately mined from 9653 of 12 833 (75.2%) queried SOR, yielding oncology reports from 10 455 patients (mean age, 60 years ± 14 [SD]; 5303 women) who met inclusion criteria. On 802 FTOR in the test set, BERT achieved better TRC classification results (F1, 0.70; 95% CI: 0.68, 0.73) than the best-performing reference linear support vector classifier (F1, 0.63; 95% CI: 0.61, 0.66) and technologist students (F1, 0.65; 95% CI: 0.63, 0.67), had similar performance to medical students (F1, 0.73; 95% CI: 0.72, 0.75), but was inferior to radiologists (F1, 0.79; 95% CI: 0.78, 0.81). Lexical complexity and semantic ambiguities in FTOR influenced human and model performance, revealing maximum F1 score drops of -0.17 and -0.19, respectively. CONCLUSION The developed deep NLP model reached the performance level of medical students but not radiologists in curating oncologic outcomes from radiology FTOR.Keywords: Neural Networks, Computer Applications-Detection/Diagnosis, Oncology, Research Design, Staging, Tumor Response, Comparative Studies, Decision Analysis, Experimental Investigations, Observer Performance, Outcomes Analysis Supplemental material is available for this article. © RSNA, 2022.
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13
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Habibzadeh F, Habibzadeh P, Yadollahie M. On Measuring Vaccine Effectiveness with Observational Study Designs. Acta Med Acad 2022; 51:134-146. [PMID: 36318007 PMCID: PMC9982864 DOI: 10.5644/ama2006-124.383] [Citation(s) in RCA: 4] [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] [Received: 07/02/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022] Open
Abstract
Herein, we present a bird's eye view of common observational study designs utilized for measurement of vaccine effectiveness. Assessing vaccines effectiveness is an integral part of vaccine research, particularly for the newly developed vaccines. A cohort study is prospective, directing from an exposure to one or more outcomes. The design is the best method to ascertain the attack rate of an infectious disease. A traditional case-control study is retrospective, directing from a given outcome to one or more exposures. The design cannot provide the relative risk, but it can provide the odds ratio, which is a good estimation of the relative risk when the attack rate is low. Critically depending on laboratory test results and performance, the test-negative case-control study design is another type of observational study commonly used nowadays for the evaluation of the vaccine effectiveness. Comparing to cohort and traditional case-control designs, conducting a test-negative case-control study is relatively cheaper and faster. Herein, we describe each of the above-mentioned study designs through examples generated by a Monte-Carlo simulation program assuming real-world conditions. CONCLUSION: The simulation shows that regardless of the study design employed, the diagnostic test specificity is of utmost importance in providing a valid estimate of the vaccine effectiveness.
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Affiliation(s)
| | - Parham Habibzadeh
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
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14
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Mott A, McDaid C, Hewitt C, Kirkham JJ. Interventions for improving the design and conduct of scientific research: A scoping review protocol. NIHR Open Res 2022; 2:4. [PMID: 37881299 PMCID: PMC10593266 DOI: 10.3310/nihropenres.13252.2] [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] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 10/27/2023]
Abstract
Background Research waste is prevalent in many scientific fields despite a number of initiatives to improve research practices. Interventions to improve practice are often implemented without evaluating their effectiveness. It is therefore important to identify the interventions that have been evaluated, assess how they have been evaluated and to identify areas where further research is required. Objectives A scoping review will be undertaken to assess what interventions, aimed at researchers or research teams, to improve research design and conduct have been evaluated. This review will also consider when in the research pathway these interventions are implemented; what aspects of research design or conduct are being targeted; and who is implementing these interventions. Methods Interventions which aim to improve the design or conduct of research will be eligible for inclusion. The review will not include interventions aimed at hypothetical research projects or interventions implemented without evaluation.The following sources will be searched: MEDLINE, EMBASE, ERIC, HMIC, EconLit, Social Policy and Practice, ProQuest theses, and MetaArXiv. Hand searching of references and citations of included studies will also be undertaken. Searches will be limited to articles published in the last 10 years.Data extraction will be completed using a data extraction template developed for this review. Results will be tabulated by type of intervention, research stage, and outcome. A narrative review will also be provided addressing each of the objectives.
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Affiliation(s)
- Andrew Mott
- York Trials Unit, University of York, UK, York, North Yorkshire, YO10 5DD, UK
| | - Catriona McDaid
- York Trials Unit, University of York, UK, York, North Yorkshire, YO10 5DD, UK
| | - Catherine Hewitt
- York Trials Unit, University of York, UK, York, North Yorkshire, YO10 5DD, UK
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester, Manchester, M13 9PL, UK
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15
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Affiliation(s)
- Purvi J Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, California, USA
| | - Harriette G C Van Spall
- Department of Medicine, Population Health Research Institute, Research Institute of St. Joseph's, McMaster University, Hamilton, Ontario, Canada
| | - Mamas Mamas
- Keele Cardiovascular Research Institute, Keele University, Stoke-on-Trent, UK
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16
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Remigio-Baker RA, Kiser S, Ferdosi H, Stuessi K, Maxfield-Panker S, Hinds Ii SR. Designing research on concussion treatment in the military setting: Important challenges to consider. Prev Med Rep 2021; 24:101603. [PMID: 34976660 DOI: 10.1016/j.pmedr.2021.101603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/06/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
Traumatic brain injury (TBI) is highly prevalent on a global scale with concussion being the most common of all TBIs. Concussion research on rehabilitation and symptom resolution is well-established, particularly among athletes, but less is known about the recovery of active duty service members (ADSMs). In a population whose occupational environment increases risk for such injury, it is imperative that treatment is optimized to achieve successful rehabilitation. The military setting, however, has challenges that must be accounted for when developing proposals to study the benefits of new interventions or treatment. This review will provide a discussion on those challenges to better understand the considerations that are essential during the developmental phase of concussion studies within the military setting. This review aims to provide investigators novice to the military setting an overview of considerations when researching concussion among ADSMs.
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Zuidgeest MGP, Goetz I, Meinecke AK, Boateng D, Irving EA, van Thiel GJM, Welsing PMJ, Oude-Rengerink K, Grobbee DE, Initiative G. The GetReal Trial Tool: Design, Assess and Discuss Clinical Drug Trials in Light of RWE Generation. J Clin Epidemiol 2021; 149:244-253. [PMID: 34929319 DOI: 10.1016/j.jclinepi.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2021] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
Abstract
Methodologies incorporating Real World Elements into clinical trial design (also called pragmatic trials) offer an attractive opportunity to assess the effect of a treatment strategy in routine care and as such guide decision making in practice. Uptake of these methods is slow for several reasons, including uncertainty about acceptability of trial results, lack of experience with the methodology and operational challenges. We developed the 'Get Real Trial Tool', an easy-to-use interface, which allows users to assess the impact of design choices on generalisability to routine clinical practice, while taking into account risk of bias, precision, acceptability and operational feasibility. The tool is grounded in the scientific literature on pragmatic trials combined with knowledge of experts from academia, pharmaceutical companies, HTA bodies, patient organisations, and regulators. The aim is to help researchers optimise trial design and facilitate translation of evidence from pragmatic trials to clinical practice. In this paper we describe the development, structure and application of the GetReal Trial Tool.
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Affiliation(s)
- Mira G P Zuidgeest
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | | | - Anna-Katharina Meinecke
- Partnerships and IEG Office, Integrated Evidence Generation & Business Innovation, Medical Affairs & Pharmacovigilance, Bayer AG
| | - Daniel Boateng
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elaine A Irving
- Clinical Development, GSK Research & Development Ltd., Stevenage, Hertfordshire, SG1 2NY, UK
| | - Ghislaine J M van Thiel
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Paco M J Welsing
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Rheumatology & Clinical immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Katrien Oude-Rengerink
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Clinical, Zeist, the Netherlands
| | - GetReal Initiative
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Eli Lilly & Co Ltd, Bracknell, UK; Partnerships and IEG Office, Integrated Evidence Generation & Business Innovation, Medical Affairs & Pharmacovigilance, Bayer AG; Clinical Development, GSK Research & Development Ltd., Stevenage, Hertfordshire, SG1 2NY, UK; Department of Rheumatology & Clinical immunology, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Clinical, Zeist, the Netherlands
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18
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Aziz YHA, Heydon SJ, Duffull SB, Marra CA. Are professional pharmacy services being offered for free in pharmacies? A feasibility study exploring the use of a time motion study in New Zealand. Pharm Pract (Granada) 2021; 19:2422. [PMID: 34457095 PMCID: PMC8370204 DOI: 10.18549/pharmpract.2021.3.2422] [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: 05/02/2021] [Accepted: 07/11/2021] [Indexed: 11/14/2022] Open
Abstract
Background Pharmacists report to be providing patient-focused clinical services for which they receive no remuneration. Limited literature exists about unfunded services leading to difficulties in ascertaining an appropriate study design for such research. Objective This study aims to assess the appropriateness of a proposed study design before launching a nationwide study to investigate the provision of unfunded patient care services. Methods A multi-methods approach was utilised consisting of (1) continuous time motion study in community pharmacies (2) semi structured patient interviews (3) patient follow up (4) semi structured interviews with pharmacy owners/managers. All observations of unfunded patient care services were recorded, numerically coded and descriptively analysed. Semi structured interviews were audio recorded and transcribed verbatim. A semantic thematic analysis was carried out. Appropriateness of study design was dictated by the ability to characterise services and obtain patient perceptions. Results Ten pharmacies took part in the feasibility study, across the city of Dunedin, New Zealand, representing a range of different practice settings and demographics. Ten patients were interviewed and six responded to follow up. Both pharmacy and patient recruitment proved challenging due to concerns around disruption to workflow and patient privacy. A continuous observation time motion study was found to be appropriate as it minimises disruption to workflow with no additional work required from the pharmacy teams. Conclusions A continuous observation time motion study proved to be an appropriate method to investigate the provision of unfunded services on a national scale. The findings of the study suggest design changes such as length of observation time, increasing patient recruitment and additional patient questions to enhance the nationwide study.
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Affiliation(s)
- Yasmin H Abdul Aziz
- BPharm, PGCertPharm, PhD. School of Pharmacy, University of Otago. Dunedin (New Zealand).
| | - Susan J Heydon
- BA(Hons), MA, PhD, DHMSA. Senior Lecturer. School of Pharmacy, University of Otago. Dunedin (New Zealand).
| | - Stephen B Duffull
- DipPharm(CIT) MPharm, PhD, FNZCP, FISOP, MPS, RegPharmNZ. Professor. School of Pharmacy, University of Otago. Dunedin (New Zealand).
| | - Carlo A Marra
- BSc(Pharm) PharmD, PhD. Professor and Dean. School of Pharmacy, University of Otago. Dunedin (New Zealand).
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19
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Phillips WR, Sturgiss E, Yang A, Glasziou P, Olde Hartman T, Orkin A, Russell GM, van Weel C. Clinician Use of Primary Care Research Reports. J Am Board Fam Med 2021; 34:648-60. [PMID: 34088824 DOI: 10.3122/jabfm.2021.03.200436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess how primary care practitioners use reports of general health care (GHC) and primary care (PC) research and how well reports deliver what they need to inform clinical practice. METHODS International, interprofessional online survey, 2019, of primary care clinicians who see patients at least half time. Respondents used frequency scales to report how often they access both GHC and PC research and how frequently reports meet needs. Free-text short comments recorded comments and suggestions. RESULTS Survey yielded 252 respondents across 29 nations, 55% (121) women, including 88% (195) physicians, nurses 5% (11), and physician assistants 3% (7). Practitioners read research reports frequently but find they usually fail to meet their needs. For PC research, 33% (77) accessed original reports in academic journals weekly or daily, and 36% found reports meet needs "frequently" or "always." They access reports of GHC research slightly more often but find them somewhat less useful. CONCLUSIONS PC practitioners access original research in academic journals frequently but find reports meet information needs less than half the time. PC research reflects the unique PC setting and so reporting has distinct focus, needs, and challenges. Practitioners desire improved reporting of study context, interventions, relationships, generalizability, and implementation.
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20
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AminiLari M, Ashoorian V, Caldwell A, Rahman Y, Nieuwlaat R, Busse JW, Mbuagbaw L. The quality of subgroup analyses in chronic pain randomized controlled trials: a methodological review. Korean J Pain 2021; 34:139-155. [PMID: 33785666 PMCID: PMC8019964 DOI: 10.3344/kjp.2021.34.2.139] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 11/05/2022] Open
Abstract
The quality of subgroup analyses (SGAs) in chronic non-cancer pain trials is uncertain. The purpose of this study was to address this issue. We conducted a comprehensive search in MEDLINE and EMBASE from January 2012 to September 2018 to identify eligible trials. Two pairs of reviewers assessed the quality of the SGAs and the credibility of subgroup claims using the 10 criteria developed by Sun et al. in 2012. The associations between the quality of the SGAs and the studies' characteristics including risk of bias, funding sources, sample size, and the latest impact factor, were assessed using multivariable logistic regression. Our search retrieved 3,401 articles of which 66 were eligible. The total number of SGAs was 177 of which 52 (29.4%) made a subgroup claim. Of these, only 15 (8.5%) were evaluated as being of high quality. Among the 30 SGAs that claimed subgroup effects using an appropriate method of performing interaction tests, the credibility of only 5 were assessed as high. None of the subgroup claims met all the credibility criteria. No significant association was found between the quality of SGAs and the studies' characteristics. The quality of the SGAs performed in chronic pain trials was poor. To enhance the quality of SGAs, scholars should consider the developed criteria when designing and conducting trials, particularly those which need to be specified a priori .
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Affiliation(s)
- Mahmood AminiLari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Vahid Ashoorian
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Alexa Caldwell
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Yasir Rahman
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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21
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Abstract
The era of the coronavirus disease 2019 (COVID-19) pandemic has led to fundamental shifts in research, ethics, and peer review including reframing of the research design, adapting methodologies to the study type, transitioning of research mechanics, changing research methodologies, overcoming data collection and standardization constraints, upholding research standards and ethics, maintaining informativeness and social value, and providing guarded peer review flexibility. Indeed, the COVID-19 crisis, despite disrupting research worldwide to an unprecedented degree, has also become a catalyst to develop strategies of adaptation to this disruption. As the COVID-19 pandemic continuous to evolve, new, cost-effective, and highly flexible research models need to be developed. Planning is crucial for ensuring short-term and long-term contingency funds to support research logistics and personnel. A mental shift must accompany changes in methodologies to mentor and support researchers who are vital to the continuity of high-caliber research in the long term. A global research perspective through interinstitutional and interprofessional collaboration will sustain adherence to the highest standards of data collection and research reporting.
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Affiliation(s)
- Edward Barroga
- Department of General Education, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan.
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22
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Andraws Yalda F, Clarkson RJ, Davies J, Rout PGJ, Sengupta A, Horner K. Does anthropomorphic model design in ex vivo studies affect diagnostic accuracy for dental root fracture using CBCT? Dentomaxillofac Radiol 2020; 49:20200093. [PMID: 32479121 PMCID: PMC7549528 DOI: 10.1259/dmfr.20200093] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/03/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The evidence for diagnostic accuracy using cone beam computed tomography (CBCT) for dental applications depends heavily on ex vivo research, but there is little knowledge of whether the model used affects the diagnostic accuracy results. The objective of this study was to determine the impact of different designs of anthropomorphic models on diagnostic accuracy for the specific task of dental root fracture detection. METHODS Horizontal or oblique root fracture was induced in 24 of 48 permanent maxillary incisors. The 48 teeth were scanned by CBCT using standard clinical exposure factors on five occasions, each with a different model design. Scans were viewed by five dental and maxillofacial radiologists, who each made a forced diagnosis of fracture or no fracture in each root and a judgment on root fracture using a five-point confidence scale. Sensitivity (Se), specificity (Sp) and areas under receiver operating characteristic (ROC) curve (Az) were calculated for each observer for each model. RESULTS There were no significant differences between the diagnostic accuracy measurements recorded using different models. There were, however, numerous significant differences between observers using the same anthropomorphic model. CONCLUSIONS Despite the differences in X-ray attenuation between the five model designs, the results suggest that the anthropomorphic model does not affect the results of diagnostic accuracy studies on root fracture using this CBCT machine at standard clinical exposures. This provides some confidence in the previously published evidence. The interobserver diagnosis differences indicate that research using only two observers could provide misleading results.
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Affiliation(s)
| | - Rosalyn J Clarkson
- Department of Radiology, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU, UK
| | - Jonathan Davies
- Department of Dental Radiological Imaging, Guy's and St Thomas' NHS Foundation Trust, Floor 23, Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Peter G J Rout
- Birmingham Dental Hospital, Birmingham Community Healthcare Foundation NHS Trust, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| | - Anita Sengupta
- Division of Dentistry, School of Medical Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9PL, UK
| | - Keith Horner
- Division of Dentistry, School of Medical Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9PL, UK
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Kim S, Kim MS, You SH, Jung SY. Conducting and Reporting a Clinical Research Using Korean Healthcare Claims Database. Korean J Fam Med 2020; 41:146-152. [PMID: 32456382 PMCID: PMC7272364 DOI: 10.4082/kjfm.20.0062] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/30/2020] [Indexed: 01/09/2023] Open
Abstract
An increasing number of studies are using healthcare claims databases to assess healthcare intervention utilization patterns or outcomes in real-world clinical settings. However, methodological issues affecting study design or data analysis can make conducting and reporting these types of studies difficult. This review presents an overview of the types of information contained in claims data, describes some advantages and limitations of using claims data for research purposes, and outlines steps for utilizing the Korea Health Insurance Review and Assessment and National Health Insurance Service databases. The study also reviews epidemiological approaches utilizing healthcare claims databases (including cross-sectional, case-control, case-crossover, and cohort designs) with respect to protocol development, analysis, and reporting of results, and introduces relevant guidelines and checklists, including the Guidelines for Good Pharmacoepidemiology Practices, the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and the Risk of Bias in Nonrandomized Studies of Interventions tool.
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Affiliation(s)
- Seonji Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myo-Song Kim
- College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Seung-Hun You
- College of Pharmacy, Chung-Ang University, Seoul, Korea
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Abstract
This is the first question one should consider before submitting a paper to an
international journal. The answer is simple: If researchers or practitioners
from another country can learn something from your paper that can influence a
practice or a research they are involved in, then your paper is relevant for an
international audience. There are many elements that can influence in this
cross-border transferability. One could think that having a big
“n”, or performing complex statistical calculations, or using
complicated study designs makes the paper more attractive to colleagues from
other countries. These elements can help, but they are not sufficient. On the
other hand, one could think that a study performed in a small hospital in a
given country will never be of interest for these foreign colleagues. That is
not necessarily correct. Let’s burst some myths.
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Affiliation(s)
- Fernando Fernandez-Llimos
- PhD, MPharm, MBA. Editor-in-chief, Pharmacy Practice. Laboratory of Pharmacology, Department of Drug Sciences, College of Pharmacy, University of Porto. Porto (Portugal)
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Shoaf SE, Ouyang J, Sergeyeva O, Estilo A, Li H, Leung D. A Post Hoc Analysis of Statin Use in Tolvaptan Autosomal Dominant Polycystic Kidney Disease Pivotal Trials. Clin J Am Soc Nephrol 2020; 15:643-650. [PMID: 32241780 PMCID: PMC7269222 DOI: 10.2215/cjn.08170719] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/26/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Tolvaptan is approved to slow kidney function decline in adults with autosomal dominant polycystic kidney disease (ADPKD) at risk of rapid progression. Because in vitro studies indicated that the tolvaptan oxobutyric acid metabolite inhibits organic anion-transporting polypeptide (OATP)1B1 and OATP1B3, United States prescribing information advises avoiding concurrent use with OATP1B1/1B3 substrates, including hepatic hydroxymethyl glutaryl-CoA reductase inhibitors (statins). This post hoc analysis of the pivotal phase 3 tolvaptan trials (Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes [TEMPO] 3:4 trial [NCT00428948] and Replicating Evidence of Preserved Renal Function: an Investigation of Tolvaptan Safety and Efficacy in ADPKD [REPRISE] trial [NCT02160145]) examined the safety of concurrent tolvaptan/statin use. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The trials randomized a combined total of 2815 subjects with early- to late-stage ADPKD to tolvaptan (n=1644) or placebo (n=1171) for 3 years (TEMPO 3:4) and 1 year (REPRISE). Statin use was unrestricted, and 597 subjects (21.2% overall; 332 [20.2%] tolvaptan, 265 [22.6%] placebo) received statins. Statin use (duration, dose change, statin change, permanent discontinuation), incidences of statin-related adverse events, and hepatic transaminase elevations were determined for subjects who received tolvaptan+statin, placebo+statin, tolvaptan alone, and placebo alone. RESULTS No differences in statin use parameters between tolvaptan- and placebo-treated subjects were observed. No statistically significant increases in commonly reported statin-related adverse events (e.g., musculoskeletal disorders, gastrointestinal symptoms) were seen between subjects receiving tolvaptan+statin and placebo+statin. For example, in TEMPO 3:4, frequencies were 5.4% and 7.8%, respectively, for myalgia (difference -2.4%; 95% confidence interval, -11.2% to 6.4%) and 9.3% and 7.8%, respectively, for abdominal pain (difference 1.5%; -7.9% to 10.9%). In an analysis that excluded participants concurrently using allopurinol, the frequency of alanine transaminase or aspartate transaminase >3× upper limit of normal in the pooled study populations was 3.6% for the tolvaptan+statin group and 2.3% for the placebo+statin group (difference 1.4%; -2.0% to 4.7%). CONCLUSIONS Tolvaptan has been used safely in combination with statins in clinical trials. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_04_06_CJN.08170719.mp3.
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Affiliation(s)
- Susan E Shoaf
- Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland
| | - John Ouyang
- Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland
| | - Olga Sergeyeva
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey
| | - Alvin Estilo
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey
| | - Hui Li
- Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland
| | - Deborah Leung
- Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland
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Pelayo S, Schiro J, Gautier PF, Jaulent MC, Marcilly R. User Driven Design: First Step in Involving Healthcare Consumers and Clinicians in Developing a Collaborative Platform to Prevent Cardiovascular Diseases. Stud Health Technol Inform 2019; 264:1313-1317. [PMID: 31438138 DOI: 10.3233/shti190439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To prevent cardiovascular diseases, eHealth solutions may be used as tools, involving health care consumers in the set-up of their prevention plan, a fundamental condition for improving their long-term adherence to the plan. This paper presents the first step in a web platform design aiming to support the co-elaboration by health care consumers and clinicians of personalized prevention plans. Applying a user driven innovation approach, first, a questionnaire and semi-structured interviews were combined to identify clinicians' needs. Then, three focus group sessions with consumers and clinicians were organized to identify their needs, creating the system workflows, its graphical user interface, and its navigation paths, with the best ideas shaped by paper mockups. An interactive mockup was designed including 30 screens (ex. user dashboards, desk for co-elaborating plan). This user driven approach enabled to design not only the technology and its graphical user interface, but also a prevention plan design process.
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Affiliation(s)
- Sylvia Pelayo
- Univ. Lille, INSERM, CHU Lille, CIC-IT/Evalab 1403 - Centre d'Investigation Clinique, EA 2694, F-59000 Lille, France
| | - Jessica Schiro
- Univ. Lille, INSERM, CHU Lille, CIC-IT/Evalab 1403 - Centre d'Investigation Clinique, EA 2694, F-59000 Lille, France
| | - Pierre-François Gautier
- Univ. Lille, INSERM, CHU Lille, CIC-IT/Evalab 1403 - Centre d'Investigation Clinique, EA 2694, F-59000 Lille, France
| | | | - Romaric Marcilly
- Univ. Lille, INSERM, CHU Lille, CIC-IT/Evalab 1403 - Centre d'Investigation Clinique, EA 2694, F-59000 Lille, France
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Fosser SM, Kamozin A, McDonald EG, Tamblyn R, Lee TC. The Opportunities and Challenges of Pragmatic Randomized Trials Using a Specialized Software: CloudTrials Project. Stud Health Technol Inform 2019; 264:1544-1545. [PMID: 31438223 DOI: 10.3233/shti190526] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pragmatic randomized trials are essential to improve knowledge of real world clinical practice. Pragmatic trials design reflect routine clinical care, which have advantages to initiate and conduct, compared to classical clinical trials. Trials help to: engage bedside clinicians, increase efficiency of patient recruitment and follow up, minimize loss to follow up and include technological patient reported outcomes. The objective is to describe the opportunities and challenges designing a specialized software to administrate pragmatic randomized trials.
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Affiliation(s)
| | - Andrey Kamozin
- Department of Medicine, McGill University, Montréal, Canada
| | | | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, McGill University, Montréal, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
| | - Todd Campbell Lee
- Clinical and Health Informatics Research Group, McGill University, Montréal, Canada.,Department of Medicine, McGill University, Montréal, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
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Asimakopoulos P, Charalampidis G, Chakravarthy KM, Mamais C. Ten years of ENT Scotland meetings: an appraisal of the publication rates of trainee-presented scientific papers. J Laryngol Otol 2019; 133:526-9. [PMID: 31155013 DOI: 10.1017/S0022215119001075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The ENT Scotland society (formerly known as the Scottish Otolaryngological Society) has two meetings a year and accepts oral presentations from trainees. This study aimed to identify publication rates from these meetings. METHODS Abstracts of the presentations are published in The Journal of Laryngology and Otology. A structured search on PubMed and Google Scholar was undertaken to identify which presentations from the 2005 to 2014 meetings have been published. RESULTS Of the 145 abstracts found, 60.7 per cent were presenting clinical research and 44.1 per cent were related to the head and neck subspecialty. Seventy-three abstracts (50.3 per cent) were associated with publication as a peer-reviewed article; otology papers were more likely to be published than those focusing on other subspecialties (64.3 per cent, p = 0.036). No correlation was found between publication and other factors. CONCLUSION Presentations at the ENT Scotland meetings undergo unbiased peer review and are as likely to be published as those of other conferences.
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Gomez N, Alves M. [Letter to the Editor Regarding the Article: "Stages for Undertaking a Systematic Review"]. ACTA MEDICA PORT 2019; 32:411. [PMID: 31166907 DOI: 10.20344/amp.12263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Nayive Gomez
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Mariana Alves
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar Lisboa Norte. Lisboa. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
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Abstract
There has been an increase in the use of systematic review as a research methodology to compile and analyze large datasets of existing studies. With this increase, the recommendations to conduct this type of research also increased. The aim of this article is to provide a guide for understanding and/or undertaking a systematic review for publication across all stages of the review process. When doing a systematic review of the literature the authors become knowledgeable of the subject and, although time-consuming, they can develop a set of skills including literature research and scientific writing. A systematic review, compared to primary research, requires relatively few resources, allowing clinicians not normally involved in research to produce clinically relevant, high-quality articles.
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Affiliation(s)
- Helena Donato
- Serviço de Documentação. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Mariana Donato
- Serviço de Otorrinolaringologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal
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Abstract
BACKGROUND The prevalence, incidence, and mortality rates of tuberculosis (TB) have declined steadily in Korea since 1965. This study aimed to identify the characteristics and provide quantitative analysis of published medical literatures on TB written by researchers based in Korea. METHODS We conducted a systematic literature search via the Web of Science database for articles in Science Citation Index (Expanded) journals, on TB, and published by researchers based in Korea, from inception to 2017. All articles were analyzed by publication year, publishing journal, article type, study design, research institutes, and research funds. RESULTS During the study period, we identified 1,101 articles and included them for analysis. The first was published in 1979, while 105 were published in 2017. Between 1979 and 2017, the compound annual growth rate of TB articles by researchers based in Korea was 13.0%. Among 1,101 articles, 682 (61.9%) were clinical research and 383 (34.8%) were basic research. Studies with cross-sectional design were the most common type among the clinical research, while biochemistry was the most common field among the basic research. The number of articles dealing with diagnostics or treatment has increased significantly, although the number of articles on vaccines, and on operational and public health, has only a slight increase. The Ministry of Health and Welfare of Korea funded studies yielding 178 (20.1%) articles. CONCLUSION Articles on TB, especially those on clinical aspects, and published by researchers based in Korea have been increasing rapidly since 1979.
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Affiliation(s)
- Hyun Woo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Affiliation(s)
- Paula Midori Castelo
- Department of Pharmaceutical Sciences, Federal University of São Paulo (UNIFESP), Brazil
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Lee JH, Jo KW, Shim TS. Correlation between GenoType MTBDR plus Assay and Phenotypic Susceptibility Test for Prothionamide in Patients with Genotypic Isoniazid Resistance. Tuberc Respir Dis (Seoul) 2018; 82:143-150. [PMID: 30302956 PMCID: PMC6435929 DOI: 10.4046/trd.2018.0027] [Citation(s) in RCA: 2] [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: 03/28/2018] [Revised: 04/28/2018] [Accepted: 06/25/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The purpose of this study was to analyze the relationship between the gene mutation patterns by the GenoType MTBDRplus (MTBDRplus) assay and the phenotypic drug susceptibility test (pDST) results of isoniazid (INH) and prothionamide (Pto). METHODS A total of 206 patients whose MTBDRplus assay results revealed katG or inhA mutations were enrolled in the study. The pDST results were compared to mutation patterns on the MTBDRplus assay. RESULTS The katG and inhA mutations were identified in 68.0% and 35.0% of patients, respectively. Among the 134 isolated katG mutations, three (2.2%), 127 (94.8%) and 11 (8.2%) were phenotypically resistant to low-level INH, high-level INH, and Pto, respectively. Among the 66 isolated inhA mutations, 34 (51.5%), 18 (27.3%) and 21 (31.8%) were phenotypically resistant to low-level INH, high-level INH, and Pto, respectively. Of the 34 phenotypic Pto resistant isolates, 21 (61.8%), 11 (32.4%), and two (5.9%) had inhA, katG, and both gene mutations. CONCLUSION It is noted that Pto may still be selected as one of the appropriate multidrug-resistant tuberculosis regimen, although inhA mutation is detected by the MTBDRplus assay until pDST confirms a Pto resistance. The reporting of detailed mutation patterns of the MTBDRplus assay may be important for clinical practice, rather than simply presenting resistance or susceptibility test results.
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Affiliation(s)
- Joo Hee Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Wook Jo
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Sun Shim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Abstract
Currently, numerous papers are published reporting analysis of biological data at different omics levels by making statistical
inferences. Of note, many studies, as those published in this Journal, report association of gene(s) at the genomic and
transcriptomic levels by undertaking appropriate statistical tests. For instance, genotype, allele or haplotype frequencies at
the genomic level or normalized expression levels at the transcriptomic level are compared between the case and control
groups using the Chi-square/Fisher’s exact test or independent (i.e. two-sampled) t-test respectively, with this culminating into
a single numeric, namely the P value (or the degree of the false positive rate), which is used to make or break the outcome of
the association test. This approach has flaws but nevertheless remains a standard and convenient approach in association
studies. However, what becomes a critical issue is that the same cut-off is used when ‘multiple’ tests are undertaken on the
same case-control (or any pairwise) comparison. Here, in brevity, we present what the P value represents, and why and when
it should be adjusted. We also show, with worked examples, how to adjust P values for multiple testing in the R environment
for statistical computing (http://www.R-project.org).
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Affiliation(s)
- Mohieddin Jafari
- Drug Design and Bioinformatics Unit, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Naser Ansari-Pour
- Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran. Electronic Address:
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Wortel RC, Incrocci L, Mulhall JP. Reporting Erectile Function Outcomes After Radiation Therapy for Prostate Cancer: Challenges in Data Interpretation. J Sex Med 2018; 14:1260-1269. [PMID: 28965787 DOI: 10.1016/j.jsxm.2017.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 07/15/2017] [Accepted: 08/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Choice of prostate cancer treatment is frequently influenced by the expected chance of treatment-induced side effects such as erectile dysfunction (ED). However, great discrepancy in cited ED rates exists in the contemporary radiation therapy literature. AIM To analyze the reported ED rates and cause of discrepancies and explore the strengths and limitations in the literature on radiation-induced ED. METHODS We performed a PubMed literature search and reviewed the literature on ED rates associated with external-beam radiotherapy and brachytherapy from the past 10 years. Eighteen studies were eligible for inclusion and subsequently reviewed. OUTCOMES Variables required for interpretation of erectile function outcomes, including patient demographics, treatment characteristics, and sexual function outcomes. RESULTS A large variety in the reported incidence of ED was found among studies. In part, these differences resulted from large variations in (i) study populations, (ii) patient characteristics, (iii) treatment characteristics, (iv) prescription of androgen deprivation therapy, (v) means of data acquisition, (vi) definitions of ED, (vii) temporal considerations, and (viii) erectile aid use. Relevant data required for adequate appraisal of sexual function outcomes were not always reported. CLINICAL IMPLICATIONS Based on the present findings, we present general recommendations for reporting of erectile function outcomes after radiotherapy for prostate cancer. These should improve future reports. STRENGTHS AND LIMITATIONS This is the first report that presents general requirements on reporting erectile function outcomes in the setting of radiotherapy for prostate cancer. We did not conduct a formal meta-analysis because we focused on concepts of research design; this might be considered a limitation. CONCLUSION In this review, we have highlighted the strengths and deficiencies of the current literature on ED after external-beam radiotherapy and brachytherapy for prostate cancer. We have made general recommendations to achieve some degree of standardization among reports and improve clinical interpretability. Wortel RC, Incrocci L, Muhall JP. Reporting Erectile Function Outcomes After Radiation Therapy for Prostate Cancer: Challenges in Data Interpretation. J Sex Med 2017;14:1260-1269.
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Affiliation(s)
- Ruud C Wortel
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands; Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - John P Mulhall
- Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Abstract
Treatment research studies employ criteria that determine which patients are eligible to participate and which are not. When such exclusion criteria produce a treatment research sample that is a small and unrepresentative subset of all patients with a particular disease, clinicians may be hesitant to apply the research results in front-line clinical practice. Accordingly, the present paper reviews the English-language literature on exclusion criteria in schizophrenia treatment research and draws initial conclusions about their impact. Empirically derived estimates of the rate of exclusion vary widely (31.0-98.2%), but the best available evidence suggests that about 4 in 5 patients with schizophrenia would be ineligible to enroll in a typical treatment research study. Women are particularly likely to be excluded from schizophrenia treatment research, which is problematic from both a clinical and social justice viewpoint. Excluded patients also tend to be older than eligible patients, and, though it has been examined in only a few studies, they also tend to have more severe problems at baseline and different outcomes over time than patients who are allowed to participate in research. More limited use of exclusion criteria in schizophrenia treatment research would be beneficial in terms of increasing generalizability, but would also potentially involve costs, particularly a need for larger samples. More modest steps that would improve treatment outcome research reports include requiring a full description of the rationale for, and nature of, any exclusion criteria, and, having a designated place in the discussion section which draws attention to the proper scope of generalization.
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Abstract
Writing a research proposal can be a challenging task for young researchers. This article explains how to write a strong research proposal to apply for funding, specifically, a proposal for The Research Council (TRC) of Oman. Three different research proposal application forms are currently used in TRC, including Open Research Grant (ORG), Graduate Research Support Program (GRSP), and Faculty-mentored Undergraduate Research Award Program (FURAP). The application forms are filled and submitted electronically on TRC website. Each of the proposals submitted to TRC is selected through a rigorous reviewing and screening process. Novelty and originality of the research idea is the most crucial element in writing a research proposal. Performing an in-depth review of the literature will assist you to compose a good researchable question and generate a strong hypothesis. The development of a good hypothesis will offer insight into the specific objectives of a study. Research objectives should be focused, measurable, and achievable by a specific time using the most appropriate methodology. Moreover, it is essential to select a proper study design in-line with the purpose of the study and the hypothesis. Furthermore, social/economic impact and reasonable budget of proposed research are important criteria in research proposal evaluation by TRC. Finally, ethical principles should be observed before writing a research proposal involving human or animal subjects.
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Affiliation(s)
- Ahmed Al-Shukaili
- Director of Health and Social Services Sector, The Research Council of Oman, Muscat, Oman
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Duarte J, Serra-Negra JM, Ferreira FM, Paiva SM, Fraiz FC. Agreement between two different approaches to assess parent-reported sleep bruxism in children. Sleep Sci 2017; 10:73-77. [PMID: 28966743 PMCID: PMC5612040 DOI: 10.5935/1984-0063.20170013] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/23/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Parents' report is the most used method for the study of sleep bruxism (SB) in children, especially in research with large samples. However, there is no consensus about the questions used to assess SB, what may difficult the comparisons between studies. OBJECTIVE The aim of this research was to evaluate the agreement between two different approaches to assess possible sleep bruxism (PSB) in children using parents' report. METHODS This cross-sectional study was conducted with 201 parents/caregivers. Prior to the questionnaire completion, all participants received a standard explanation of SB concept. Subsequently, the parents/caregivers answered a general question (GQ) and a frequency-time question (FTQ) about SB, and the answers were compared. RESULTS The majority of the participants were the children's mothers (73%) and the childrens mean age was 7.5 years (SD: 2.25). PSB frequency in children did not differ statistically through the two questions [GQ: 30.7% (CI95%: 24.2 - 37.1) and FTQ: 26.6% (CI95%: 20.4 - 32.8)], and an almost perfect agreement was observed between the answers (kp=0.812). Nevertheless, the FTQ showed a more coherent relation with the factors already recognized as associated with childhood bruxism than GQ. CONCLUSIONS Different approaches result in similar PSB frequency, however, they show different ability to identify PSB associated factors and suggest the need of questions including frequency and time in further studies.
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Affiliation(s)
- Joyce Duarte
- Univerisidade Federal do Paraná, Department Of
Stomatology - Curitiba - Pr - Brazil
| | - Júnia Maria Serra-Negra
- Universidade Federal de Minas Gerais, Department of
Pediatric Dentistry and Orthodontics - Belo Horizonte - MG - Brazil
| | - Fernanda Morais Ferreira
- Universidade Federal de Minas Gerais, Department of
Pediatric Dentistry and Orthodontics - Belo Horizonte - MG - Brazil
| | - Saul Martins Paiva
- Universidade Federal de Minas Gerais, Department of
Pediatric Dentistry and Orthodontics - Belo Horizonte - MG - Brazil
| | - Fabian Calixto Fraiz
- Univerisidade Federal do Paraná, Department Of
Stomatology - Curitiba - Pr - Brazil
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Shaw DL. Is Open Science the Future of Drug Development? Yale J Biol Med 2017; 90:147-151. [PMID: 28356902 PMCID: PMC5369032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Traditional drug development models are widely perceived as opaque and inefficient, with the cost of research and development continuing to rise even as production of new drugs stays constant. Searching for strategies to improve the drug discovery process, the biomedical research field has begun to embrace open strategies. The resulting changes are starting to reshape the industry. Open science-an umbrella term for diverse strategies that seek external input and public engagement-has become an essential tool with researchers, who are increasingly turning to collaboration, crowdsourcing, data sharing, and open sourcing to tackle some of the most pressing problems in medicine. Notable examples of such open drug development include initiatives formed around malaria and tropical disease. Open practices have found their way into the drug discovery process, from target identification and compound screening to clinical trials. This perspective argues that while open science poses some risks-which include the management of collaboration and the protection of proprietary data-these strategies are, in many cases, the more efficient and ethical way to conduct biomedical research.
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Affiliation(s)
- Daniel L. Shaw
- Daniel L. Shaw, BA, Yale School of Medicine, Yale University, 333 Cedar Street, New Haven, CT 06510,
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Laan BJ, Spijkerman IJB, Godfried MH, Pasmooij BC, Maaskant JM, Borgert MJ, Opmeer BC, Vos MC, Geerlings SE. De-implementation strategy to Reduce the Inappropriate use of urinary and intravenous CATheters: study protocol for the RICAT-study. BMC Infect Dis 2017; 17:53. [PMID: 28068924 PMCID: PMC5223587 DOI: 10.1186/s12879-016-2154-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 11/23/2016] [Accepted: 12/22/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients. However, up to 56% of the catheters do not have an appropriate indication and some serious complications with the use of these catheters can occur. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%, and to evaluate the affecting factors of our de-implementation strategy. METHODS In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands. Firstly, we will define a list of appropriate indications for urinary and (peripheral and central) intravenous catheters, which will restrict the use of catheters and urge catheter removal when the indication is no longer appropriate. Secondly, after the baseline measurements, the intervention will take place, which consists of a kick-off meeting, including a competitive feedback report of the baseline measurements, and education of healthcare workers and patients. Additional strategies based on the baseline data and local conditions are optional. The primary endpoint is the percentage of catheters with an inappropriate indication on the day of data collection before and after the de-implementation strategy. Secondary endpoints are catheter-related infections or other complications, catheter re-insertion rate, length of hospital (and ICU) stay and mortality. In addition, the cost-effectiveness of the de-implementation strategy will be calculated. DISCUSSION This study aims to reduce the use of urinary and intravenous catheters with an inappropriate indication, and as a result reduce the catheter-related complications. If (cost-) effective it provides a tool for a nationwide approach to reduce catheter-related infections and other complications. TRIAL REGISTRATION Dutch trial registry: NTR6015 . Registered 9 August 2016.
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Affiliation(s)
- Bart J Laan
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Ingrid J B Spijkerman
- Department of Medical Microbiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Mieke H Godfried
- Department of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Berend C Pasmooij
- Department of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Marjon J Borgert
- Department of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Brent C Opmeer
- Clinical Research Unit, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Margreet C Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Suzanne E Geerlings
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Szekér S, Fogarassy G, Vathy-Fogarassy Á. Comparison of Control Group Generating Methods. Stud Health Technol Inform 2017; 236:311-318. [PMID: 28508812] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Retrospective studies suffer from drawbacks such as selection bias. As the selection of the control group has a significant impact on the evaluation of the results, it is very important to find the proper method to generate the most appropriate control group. In this paper we suggest two nearest neighbors based control group selection methods that aim to achieve good matching between the individuals of case and control groups. The effectiveness of the proposed methods is evaluated by runtime and accuracy tests and the results are compared to the classical stratified sampling method.
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Affiliation(s)
- Szabolcs Szekér
- Department of Computer Science and Systems Technology, University of Pannonia, Hungary
| | | | - Ágnes Vathy-Fogarassy
- Department of Computer Science and Systems Technology, University of Pannonia, Hungary
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Abstract
A threshold probability value of 'p≤0.05' is commonly used in clinical investigations to indicate statistical significance. To allow clinicians to better understand evidence generated by research studies, this review defines the p value, summarizes the historical origins of the p value approach to hypothesis testing, describes various applications of p≤0.05 in the context of clinical research and discusses the emergence of p≤5×10(-8) and other values as thresholds for genomic statistical analyses. Corresponding issues include a conceptual approach of evaluating whether data do not conform to a null hypothesis (ie, no exposure-outcome association). Importantly, and in the historical context of when p≤0.05 was first proposed, the 1-in-20 chance of a false-positive inference (ie, falsely concluding the existence of an exposure-outcome association) was offered only as a suggestion. In current usage, however, p≤0.05 is often misunderstood as a rigid threshold, sometimes with a misguided 'win' (p≤0.05) or 'lose' (p>0.05) approach. Also, in contemporary genomic studies, a threshold of p≤10(-8) has been endorsed as a boundary for statistical significance when analyzing numerous genetic comparisons for each participant. A value of p≤0.05, or other thresholds, should not be employed reflexively to determine whether a clinical research investigation is trustworthy from a scientific perspective. Rather, and in parallel with conceptual issues of validity and generalizability, quantitative results should be interpreted using a combined assessment of strength of association, p values, CIs, and sample size.
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Affiliation(s)
- John Concato
- Clinical Epidemiology Research Center, Cooperative Studies Program, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - John A Hartigan
- Department of Statistics, Yale University, New Haven, Connecticut, USA
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Mallinson T, Lotrecchiano GR, Schwartz LS, Furniss J, Leblanc-Beaudoin T, Lazar D, Falk-Krzesinski HJ. Pilot analysis of the Motivation Assessment for Team Readiness, Integration, and Collaboration (MATRICx) using Rasch analysis. J Investig Med 2016; 64:1186-93. [PMID: 27388617 DOI: 10.1136/jim-2016-000173] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2016] [Indexed: 11/04/2022]
Abstract
Healthcare services and the production of healthcare knowledge are increasingly dependent on highly functioning, multidisciplinary teams, requiring greater awareness of individuals' readiness to collaborate in translational science teams. Yet, there is no comprehensive tool of individual motivations and threats to collaboration that can guide preparation of individuals for work on well-functioning teams. This prospective pilot study evaluated the preliminary psychometric properties of the Motivation Assessment for Team Readiness, Integration, and Collaboration (MATRICx). We examined 55 items of the MATRICx in a sample of 125 faculty, students and researchers, using contemporary psychometric methods (Rasch analysis). We found that the motivator and threat items formed separate constructs relative to collaboration readiness. Further, respondents who identified themselves as inexperienced at working on collaborative projects defined the motivation construct differently from experienced respondents. These results are consistent with differences in strategic alliances described in the literature-for example, inexperienced respondents reflected features of cooperation and coordination, such as concern with sharing information and compatibility of goals. In contrast, the more experienced respondents were concerned with issues that reflected a collective purpose, more typical of collaborative alliances. While these different types of alliances are usually described as representing varying aspects along a continuum, our findings suggest that collaboration might be better thought of as a qualitatively different state than cooperation or coordination. These results need to be replicated in larger samples, but the findings have implications for the development and design of educational interventions that aim to ready scientists and clinicians for greater interdisciplinary work.
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Affiliation(s)
- Trudy Mallinson
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington District of Columbia, USA
| | - Gaetano R Lotrecchiano
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington District of Columbia, USA
| | - Lisa S Schwartz
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington District of Columbia, USA
| | | | | | - Danielle Lazar
- Consulting Solutions at Envision Pharma Group, Philadelphia, Pennsylvania, USA
| | - Holly J Falk-Krzesinski
- Elsevier, Global Academic Relations, New York, New York, USA Northwestern University School of Professional Studies, Chicago, Illinois, USA
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Carlin CS, Flottemesch TJ, Solberg LI, Werner AM. System Transformation in Patient-Centered Medical Home (PCMH): Variable Impact on Chronically Ill Patients' Utilization. J Am Board Fam Med 2016; 29:482-95. [PMID: 27390380 DOI: 10.3122/jabfm.2016.04.150360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/22/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Research connecting patient-centered medical homes (PCMHs) with improved quality and reduced utilization is inconsistent, possibly because individual domains of change, and the stage of change, are not incorporated in the research design. The objective of this study was to examine the association between stage and domain of change and patterns of health care utilization. METHODS This was a cross-sectional observational study that including 87 Minnesota clinics certified as medical homes. Patients included those receiving management for diabetes or cardiovascular disease with insurance coverage by payers participating in the study. PCMH transformation stage was defined by practice systems in place, with measurements summarized in 5 domains. Health care utilization was measured by total utilization, frequency of outpatient visits and prescriptions, and occurrence of inpatient and emergency department visits. RESULTS PCMH transformation was associated with few changes in utilization, but there were important differences by the underlying domains of change. We demonstrate meaningful differences in the impact of PCMH transformation by diagnosis cohort and comorbidity status of the patient. CONCLUSIONS Because the association of health care utilization with PCMH transformation varied by transformation domain and patient diagnosis, practice leaders need to be supported by research incorporating detailed measures of PCMH transformation.
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Colombo CJ, Baer S, Blake L, Bollag WB, Colombo R, Diamond M, George V, Huber L, Merchen L, Miles K, Yang F, Nahman NS. A departmental initiative for clinical and translational research. J Investig Med 2016; 64:1001-5. [PMID: 27073213 DOI: 10.1136/jim-2016-000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/18/2016] [Indexed: 11/04/2022]
Abstract
To encourage departmental research activities, the Department of Medicine of the Medical College of Georgia (MCG) introduced an internally funded Translational Research Program (TRP) in 2014. Patterned after the Vanderbilt Institute for Clinical and Translational Research, the program offers research studios for project guidance, research mentoring and the availability of limited financial support through research vouchers. Additional academic services include abstract reviewing, conducting research conferences, organizing departmental research programs for students, and offering courses in biostatistics. During the first 15 months of its existence, the TRP working group addressed 132 distinct activities. Research mentoring, publications, and the conduct of research studios or voucher approvals encompassed 49% of working group activities. Other academic services constituted the remaining 51%. Twenty-four per cent of TRP committee activities involved research mentoring of 32 investigators (25% faculty and 75% trainees). Mentored projects generated 17 abstracts, 2 manuscripts and $87,000 in funds. The TRP conducted 13 research studios; trainees presented 54%. The TRP reviewed 36 abstracts for local and state organizations. Monthly research conferences and statistical courses were conducted and well attended. Our experience thus far indicates that a departmental TRP may serve to facilitate the growth of patient-oriented research with minimal financial support. It requires active engagement of volunteer faculty and departmental leadership willing to balance research with the other demands of the academic mission.
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Affiliation(s)
- Christopher J Colombo
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA Dwight David Eisenhower Army Medical Center, Fort Gordon, Georgia, USA
| | - Stephanie Baer
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA Charlie Norwood VAMC, Augusta, Georgia, USA
| | - Lindsay Blake
- University Libraries, Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Charlie Norwood VAMC, Augusta, Georgia, USA Department of Physiology, Augusta University, Augusta, Georgia, USA
| | - Rhonda Colombo
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Matthew Diamond
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA Charlie Norwood VAMC, Augusta, Georgia, USA
| | - Varghese George
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia, USA
| | - Lu Huber
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA Charlie Norwood VAMC, Augusta, Georgia, USA
| | - Lee Merchen
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Kathy Miles
- Research Development Services, Augusta University, Augusta, Georgia, USA
| | - Frances Yang
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia, USA
| | - N Stanley Nahman
- Department of Medicine at the Medical College of Georgia, Augusta University, Augusta, Georgia, USA Charlie Norwood VAMC, Augusta, Georgia, USA
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Wendler JJ, Fischbach K, Ricke J, Jürgens J, Fischbach F, Köllermann J, Porsch M, Baumunk D, Schostak M, Liehr UB, Pech M. Irreversible Electroporation (IRE): Standardization of Terminology and Reporting Criteria for Analysis and Comparison. Pol J Radiol 2016; 81:54-64. [PMID: 26966472 PMCID: PMC4760650 DOI: 10.12659/pjr.896034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 09/20/2015] [Accepted: 09/22/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Irreversible electroporation (IRE) as newer ablation modality has been introduced and its clinical niche is under investigation. At present just one IRE system has been approved for clinical use and is currently commercially available (NanoKnife® system). In 2014, the International Working Group on Image-Guided Tumor Ablation updated the recommendation about standardization of terms and reporting criteria for image-guided tumor ablation. The IRE method is not covered in detail. But the non-thermal IRE method and the NanoKnife System differ fundamentally from established ablations techniques, especially thermal approaches, e.g. radio frequency ablation (RFA). MATERIAL/METHODS As numerous publications on IRE with varying terminology exist so far - with numbers continuously increasing - standardized terms and reporting criteria of IRE are needed urgently. The use of standardized terminology may then allow for a better inter-study comparison of the methodology applied as well as results achieved. RESULTS Thus, the main objective of this document is to supplement the updated recommendation for image-guided tumor ablation by outlining a standardized set of terminology for the IRE procedure with the NanoKnife Sytem as well as address essential clinical and technical informations that should be provided when reporting on IRE tumor ablation. CONCLUSIONS We emphasize that the usage of all above recommended reporting criteria and terms can make IRE ablation reports comparable and provide treatment transparency to assess the current value of IRE and provide further development.
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Affiliation(s)
- Johann J Wendler
- Department of Urology, University of Magdeburg, Magdeburg, Germany
| | | | - Jens Ricke
- Department of Radiology, University of Magdeburg, Magdeburg, Germany
| | - Julian Jürgens
- Department of Radiology, University of Magdeburg, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology, University of Magdeburg, Magdeburg, Germany
| | - Jens Köllermann
- Department of Pathology, Sana Klinikum Offenbach a. M., Offenbach Am Main, Germany
| | - Markus Porsch
- Department of Urology, University of Magdeburg, Magdeburg, Germany
| | - Daniel Baumunk
- Department of Urology, University of Magdeburg, Magdeburg, Germany
| | - Martin Schostak
- Department of Radiology, University of Magdeburg, Magdeburg, Germany
| | - Uwe-Bernd Liehr
- Department of Urology, University of Magdeburg, Magdeburg, Germany
| | - Maciej Pech
- Department of Radiology, University of Magdeburg, Magdeburg, Germany
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Abstract
PURPOSE Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol and drug free living environment that supports sustained recovery. Residential recovery homes, called "sober living houses" in California, are alcohol and drug-free living environments that offer long-term support for persons with addictive disorders. They do not offer formal treatment services but usually encourage or mandate attendance at self-help recovery groups such as Alcoholics Anonymous. APPROACH This paper weighs the strengths and weaknesses of different research designs for studying residential recovery homes. Alternatives to randomized designs that are able to capture "real world" data that are readily generalized are described and understudied topics are identified. FINDINGS A significant limitation of traditional randomized designs is they eliminate mutual selection processes between prospective residents and recovery home residents and staff. Naturalistic research designs have the advantage of including mutual selection processes and there are methods available for limiting self-selection bias. Qualitative methods should be used to identify factors that residents experience as helpful that can then be studied further. Innovative studies are needed to investigate how outcomes are affected by architectural characteristics of the houses and resident interactions with the surrounding community. PRACTICAL IMPLICATIONS Use of the recommended strategies could lead to findings that are more informative, intuitively appealing, and interpretable. SOCIAL IMPLICATIONS Recovery homes and similar programs will be more responsive to consumers. ORIGINALITY This paper represents one of the first to review various options for studying recovery homes and to provide suggestions for new studies.
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Witkiewitz K, Finney JW, Harris AH, Kivlahan DR, Kranzler HR. Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders. Alcohol Clin Exp Res 2015; 39:1557-70. [PMID: 26250333 PMCID: PMC4558228 DOI: 10.1111/acer.12800] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/30/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Over the past 60 years, the view that "alcoholism" is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and nonpharmacological interventions for AUDs. METHODS This paper provides a narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs. RESULTS Despite considerable improvements in the design of alcohol clinical trials over the past 2 decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy. CONCLUSIONS The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD.
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Affiliation(s)
- Katie Witkiewitz
- Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
| | - John W. Finney
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA
| | - Alex H.S Harris
- VA Substance Use Disorder Quality Enhancement Research Initiative, VA Palo Alto Health Care System, Menlo Park, CA
| | - Daniel R. Kivlahan
- Veterans Health Administration, Washington, DC and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Henry R. Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and VISN4 MIRECC, Philadelphia VAMC, Philadelphia, PA
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Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, Carrino J, Chou R, Cook K, DeLitto A, Goertz C, Khalsa P, Loeser J, Mackey S, Panagis J, Rainville J, Tosteson T, Turk D, Von Korff M, Weiner DK. Report of the National Institutes of Health task force on research standards for chronic low back pain. J Manipulative Physiol Ther 2014; 37:449-67. [PMID: 25127996 DOI: 10.1016/j.jmpt.2014.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 07/08/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The purpose of this article is to disseminate the report of the National Institutes of Health (NIH) task force on research standards for cLBP. METHODS The NIH Pain Consortium charged a research task force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting. RESULTS The panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research subjects (drawing heavily on the Patient Reported Outcomes Measurement Information System methodology); reporting "responder analyses" in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved these recommendations, which investigators should incorporate into NIH grant proposals. CONCLUSIONS The RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of cLBP. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will become a dynamic document and undergo continual improvement.
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Affiliation(s)
- Richard A Deyo
- Professor, Department of Family Medicine, Oregon Health & Science University, Portland, OR; Professor, Department of Medicine, Oregon Health & Science University, Portland, OR; Professor, Department of Public Health & Community Medicine, Oregon Health & Science University, Portland, OR.
| | - Samuel F Dworkin
- Professor, Department of Oral Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Dagmar Amtmann
- Research Associate Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Gunnar Andersson
- Professor, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - David Borenstein
- Clinical Professor, Department of Medicine, George Washington University Medical Center, Washington, DC
| | - Eugene Carragee
- Professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA
| | - John Carrino
- Associate Professor, Department of Radiology, Johns Hopkins University, Baltimore, MD
| | - Roger Chou
- Professor, Department of Medicine, Oregon Health and Science University, Portland, OR; Professor, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR
| | - Karon Cook
- Research Associate Professor, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Anthony DeLitto
- Professor, Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Christine Goertz
- Vice Chancellor of Research & Health Policy, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA
| | - Partap Khalsa
- Deputy Director, National Institutes of Health, Division of Extramural Research, National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - John Loeser
- Professor Emeritus, Department of Neurological Surgery, University of Washington, Seattle, WA; Professor Emeritus, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
| | - Sean Mackey
- Professor, Department of Anesthesia and Pain Management, Stanford University, Stanford, CA
| | - James Panagis
- Program Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Orthopaedics Research Program, Bethesda, MD
| | - James Rainville
- Chief, Department of Physical Medicine and Rehabilitation, New England Baptist Hospital, Roxbury Crossing, MA
| | - Tor Tosteson
- Professor, Department of Community and Family Medicine and The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Dennis Turk
- Professor Emeritus, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
| | | | - Debra K Weiner
- Professor, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; Professor, Department of Anesthesiology; University of Pittsburgh, Pittsburgh, PA. Geriatric Research, Educational and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA
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Shin SY, Kim WS, Lee JH. Characteristics desired in clinical data warehouse for biomedical research. Healthc Inform Res 2014; 20:109-16. [PMID: 24872909 PMCID: PMC4030054 DOI: 10.4258/hir.2014.20.2.109] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 01/13/2014] [Revised: 03/22/2014] [Accepted: 04/06/2014] [Indexed: 11/25/2022] Open
Abstract
Objectives Due to the unique characteristics of clinical data, clinical data warehouses (CDWs) have not been successful so far. Specifically, the use of CDWs for biomedical research has been relatively unsuccessful thus far. The characteristics necessary for the successful implementation and operation of a CDW for biomedical research have not clearly defined yet. Methods Three examples of CDWs were reviewed: a multipurpose CDW in a hospital, a CDW for independent multi-institutional research, and a CDW for research use in an institution. After reviewing the three CDW examples, we propose some key characteristics needed in a CDW for biomedical research. Results A CDW for research should include an honest broker system and an Institutional Review Board approval interface to comply with governmental regulations. It should also include a simple query interface, an anonymized data review tool, and a data extraction tool. Also, it should be a biomedical research platform for data repository use as well as data analysis. Conclusions The proposed characteristics desired in a CDW may have limited transfer value to organizations in other countries. However, these analysis results are still valid in Korea, and we have developed clinical research data warehouse based on these desiderata.
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Affiliation(s)
- Soo-Yong Shin
- Department of Biomedical Informatics, Asan Medical Center, Seoul, Korea
| | - Woo Sung Kim
- Department of Biomedical Informatics, Asan Medical Center, Seoul, Korea. ; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Ho Lee
- Department of Biomedical Informatics, Asan Medical Center, Seoul, Korea. ; Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
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