1
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Johnson AM, Charre-Perales J, Todd A, Arguelles-Ramos M, Ali AAB. The impact of dietary oregano essential oil supplementation on fatty acid composition and lipid stability in eggs stored at room temperature. Br Poult Sci 2024:1-8. [PMID: 38507293 DOI: 10.1080/00071668.2024.2326886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/17/2024] [Indexed: 03/22/2024]
Abstract
1. In many countries, eggs are not refrigerated and must be stored at room temperature. The objective of this study was to explore the effects of dietary oregano oil (275 mg/ kg; ORE) versus an unsupplemented control diet (CON) on laying hens on the shelf life and fatty acid profile of eggs.2. Treatments were randomly distributed into 10 pens containing 27 birds each. A total of 200 eggs were collected from both groups on the same day and were stored for either 0, 10, 21 and 35 d. At each storage time, egg yolks were analysed for fatty acid profile and lipid peroxidation.3. The main indicator of lipid peroxidation, malondialdehyde (MDA), was significantly lower in ORE eggs compared to CON eggs (p = 0.001). Storage time had a significant impact on MDA concentrations (p = 0.023), with the highest found after 35 d. Significant differences were found for individual fatty acids, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA). Palmitic acid, stearic acid, oleic acid, linoleic acid and arachidonic acid were significantly lower in ORE eggs compared to CON eggs (p < 0.05). Palmitoleic acid (p = 0.002), linolenic acid (p = 0.001) and docosahexaenoic acid (DHA, p = 0.001) were significantly higher in ORE eggs.4. Storage only affected oleic, linolenic, linoleic, arachidonic and docosahexaenoic acids (p < 0.05). Total SFA, MUFA, n-6 and ratio of n-3 to n-6 (n-3:n-6) PUFA were significantly higher in CON eggs (p < 0.05). The ratio of SFA to PUFA (SFA:PUFA, p = 0.005) and total n-3 PUFA (p = 0.001) were significantly higher in ORE eggs.5. The n-3:n-6 ratio was significantly impacted by treatment (p = 0.021) and storage (p = 0.031) with no significant interaction. This ratio is important for human health indication and could lead to the development of designer eggs.
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Affiliation(s)
- A M Johnson
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - J Charre-Perales
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - A Todd
- College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - M Arguelles-Ramos
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - A A B Ali
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
- Animal Behavior and Management, Veterinary Medicine, Cairo University, Cairo, Egypt
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2
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Gorman BG, Campbell E, Mullen BL, Deo N, Ahn J, Carley S, Castro MR, Todd A, Vidal NY. Association between Hashimoto's thyroiditis and melanoma: a retrospective matched cohort study. Arch Dermatol Res 2023; 315:2721-2724. [PMID: 37477680 DOI: 10.1007/s00403-023-02669-4] [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] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/16/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
An inflammatory microenvironment has been shown to increase risk for malignant melanoma, suggesting that melanoma may be related to a pro-inflammatory state. Though Hashimoto's thyroiditis is one of the most common autoimmune diseases, there are no investigations of its relationship with melanoma. We aim to determine if Hashimoto's increases risk of developing melanoma. A retrospective, validated cohort of patients with a diagnosis of Hashimoto's between 2005 and 2020 were identified using the Olmsted County database. Patients were age and sex matched to controls without a Hashimoto's diagnosis. The primary outcomes were development of melanoma and time to first melanoma diagnosis. 4805 patients were included in the study, with 1726 (36%) having a diagnosis of Hashimoto's. Hashimoto's patients had no significant difference in risk of melanoma (relative risk 0.96, 95% CI 0.78-1.17) or nonmelanoma skin cancer (relative risk 0.95, 95% CI 0.86-1.06) compared with matched controls. This suggests that the local proinflammatory environment present in Hashimoto's does not contribute significantly to melanoma risk. Larger studies may be needed to further characterize the relationship between these diseases.
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Affiliation(s)
- B G Gorman
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA.
| | - E Campbell
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - B L Mullen
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - N Deo
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - J Ahn
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Carley
- Sharp Rees-Stealy Dermatology, San Diego, CA, USA
| | - M R Castro
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - A Todd
- Clinical Trials and Biostatistics Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - N Y Vidal
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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3
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Deo N, Campbell E, Gorman BG, Mullen BM, Ahn J, Carley S, Castro MR, Todd A, Vidal NY. Incidence of Melanoma is Not Elevated in Patients with Graves’ Disease: A Retrospective Matched Cohort Study. JAAD Int 2023; 11:222-223. [PMID: 37152216 PMCID: PMC10154956 DOI: 10.1016/j.jdin.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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4
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Robinson-Barella A, Sile L, Govind T, Guraya HK, O’Brien N, Harris V, Pilkington G, Todd A, Husband A. Using a qualitative co-design approach to identify recommendations for improving access to medication reviews for people from ethnic minority communities. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac089.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
Introduction
Reviews of medication are vital to support medicine effectiveness and optimise person-centred care outcomes. However, inequalities negatively impact ethnic minority populations when accessing medicine review services.1 It is important to identify opportunities to improve access for these communities. Previous studies have demonstrated the significance of overcoming accessibility barriers, but specific detail about how best to achieve this is lacking.2,3 Through co-design workshops, this study seeks to integrate the voices of those people from ethnic minority populations to gain better insight into improving access to medicines review services for ethnic minority communities.
Aim
This qualitative, person-centred co-design study sought to build greater knowledge and understanding by involving representatives from communities whose needs may remain unmet. When considering the value that medication reviews can offer in optimising a person’s medication, this study aimed to: (i) better understand existing barriers that may impact those from ethnic minority communities when accessing services and to (ii) identify measures that may facilitate improved service accessibility for these groups.
Methods
A series of co-design workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call whilst adhering to COVID-19 restrictions. Existing evidence-based perceptions affecting access to medicines services were critiqued and recommendations were generated to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim to enable thematic analysis. QSR NVivo (Version 12) facilitated data analysis. The Health Research Authority granted ethical approval (ref: 21/HRA/1426).
Results
Twelve participants were recruited: including 8 UK citizens, 2 asylum seekers and 2 participants in receipt of residency visas. In total, 4 different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and co-create recommendations. Three recommendations were developed and centred on: (i) delivering culturally competent medicines review services; (ii) building awareness of medicines review services and how to access them; and (iii) enabling better discussions with patients from ethnic minority communities.
Discussion/Conclusion
The results have important implications for overcoming ethnic inequalities in access to medicines reviews. The data highlighted the significance of raising awareness of the medicine review services and understanding each person’s lived experiences in order to address barriers that currently affect access. Delivering medication review services with cultural competency is vital; steps should be taken to address potential language barriers and build patient-provider relationships through in-person medication reviews. Collaborative co-production approaches could enable better design, implementation and delivery of medication services that are accessible and culturally competent, in order to best meet the needs of ethnic minority communities. Steps should be taken to address knowledge gaps around cultural competence training to enable the creation of pharmacies as inclusive, person-centred healthcare settings. Methods for improving person-centred communication within pharmacies should be further explored. Close, collaborative working with individual populations could enable specific tailoring of medicines review services that best meet the needs of the community. The National Institute for Health Research Applied Research Collaboration (NIHR ARC) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualisation. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and the findings were reported, with cultural competence and sensitivity.
References
1. Robinson A, et al. A qualitative exploration of the barriers and facilitators affecting ethnic minority patient groups when accessing medicine review services: perspectives of healthcare professionals. Health Expectations, 2021. DOI: 10.1111/hex.13410.
2. Robinson A, et al. “He or she maybe doesn’t know there is such a thing as a review”: a qualitative investigation exploring barriers and facilitators to accessing medication reviews from the perspective of people from ethnic minority communities. Health Expectations, 2022. DOI: 10.1111/hex.13482.
3. Latif A, et al. A qualitative exploration to understand access to pharmacy medication reviews: views from marginalized patient groups. Pharmacy, 2020. DOI: 10.3390/pharmacy8020073.
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Affiliation(s)
| | - L Sile
- Liverpool John Moores University
| | - T Govind
- English Pharmacy Board, Royal Pharmaceutical Society
| | | | | | | | - G Pilkington
- West End Family Health Primary Care Network , UK
| | - A Todd
- School of Pharmacy, Newcastle University
| | - A Husband
- School of Pharmacy, Newcastle University
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5
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Gentle SJ, Moore M, Blackmon R, Brugh B, Todd A, Wingate M, Mazzoni S. Improving birth certificate data accuracy in Alabama. Health Sci Rep 2022; 5:e607. [PMID: 35509413 PMCID: PMC9059177 DOI: 10.1002/hsr2.607] [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: 01/14/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
Objective Accurate vital statistics data are critical for monitoring population health and strategizing public health interventions. Previous analyses of statewide birth data have identified several factors that may reduce birth certificate accuracy including systematic errors and limited data review by clinicians. The aim of this initiative was to increase the proportion of hospitals in Alabama reporting accurate birth certificate data from 67% to 87% within 1 year. Methods The Alabama Perinatal Quality Collaborative led this statewide collaborative effort. Process measures included monthly monitoring of 11 variables across 5-10 patient birth certificates per month per hospital. Accuracy determination, defined as ≥95% accuracy of the variables analyzed, was performed by health care specialists at each hospital by comparing birth certificate variables from vital statistics with data obtained from original hospital source materials. Three months of retrospective, baseline accuracy data were collected before project initiation from which actionable drivers and change ideas were identified at individual hospitals. Data were analyzed using statistical process control measures. Results Thirty-one hospitals entered data throughout the course of the initiative, accounting for 850 chart analyses and 9350 variable assessments. The least accurately reported variables included birth weight, maternal hypertension, and antenatal corticosteroid exposure. At baseline, 67% of hospitals reported birth certificate accuracy rates ≥ 95%, which increased to 90% of hospitals within 2 months and was sustained for the remainder of the initiative. Conclusion Statewide, multidisciplinary quality improvement efforts increased birth certificate accuracy vital to public health surveillance.
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Affiliation(s)
- Samuel J. Gentle
- Department of PediatricsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Matthew Moore
- Department of Health Care Organization and PolicyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | | | - Brenda Brugh
- Alabama Department of Public HealthMontgomeryAlabamaUSA
| | - Allison Todd
- Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Martha Wingate
- Department of Health Care Organization and PolicyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Sara Mazzoni
- Department of Obstetrics and GynecologyUniversity of Washington Medical CenterSeattleWashingtonUSA
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6
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Cozzi GD, Blanchard CT, Champion ML, Todd A, Davis M, Chandler-Laney P, Casazza K, Casey BM, Tita AT, Szychowski JM, Subramaniam A. Factors Associated with Appropriate Gestational Weight Gain among Women with Obesity. Am J Perinatol 2022; 39:272-280. [PMID: 32854132 PMCID: PMC9105824 DOI: 10.1055/s-0040-1715529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to compare attendance of nutritional counseling, dietary composition, exercise patterns, and socioeconomic factors among obese women with inappropriate gestational weight gain (iGWG) versus appropriate GWG (aGWG). STUDY DESIGN Medicaid-eligible women receiving prenatal care at a tertiary care center from January 2013 to December 2015 were offered individualized nutritional counseling by a registered dietitian encouraging well-balanced meals and 150 min/wk of exercise. We conducted a prospective case-control study of obese women (body mass index or BMI ≥30) with a singleton gestation with iGWG (<11 or >20 pounds) versus aGWG (11-20 pounds). Dietary intake, activity level, and socioeconomic factors were compared with Chi-square, Fisher's exact, Student's t-test, and Wilcoxon Rank Sum tests as indicated, and odds ratios with 95% confidence intervals were calculated. Multivariate regression analysis for significant variables was performed. A subgroup analysis of women with BMI ≥40 was planned. RESULTS A total of 401 women were analyzed: 78% (n = 313) with iGWG and 22% (n = 88) with aGWG. Demographics were similar between groups. Women with iGWG less frequently reported physician reinforcement of counseling and reported more physical inactivity and unemployment; there were no differences in caloric intake or macronutrient profile between groups. Multivariate regression identified physician reinforcement and employment as independent predictors of aGWG. Among women with BMI ≥40 (n = 133), those with iGWG (78%) were less likely to attend counseling, report physician reinforcement of counseling, and have adequate caloric and protein intake when compared with those with aGWG (22%). Activity level and socioeconomic factors were not different between groups. CONCLUSION Physician reinforcement of nutritional counseling, greater activity level, and employment are associated with aGWG in women with BMI ≥30, while individualized professional nutritional counseling and dietary modifications were further associated with aGWG in women with BMI ≥40. Thus, greater focus should be placed on enhancing exposure to counseling and altering nutritional and exercise choices to optimize aGWG. KEY POINTS · Physician reinforcement of nutritional counseling by a dietitian is crucial for obese women.. · Physical inactivity and unemployment are associated with inappropriate gestational weight gain.. · Nutritional counseling is associated with appropriate gestational weight gain in women with BMI ≥40..
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Affiliation(s)
- Gabriella D. Cozzi
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christina T. Blanchard
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Macie L. Champion
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Allison Todd
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Margaret Davis
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama,Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paula Chandler-Laney
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Krista Casazza
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, Alabama,Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brian M. Casey
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alan T. Tita
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeff M. Szychowski
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Akila Subramaniam
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
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7
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Meier AC, Shirley MH, Beirne C, Breuer T, Lewis M, Masseloux J, Jasperse‐Sjolander L, Todd A, Poulsen JR. Improving population estimates of difficult‐to‐observe species: A dung decay model for forest elephants with remotely sensed imagery. Anim Conserv 2021. [DOI: 10.1111/acv.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. C. Meier
- Nicholas School of the Environment Duke University Durham NC USA
| | - M. H. Shirley
- Institute of Environment Florida International University North Miami FL USA
| | - C. Beirne
- Nicholas School of the Environment Duke University Durham NC USA
| | - T. Breuer
- World Wide Fund for Nature Germany Berlin Germany
| | - M. Lewis
- Nicholas School of the Environment Duke University Durham NC USA
| | - J. Masseloux
- Nicholas School of the Environment Duke University Durham NC USA
| | | | - A. Todd
- Fauna and Flora International Cambridge United Kingdom
| | - J. R. Poulsen
- Nicholas School of the Environment Duke University Durham NC USA
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8
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Morgan JL, Shrestha A, Reed MWR, Herbert E, Bradburn M, Walters SJ, Martin C, Collins K, Ward S, Holmes G, Burton M, Lifford K, Edwards A, Ring A, Robinson T, Chater T, Pemberton K, Brennan A, Cheung KL, Todd A, Audisio R, Wright J, Simcock R, Thomson AM, Gosney M, Hatton M, Green T, Revill D, Gath J, Horgan K, Holcombe C, Winter MC, Naik J, Parmeschwar R, Wyld L. Bridging the age gap in breast cancer: impact of omission of breast cancer surgery in older women with oestrogen receptor-positive early breast cancer on quality-of-life outcomes. Br J Surg 2021; 108:315-325. [PMID: 33760065 PMCID: PMC10364859 DOI: 10.1093/bjs/znaa125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/15/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Primary endocrine therapy may be an alternative treatment for less fit women with oestrogen receptor (ER)-positive breast cancer. This study compared quality-of-life (QoL) outcomes in older women treated with surgery or primary endocrine therapy. METHODS This was a multicentre, prospective, observational cohort study of surgery or primary endocrine therapy in women aged over 70 years with operable breast cancer. QoL was assessed using European Organisation for Research and Treatment of cancer QoL questionnaires QLQ-C30, -BR23, and -ELD14, and the EuroQol Five Dimensions 5L score at baseline, 6 weeks, and 6, 12, 18, and 24 months. Propensity score matching was used to adjust for baseline variation in health, fitness, and tumour stage. RESULTS The study recruited 3416 women (median age 77 (range 69-102) years) from 56 breast units. Of these, 2979 (87.2 per cent) had ER-positive breast cancer; 2354 women had surgery and 500 received primary endocrine therapy (125 were excluded from analysis due to inadequate data or non-standard therapy). Median follow-up was 52 months. The primary endocrine therapy group was older and less fit. Baseline QoL differed between the groups; the mean(s.d.) QLQ-C30 global health status score was 66.2(21.1) in patients who received primary endocrine therapy versus 77.1(17.8) among those who had surgery plus endocrine therapy. In the unmatched analysis, changes in QoL between 6 weeks and baseline were noted in several domains, but by 24 months most scores had returned to baseline levels. In the matched analysis, major surgery (mastectomy or axillary clearance) had a more pronounced adverse impact than primary endocrine therapy in several domains. CONCLUSION Adverse effects on QoL are seen in the first few months after surgery, but by 24 months these have largely resolved. Women considering surgery should be informed of these effects.
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Affiliation(s)
- J L Morgan
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - A Shrestha
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - M W R Reed
- Brighton and Sussex Medical School, Brighton, UK
| | - E Herbert
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - M Bradburn
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - S J Walters
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - C Martin
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - K Collins
- Faculty of Health and Wellbeing, Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - S Ward
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - G Holmes
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - M Burton
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - K Lifford
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - A Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - A Ring
- Department of Medical Oncology, Royal Marsden Hospital, London, UK
| | - T Robinson
- Department of Cardiovascular Sciences and National Institute for Health Research Biomedical Research Centre, University of Leicester, Cardiovascular Research Centre, Glenfield General Hospital, Leicester, UK
| | - T Chater
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - K Pemberton
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - A Brennan
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - K L Cheung
- School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - A Todd
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - R Audisio
- Department of Surgery, University of Gothenberg, Sahlgrenska Universitetssjukhuset, Gothenberg, Sweden
| | - J Wright
- Brighton and Sussex Medical School, Brighton, UK
| | - R Simcock
- Brighton and Sussex Medical School, Brighton, UK
| | - A M Thomson
- Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - M Gosney
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - M Hatton
- Sheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Sheffield, UK
| | - T Green
- North Trent Cancer Research Network Consumer Research Panel, Sheffield, UK
| | - D Revill
- North Trent Cancer Research Network Consumer Research Panel, Sheffield, UK
| | - J Gath
- North Trent Cancer Research Network Consumer Research Panel, Sheffield, UK
| | - K Horgan
- Department of Breast Surgery, Bexley Cancer Centre, St James's University Hospital, Leeds, UK
| | - C Holcombe
- Department of Breast Surgery, Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - M C Winter
- Sheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Sheffield, UK
| | - J Naik
- Department of General Surgery, Pinderfields Hospital, Mid Yorkshire NHS Foundation Trust, Wakefield, UK
| | - R Parmeschwar
- Department of Breast Surgery, University Hospitals of Morecambe Bay, Lancaster, UK
| | - L Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
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9
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Ehrlich-Jones L, Durkin J, Byrne R, Todd A, Reis JP, Wolfman J, Gaebler-Spira D, Marciniak C. Breast Health Experiences in Women with Cerebral Palsy: A Qualitative Approach. ACTA ACUST UNITED AC 2021; 2:195-200. [PMID: 34235506 PMCID: PMC8243704 DOI: 10.1089/whr.2020.0115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Background: All women, regardless of disability status, should receive screening for breast cancer. In 2010, only 61.4% of women with disabilities (WWD) received a mammogram in the past 2 years compared to 75% of women without disabilities. The purpose of this study is to explore breast cancer screening experiences of women with cerebral palsy (CP) with the aim of identifying factors that could improve screening rates for WWD. Methods: Thirty women with CP, 22–72 years of age, residing in New York, Chicago, or Los Angeles areas participated in individual or group interviews about breast health. Twenty-five of the participants identified themselves as white, and one self-identified as Hispanic or Latina. Facilitators used a semistructured guide across the three sites. Qualitative analysis utilized an iterative coding process to generate themes related to breast health. Results: We identified six predominant themes in these interviews, which revolved around physical, environmental, and emotional barriers and facilitators. Within each theme, we identified subthemes. Physical barriers included the most highly identified subthemes of age, pain, holding breath, holding still, spasticity, standing, fatigue, and positioning. Self-advocacy and communication between the health care professional and the patient were the most common subthemes identified among the emotional facilitators. Conclusion: Women with CP perceive a variety of issues impacting breast health. These findings are multifaceted and suggest that improving screening rates for women with CP should address these barriers and facilitators.
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Affiliation(s)
- Linda Ehrlich-Jones
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jordyn Durkin
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel Byrne
- Cerebral Palsy Foundation, New York, New York, USA.,Division of Pediatric Orthopedics, Columbia University Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA
| | - Allison Todd
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | | | - Judith Wolfman
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Lynn Sage Breast Center, Chicago, Illinois, USA
| | - Deborah Gaebler-Spira
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatrics, and Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | - Christina Marciniak
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Attending Physician, Shirley Ryan AbilityLab, Chicago, Illinois, USA
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Wyld L, Reed MWR, Collins K, Burton M, Lifford K, Edwards A, Ward S, Holmes G, Morgan J, Bradburn M, Walters SJ, Ring A, Robinson TG, Martin C, Chater T, Pemberton K, Shrestha A, Nettleship A, Murray C, Brown M, Richards P, Cheung KL, Todd A, Harder H, Brain K, Audisio RA, Wright J, Simcock R, Armitage F, Bursnall M, Green T, Revell D, Gath J, Horgan K, Holcombe C, Winter M, Naik J, Parmeshwar R, Gosney M, Hatton M, Thompson AM. Bridging the age gap in breast cancer: cluster randomized trial of two decision support interventions for older women with operable breast cancer on quality of life, survival, decision quality, and treatment choices. Br J Surg 2021; 108:499-510. [PMID: 33760077 PMCID: PMC10364907 DOI: 10.1093/bjs/znab005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/04/2020] [Accepted: 12/28/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND Rates of surgery and adjuvant therapy for breast cancer vary widely between breast units. This may contribute to differences in survival. This cluster RCT evaluated the impact of decision support interventions (DESIs) for older women with breast cancer, to ascertain whether DESIs influenced quality of life, survival, decision quality, and treatment choice. METHODS A multicentre cluster RCT compared the use of two DESIs against usual care in treatment decision-making in older women (aged at least ≥70 years) with breast cancer. Each DESI comprised an online algorithm, booklet, and brief decision aid to inform choices between surgery plus adjuvant endocrine therapy versus primary endocrine therapy, and adjuvant chemotherapy versus no chemotherapy. The primary outcome was quality of life. Secondary outcomes included decision quality measures, survival, and treatment choice. RESULTS A total of 46 breast units were randomized (21 intervention, 25 usual care), recruiting 1339 women (670 intervention, 669 usual care). There was no significant difference in global quality of life at 6 months after the baseline assessment on intention-to-treat analysis (difference -0.20, 95 per cent confidence interval (C.I.) -2.69 to 2.29; P = 0.900). In women offered a choice of primary endocrine therapy versus surgery plus endocrine therapy, knowledge about treatments was greater in the intervention arm (94 versus 74 per cent; P = 0.003). Treatment choice was altered, with a primary endocrine therapy rate among women with oestrogen receptor-positive disease of 21.0 per cent in the intervention versus 15.4 per cent in usual-care sites (difference 5.5 (95 per cent C.I. 1.1 to 10.0) per cent; P = 0.029). The chemotherapy rate was 10.3 per cent at intervention versus 14.8 per cent at usual-care sites (difference -4.5 (C.I. -8.0 to 0) per cent; P = 0.013). Survival was similar in both arms. CONCLUSION The use of DESIs in older women increases knowledge of breast cancer treatment options, facilitates shared decision-making, and alters treatment selection. Trial registration numbers: EudraCT 2015-004220-61 (https://eudract.ema.europa.eu/), ISRCTN46099296 (http://www.controlled-trials.com).
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Affiliation(s)
- L Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - M W R Reed
- Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - K Collins
- College of Health, Wellbeing and Life Sciences, Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - M Burton
- College of Health, Wellbeing and Life Sciences, Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - K Lifford
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - A Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - S Ward
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - G Holmes
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - J Morgan
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - M Bradburn
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - S J Walters
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - A Ring
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - T G Robinson
- Department of Cardiovascular Sciences and NIHR Biomedical Research Centre, University of Leicester, Cardiovascular Research Centre, Glenfield General Hospital, Leicester, UK
| | - C Martin
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - T Chater
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - K Pemberton
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - A Shrestha
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - A Nettleship
- EpiGenesys, University of Sheffield, Sheffield, UK
| | - C Murray
- EpiGenesys, University of Sheffield, Sheffield, UK
| | - M Brown
- EpiGenesys, University of Sheffield, Sheffield, UK
| | - P Richards
- Department of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - K L Cheung
- University of Nottingham, Royal Derby Hospital, Derby, UK
| | - A Todd
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - H Harder
- Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - K Brain
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - R A Audisio
- University of Gothenberg, Sahlgrenska Universitetssjukhuset, Gothenberg, Sweden
| | - J Wright
- Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - R Simcock
- Brighton and Sussex Medical School, Falmer, Brighton, UK
| | | | - M Bursnall
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - T Green
- Yorkshire and Humber Consumer Research Panel (yhcrp.org.uk), Leeds, UK
| | - D Revell
- Yorkshire and Humber Consumer Research Panel (yhcrp.org.uk), Leeds, UK
| | - J Gath
- Yorkshire and Humber Consumer Research Panel (yhcrp.org.uk), Leeds, UK
| | - K Horgan
- Department of Breast Surgery, Bexley Cancer Centre, St James's University Hospital, Leeds, UK
| | - C Holcombe
- Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - M Winter
- Weston Park Hospital, Sheffield, UK
| | - J Naik
- Pinderfields Hospital, Mid Yorkshire NHS Foundation Trust, Wakefield, UK
| | - R Parmeshwar
- University Hospitals of Morecambe Bay, Lancaster, UK
| | - M Gosney
- Royal Berkshire NHS Foundation Trust, Reading, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | - A M Thompson
- Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
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Champion ML, Blanchard CT, Cozzi GD, Todd A, Davis M, Chandler-Laney P, Casazza K, Casey BM, Tita A, Subramaniam A. 936 Sociodemographic factors and maternal and neonatal outcomes in obese women (BMI≥30). Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boitano TKL, Smith HJ, Cohen AC, Todd A, Leath Iii CA, Straughn JM. An enhanced recovery protocol decreases complication rates in high-risk gynecologic oncology patients undergoing non-emergent laparotomy. Int J Gynecol Cancer 2021; 31:721-726. [PMID: 33495207 DOI: 10.1136/ijgc-2020-002270] [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: 11/20/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Enhanced recovery protocols are now established as the standard of care leading to improved perioperative outcomes and associated cost-benefits. The objective of this study was to evaluate the impact of an enhanced recovery program on complication rates in high-risk gynecologic oncology patients undergoing surgery. METHODS This retrospective cohort study included gynecologic oncology patients with pathology-proven malignancy undergoing non-emergent laparotomy from October 2016 to December 2018 managed on an enhanced recovery protocol, and a control group from October 2015 through September 2016 prior to enhanced recovery protocol implementation. The primary outcome was complication rates in a high-risk population pre- and post-enhanced recovery protocol. High-risk patients were defined as those with obesity (body mass index >30 kg/m2) and/or age ≥65 years. Analysis was performed using Statistical Package for Social Sciences (SPSS) v.24. RESULTS A total of 363 patients met the inclusion criteria: 104 in the control group and 259 in the enhanced recovery protocol group. Patient demographics, including age, body mass index, diagnosis, and performance status, were similar. Overall complication rates were less in the enhanced recovery protocol group (29% vs 53.8%; p<0.0001). The enhanced recovery protocol group had a shorter length-of-stay compared with control (3.3 vs 4.2 days; p<0.0001). The 30-day readmission rates were similar between the groups (9.6% vs 13.5%; p=0.19). In the enhanced recovery protocol group compared with control, complication rates were less in obese patients (29.4% vs 57.8%; p<0.0001), morbidly obese patients (20.9% vs 76.2%; p<0.0001), and age ≥65 (36.1% vs 57.1%; p<0.0001). The most common complications in the enhanced recovery protocol group were ileus (9.7%), pulmonary complications (2.7%), and blood transfusions (10.8%). CONCLUSIONS Implementation of an enhanced recovery protocol decreases complication rates and length-of-stay in morbidly obese and geriatric patients with gynecologic malignancy without an increase in readmission rates.
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Affiliation(s)
- Teresa K L Boitano
- Division of Gynecologic Oncology, Obstetrics and Gynecology, University of Alabama at Birmingham HCOP, Birmingham, Alabama, USA
| | - Haller J Smith
- Division of Gynecologic Oncology, Obstetrics and Gynecology, University of Alabama at Birmingham HCOP, Birmingham, Alabama, USA
| | - Alexander C Cohen
- Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Allison Todd
- Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Charles A Leath Iii
- Division of Gynecologic Oncology, Obstetrics and Gynecology, University of Alabama at Birmingham HCOP, Birmingham, Alabama, USA
| | - J Michael Straughn
- Division of Gynecologic Oncology, Obstetrics and Gynecology, University of Alabama at Birmingham HCOP, Birmingham, Alabama, USA
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Boitano TK, Sanders LJ, Gentry ZL, Smith HJ, Leath CA, Xhaja A, Leal L, Todd A, Straughn JM. Decreasing opioid use in postoperative gynecologic oncology patients through a restrictive opioid prescribing algorithm. Gynecol Oncol 2020; 159:773-777. [DOI: 10.1016/j.ygyno.2020.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/07/2020] [Indexed: 01/09/2023]
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Boitano T, Lipking K, Smith H, Buddemeyer K, Xhaja A, Leal L, Todd A, Straughn J. Patient satisfaction of a restrictive opioid prescribing algorithm in gynecologic oncology patients undergoing surgery. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wyld L, Reed M, Collins K, Burton M, Lifford K, Edwards A, Ward S, Holmes G, Morgan J, Bradburn M, Walters S, Ring A, Martin C, Shrestha A, Nettleship A, Brown M, Richards P, Todd A, Harder H, Brain K. Cluster randomised trial to evaluate the clinical benefits of decision support interventions for older women with operable breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30545-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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KL. Boitano T, Smith HJ, Todd A, Leath CA, Straughn JM. Enhanced Recovery Protocol Decreases Complication and Readmission Rates in High-Risk Gynecologic Oncology Patients Undergoing Non-Emergent Laparotomy. J Am Coll Surg 2020. [DOI: 10.1016/j.jamcollsurg.2020.07.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cozzi GD, Blanchard CT, Champion ML, Todd A, Davis M, Chandler-Laney P, Casazza K, Casey BM, Tita AT, Subramaniam A. 748: Factors associated with appropriate gestational weight gain among obese women. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Partridge S, Raeside R, Singleton A, Mandoh M, Todd A, Latham Z, Hyun K, Gibson A, Redfern J. 726 Discretionary Food on Demand: Is the Emerging Trend of Online Food Delivery Contributing to Overconsumption of Discretionary Foods? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Todd A, Mandoh M, Redfern J, Partridge S. 736 Mapping Obesity Prevention and Management Approaches for Adolescents Within New South Wales. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Greystoke A, Ward A, Welford J, Rushton C, Short D, Todd A, Rafferty R, Hunt K, Duncan L, Tanner L, Gardiner J. Implementation of the Rockwood Clinical Frailty Score (CFS) into the Newcastle upon Tyne NHS Trust lung cancer practice. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30220-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Reungwetwattana T, Gray J, Markovets A, Nogami N, Lee J, Cho B, Chewaskulyong B, Majem M, Peled N, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gray J, Peled N, Markovets A, Nogami N, Lee JS, Cho B, Chewaskulyong B, Majem M, Reungwetwattana T, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Boitano TKL, Smith HJ, Harmon D, Xhaja A, Leal L, Todd A, Straughn JM. Addressing the Opioid Epidemic Through Restrictive Opioid Prescribing Practices. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sung P, Rafferty M, Doyle L, Kliver E, Bines K, Traines J, Scarpa A, Marciniak C, Solanki S, Todd A. Technology-based Forced Paced Cycling in Parkinson’s Disease: Is it Feasible and Effective? Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.08.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jänne P, Planchard D, Howarth P, Todd A, Kobayashi K. OA07.01 Osimertinib Plus Platinum/Pemetrexed in Newly-Diagnosed Advanced EGFRm-Positive NSCLC; The Phase 3 FLAURA2 Study. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.441] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Acs B, Leung SC, Pelekanou V, Bai Y, Martinez-Morilla S, Toki M, Chang MC, Gholap A, Jadhav A, Hugh JC, Bigras G, Laurinavicius A, Augulis R, Levenson R, Todd A, Piper T, Virk S, van der Vegt B, Hayes DF, Dowsett M, Nielsen TO, Rimm DL. Abstract P4-02-01: Analytical validation of an automated digital scoring protocol for Ki67: International multicenter collaboration study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background/Goal: Ki67 expression has been a valuable prognostic marker in breast cancer, but has not seen broad adoption due to lack of standardization between institutions. Automation could represent a solution. Here we tested 3 automated digital image analysis (DIA) platforms including an open source platform to: (i) Investigate the reproducibility of Ki67 measurement across platforms with supervised classifiers performed by the same operator and by multiple operators. (ii) Compare accuracy of the 3 DIA platforms against outcome (prognostic potential). (iii) Assess inter-laboratory reproducibility of a calibrated DIA tool to evaluate Ki67 in breast cancer among 10 participating labs of the International Ki67 in Breast Cancer Working Group (IKWG).
Methods: The Mib-1 antibody (Dako) was used to detect Ki67 (dilution 1:100). HALO (H) (IndicaLabs), QuantCenter (QC) (3DHistech), QuPath (QP) (open-source software) digital image analysis (DIA) platforms were used to evaluate Ki67 expression. As a ground truth, we evaluated Ki67 LI with meticulous manual tissue segmentation using the Spectrum Webscope (SW) (Aperio). Calibration was performed using 30 ER+ breast cancer cases from phase 3 of the IKWG initiative where blocks were centrally cut and stained for Ki67. The inter-laboratory analysis was done with 10 participating laboratories divided into 2 groups where members within the same group were given the same set of images. The outcome cohort consisted of 149 breast cancer cases from the Yale Pathology archives in tissue microarray format. Intra-class correlation coefficient (ICC) was used to measure reproducibility with the pre-specified criterion for success being to exceed 0.80. Kaplan-Meier analysis supported with log-rank test was performed to assess prognostic potential.
Results: All 3 DIA platforms showed excellent inter-platform reproducibility (ICC: 0.933, CI: 0.879-0.966). Also, excellent reproducibility was found between all DIA platforms and the reference standard Ki67 values of SW (QP ICC: 0.970, CI: 0.936-0.986; H ICC: 0.968, CI: 0.933-0.985; QC ICC: 0.964, CI: 0.919-0.983). The intra-DIA reproducibility was also excellent for all platforms (QP ICC: 0.992, CI: 0.986-0.996; H ICC: 0.972, CI: 0.924-0.988; QC ICC: 0.978, CI: 0.932-0.991). Comparing each DIA against outcome, the hazard ratios were similar (QP=3.309, H=3.077, QC=3.731). The inter-operator reproducibility was particularly high (ICC: 0.962-0.995). As QP is open source software and also showed the lowest intra-DIA platform variability, we selected the QP platform to investigate inter-laboratory reproducibility among 10 IKWG labs. The different-section ICC across the 10 labs was 0.974 (CI: 0.954 - 0.986). The same-section ICC estimate was 0.984 (CI: 0.971-0.992) for group 1 and 0.978 (CI: 0.956-0.989) for group 2.
Conclusions: Our results showed outstanding reproducibility both within and between DIA platforms. We also found the platforms essentially indistinguishable with respect to prediction of breast cancer patient outcome. Automated Ki67 evaluation using a calibrated, open-source DIA platform (QuPath) met the pre-specified criterion of success in the multi-institutional setting. Assessment of clinical utility is planned.
Citation Format: Acs B, Leung SC, Pelekanou V, Bai Y, Martinez-Morilla S, Toki M, Chang MC, Gholap A, Jadhav A, Hugh JC, Bigras G, Laurinavicius A, Augulis R, Levenson R, Todd A, Piper T, Virk S, van der Vegt B, Hayes DF, Dowsett M, Nielsen TO, Rimm DL. Analytical validation of an automated digital scoring protocol for Ki67: International multicenter collaboration study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-02-01.
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Affiliation(s)
- B Acs
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - SC Leung
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - V Pelekanou
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - Y Bai
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - S Martinez-Morilla
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - M Toki
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - MC Chang
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - A Gholap
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - A Jadhav
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - JC Hugh
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - G Bigras
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - A Laurinavicius
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - R Augulis
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - R Levenson
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - A Todd
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - T Piper
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - S Virk
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - B van der Vegt
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - DF Hayes
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - M Dowsett
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - TO Nielsen
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
| | - DL Rimm
- Yale School of Medicine, New Haven, CT; Karolinska Institute, Stockholm, Sweden; University of British Columbia, Vancouver, BC, Canada; Sinai Health System and University of Toronto, Toronto, ON, Canada; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; University of Alberta, Edmonton, AB, Canada; Vilnius University Faculty of Medicine and National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, Kingston, ON, Canada; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Institute of Cancer Research, London, United Kingdom
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Cho B, Cheng Y, Zhou C, Ohe Y, Imamura F, Lin MC, Majem M, Shah R, Rukazenkov Y, Todd A, Markovets A, Barrett C, Chmielecki J, Gray J, Ramalingam S. Mechanisms of acquired resistance to first-line osimertinib: Preliminary data from the phase III FLAURA study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy483.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Planchard D, Boyer M, Lee JS, Dechaphunkul A, Cheema P, Takahashi T, Todd A, McKeown A, Rukazenkov Y, Ohe Y. Osimertinib vs standard of care (SoC) EGFR-TKI as first-line therapy in patients (pts) with untreated EGFRm advanced NSCLC: FLAURA post-progression outcomes. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brown H, Vansteenkiste J, Nakagawa K, Cobo Dols M, John T, Barker C, Kohlmann A, Todd A, Saggese M, Chmielecki J, Markovets A, Ramalingam S. MA15.03 PD-L1 Expression in Untreated EGFRm Advanced NSCLC and Response to Osimertinib and SoC EGFR-TKIs in the FLAURA Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ramalingam S, Cheng Y, Zhou C, Ohe Y, Imamura F, Cho B, Lin MC, Majem M, Shah R, Rukazenkov Y, Todd A, Markovets A, Barrett J, Chmielecki J, Gray J. Mechanisms of acquired resistance to first-line osimertinib: Preliminary data from the phase III FLAURA study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.063] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nandam N, Gaebler-Spira D, Byrne R, Wolfman J, Reis JP, Hung CW, Todd A, Durkin J, Marciniak C. Breast cancer screening in women with cerebral palsy: Could care delivery be improved? Disabil Health J 2018; 11:435-441. [PMID: 29500093 DOI: 10.1016/j.dhjo.2018.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Women with disabilities (WWD) have reported lower mammography rates than the general population, however rates for women with cerebral palsy (CP) have not been specifically studied. OBJECTIVE To evaluate mammography rates in women with CP and to identify strengths and barriers with their screening experience. METHODS Women with CP 40 years or older (n = 118) participating in a prospective cross-sectional survey were queried regarding screening status, imaging modality, and accommodation needs and availability. Categorical variables were summarized and Chi-square testing used to assess factors contributing to screening compliance. The effect of functional factors on screening was evaluated using logistic regression. RESULTS 77 women (65.3%) had mammograms within the past two years; 56 (47.5%) were screening mammograms. Severity of fine motor deficits was associated with lack of screening (OR 0.559, p = 0.019). 85 (72.0%) experienced positive staff attitudes. Facilities most often met needs for ramps, elevators, and/or wide doorways (92.9%), exam explanations (84.4%), and accessible parking (82.5%). Needs least often met included accommodations for standing (59.3%) or for difficulties with arm/shoulder positioning (57.1%), and wheelchair-accessible mammogram machines (59.1%). CONCLUSIONS The screening compliance rate for women with CP is low, although the 2-year mammography rate is comparable to that reported for WWD and the general female U.S. POPULATION Women were usually offered respectful care. Adequate physical accommodations during the procedure were reported less often than overall facility environmental accommodations. These findings demonstrate the need for improved screening rates in women with CP, and highlight areas for improving their screening experience.
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Affiliation(s)
- Neeharika Nandam
- Northwestern University Feinberg School of Medicine, 420 E. Superior St., Chicago, IL 60611, USA
| | - Deborah Gaebler-Spira
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, #1022, Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue #86, Chicago, IL 606111, USA; Shirley Ryan AbilityLab, 355 East Erie Street, Chicago, IL 60611, USA
| | - Rachel Byrne
- Cerebral Palsy Foundation, 3 Columbus Circle, 15th Floor, New York, NY 10019, USA; Division of Pediatric Orthopedics, Columbia University Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, 3959 Broadway, Room 800N, New York, NY 10032, USA
| | - Judith Wolfman
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 800, Chicago, IL 60611, USA; Lynn Sage Breast Center, 250 E. Superior St., Chicago, IL 60611, USA
| | - Judy Panko Reis
- Access Living, 115 West Chicago Avenue, Chicago, IL 60654, USA
| | - Chun Wai Hung
- Division of Pediatric Orthopedics, Columbia University Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, 3959 Broadway, Room 800N, New York, NY 10032, USA
| | - Allison Todd
- Shirley Ryan AbilityLab, 355 East Erie Street, Chicago, IL 60611, USA
| | - Jordyn Durkin
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., 14th Floor, Chicago, IL 60611, USA
| | - Christina Marciniak
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, #1022, Chicago, IL 60611, USA; Shirley Ryan AbilityLab, 355 East Erie Street, Chicago, IL 60611, USA; Department of Neurology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Ward 12-140, Chicago, IL 60611, USA.
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Todd A, Hillier-Brown F, Thomson K, Balaj M, Walton N, Bambra C. The effects of community pharmacy public health interventions on health and health inequalities. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Todd
- Newcastle University, Newcastle upon Tyne, UK
| | | | - K Thomson
- Newcastle University, Newcastle upon Tyne, UK
| | - M Balaj
- Norwegian University of Science and Technology, Trondheim, Norway
| | - N Walton
- Newcastle University, Newcastle upon Tyne, UK
| | - C Bambra
- Newcastle University, Newcastle upon tyne, United Arab Emirates
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Todd A, Thomson K, Hillier-Brown F, McNamara C, Huijits T, Bambra C. The effects of public health policies on health inequalities in European welfare states. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Todd
- Newcastle University, Newcastle upon Tyne, UK
| | - K Thomson
- Newcastle University, Newcastle upon Tyne, UK
| | | | - C McNamara
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - C Bambra
- Newcastle University, Newcastle upon Tyne, UK
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Todd A. The challenges of staffing a shortage speciality in a remote location. Rural Remote Health 2016. [DOI: 10.22605/rrh4106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Reynolds D, Gandhi M, Todd A. Recruiting consultants in a shortage speciality: factors influencing radiology trainees preferred choice of centre after completion of core training. Rural Remote Health 2016. [DOI: 10.22605/rrh4105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Rathbone AP, Todd A, Jamie K, Bonam M, Banks L, Husband AK. A systematic review and thematic synthesis of patients' experience of medicines adherence. Res Social Adm Pharm 2016; 13:403-439. [PMID: 27432023 DOI: 10.1016/j.sapharm.2016.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 02/22/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medicines non-adherence continues to be problematic in health care practice. After decades of research, few interventions have a robust evidence-based demonstrating their applicability to improve adherence. Phenomenology has a place within the health care research environment. OBJECTIVE To explore patients' lived experiences of medicines adherence reported in the phenomenonologic literature. METHODS A systematic literature search was conducted to identify peer-reviewed and published phenomenological investigations in adults that aimed to investigate patients' lived experiences of medicines adherence. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Tool. Thematic synthesis was conducted using a combination of manual coding and NVivo10 [QSR International, Melbourne] coding to aid data management. RESULTS Descriptive themes identified included i) dislike for medicines, ii) survival, iii) perceived need, including a) symptoms and side-effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction. CONCLUSIONS This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, health care professionals, the media and the medicine, itself. Health care professionals and policy makers should seek to re-locate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription.
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Affiliation(s)
- A P Rathbone
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom
| | - A Todd
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom
| | - K Jamie
- School of Applied Social Sciences, Durham University, 32 Old Elvet, Durham DH1 3HN, United Kingdom
| | - M Bonam
- AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom
| | - L Banks
- AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom
| | - A K Husband
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom.
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Jukkala AM, Miltner RS, Morrison SL, Gisiger-Camata S, Todd A, Moneyham LD, Meneses KM. A Team Approach to Enhance Scholarship Among Honors Students in Nursing. Nurs Educ Perspect 2016; 37:177-179. [PMID: 27405203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Honors programs within schools of nursing have the potential to enhance young nurses' interest in developing programs of research early in their careers and can thus contribute to the successful development of nursing knowledge. Such programs also provide opportunities to enhance knowledge and skill in leadership and teamwork at a critical time during the development of their professional nurse identity. This article presents the successful approach one organization took when revising its honors program to meet the current needs of students, society, and the profession.
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Todd A, Pringle A, Keir S. 27NO DECISION ABOUT ME WITHOUT ME. Age Ageing 2015. [DOI: 10.1093/ageing/afv106.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Keir S, Todd A, Young PB. 29AVOIDING HARM AT THE END OF LIFE: HOW GOOD ARE WE? Age Ageing 2015. [DOI: 10.1093/ageing/afv106.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bousleiman SZ, Rice MM, Moss J, Todd A, Rincon M, Mallett G, Milluzzi C, Allard D, Dorman K, Ortiz F, Johnson F, Reed P, Tolivaisa S. Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals. Am J Obstet Gynecol 2015; 213:398.e1-11. [PMID: 25957021 PMCID: PMC4556564 DOI: 10.1016/j.ajog.2015.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/08/2015] [Accepted: 05/02/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We sought to evaluate the frequency of, and factors associated with, the use of 3 evidence-based interventions: antenatal corticosteroids for fetal lung maturity, progesterone for prevention of recurrent preterm birth, and magnesium sulfate for fetal neuroprotection. STUDY DESIGN A self-administered survey was conducted from January through May 2011 among obstetricians from 21 hospitals that included 30 questions regarding their knowledge, attitudes, and practice of the 3 evidence-based interventions and the 14-item short version of the Team Climate for Innovation survey. Frequency of use of each intervention was ascertained from an obstetrical cohort of women between January 2010 and February 2011. RESULTS A total of 329 obstetricians (74% response rate) who managed 16,946 deliveries within the obstetrical cohort participated in the survey. More than 90% of obstetricians reported that they incorporated each intervention into routine practice. Actual frequency of administration in women eligible for the treatments was 93% for corticosteroids, 39% for progesterone, and 71% for magnesium sulfate. Provider satisfaction with quality of treatment evidence was 97% for corticosteroids, 82% for progesterone, and 57% for magnesium sulfate. Obstetricians perceived that barriers to treatment were most frequent for progesterone (76%), 30% for magnesium sulfate, and 17% for corticosteroids. Progesterone use was more frequent among patients whose provider reported the quality of the evidence was above average to excellent compared with poor to average (42% vs 25%, respectively; P < .001), and they were satisfied with their knowledge of the intervention (41% vs 28%; P = .02), and was less common among patients whose provider reported barriers to hospital or pharmacy drug delivery (31% vs 42%; P = .01). Corticosteroid administration was more common among patients who delivered at hospitals with 24 hours a day-7 days a week maternal-fetal medicine specialist coverage (93% vs 84%; P = .046), CONCLUSION: Obstetricians in Maternal-Fetal Medicine Units Network hospitals frequently use these evidence-based interventions; however, progesterone use was found to be related to their assessment of evidence quality. Neither progesterone nor the other interventions were associated with overall climate of innovation within a hospital as measured by the Team Climate for Innovation. National Institutes of Health Consensus Conference Statements may also have an impact on use; there is such a statement for antenatal corticosteroids but not for progesterone for preterm prevention or magnesium sulfate for fetal neuroprotection.
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Affiliation(s)
- Sabine Zoghbi Bousleiman
- Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY.
| | - Madeline Murguia Rice
- Department of Obstetrics and Gynecology, George Washington University Biostatistics Center, Washington, DC
| | - Joan Moss
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX
| | - Allison Todd
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Monica Rincon
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR
| | - Gail Mallett
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Cynthia Milluzzi
- Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH
| | - Donna Allard
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI
| | - Karen Dorman
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Felecia Ortiz
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, TX
| | - Francee Johnson
- Department of Obstetrics and Gynecology, The Ohio State University School of Medicine, Columbus, OH
| | - Peggy Reed
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT
| | - Susan Tolivaisa
- Department of Obstetrics and Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
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Rathbone AP, Husband AK, Todd A, Jamie K. PP53 “I’ve never been a big tablet taker”: a phenomenology of the experiences of medicines adherence in men with diabetes. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hanley J, Fairbrother P, Krishan A, McCloughan L, Padfield P, Paterson M, Pinnock H, Sheikh A, Sudlow C, Todd A, McKinstry B. Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA). Trials 2015; 16:117. [PMID: 25873155 PMCID: PMC4404620 DOI: 10.1186/s13063-015-0628-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 03/03/2015] [Indexed: 11/24/2022] Open
Abstract
Background Good blood pressure (BP) control reduces the risk of recurrence of stroke/transient ischaemic attack (TIA). Although there is strong evidence that BP telemonitoring helps achieve good control, none of the major trials have considered the effectiveness in stroke/TIA survivors. We therefore conducted a feasibility study for a trial of BP telemonitoring for stroke/TIA survivors with uncontrolled BP in primary care. Method Phase 1 was a pilot trial involving 55 patients stratified by stroke/TIA randomised 3:1 to BP telemonitoring for 6 months or usual care. Phase 2 was a qualitative evaluation and comprised semi-structured interviews with 16 trial participants who received telemonitoring and 3 focus groups with 23 members of stroke support groups and 7 carers. Results Overall, 125 patients (60 stroke patients, 65 TIA patients) were approached and 55 (44%) patients were randomised including 27 stroke patients and 28 TIA patients. Fifty-two participants (95%) attended the 6-month follow-up appointment, but one declined the second daytime ambulatory blood pressure monitoring (ABPM) measurement resulting in a 93% completion rate for ABPM − the proposed primary outcome measure for a full trial. Adherence to telemonitoring was good; of the 40 participants who were telemonitoring, 38 continued to provide readings throughout the 6 months. There was a mean reduction of 10.1 mmHg in systolic ABPM in the telemonitoring group compared with 3.8 mmHg in the control group, which suggested the potential for a substantial effect from telemonitoring. Our qualitative analysis found that many stroke patients were concerned about their BP and telemonitoring increased their engagement, was easy, convenient and reassuring. Conclusions A full-scale trial is feasible, likely to recruit well and have good rates of compliance and follow-up. Trial Registration ISRCTN61528726 15/12/2011. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0628-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janet Hanley
- Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK. .,Edinburgh Health Services Research Unit/Edinburgh Clinical Trials Unit, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
| | - Peter Fairbrother
- NHS Lothian, C/O Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Ashma Krishan
- Edinburgh Health Services Research Unit/Edinburgh Clinical Trials Unit, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
| | - Lucy McCloughan
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Paul Padfield
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Mary Paterson
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Hilary Pinnock
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Aziz Sheikh
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Cathie Sudlow
- Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Allison Todd
- NHS Lothian, C/O Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
| | - Brian McKinstry
- Edinburgh Health Services Research Unit/Edinburgh Clinical Trials Unit, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. .,Telescot Programme, Centre for Population Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9DX, UK.
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Menard S, Todd A, Durham HA, Lammi-Keefe CJ, Lampila LE. Benchmarking Select Nutrients in Domestic, Wild Caught and Imported, Farmed Shrimp. Journal of Aquatic Food Product Technology 2015. [DOI: 10.1080/10498850.2012.760187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stoddart A, van der Pol M, Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, McKinstry B. Telemonitoring for chronic obstructive pulmonary disease: a cost and cost-utility analysis of a randomised controlled trial. J Telemed Telecare 2015; 21:108-18. [DOI: 10.1177/1357633x14566574] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We compared the costs and cost-effectiveness of telemonitoring vs usual care for patients with chronic obstructive pulmonary disease (COPD). A total of 256 patients were randomised to either telemonitoring or usual care. In the telemonitoring arm, the touch-screen telemonitoring equipment transmitted data to clinical teams monitoring the patients. Total healthcare costs were estimated over a 12-month period from a National Health Service perspective and quality adjusted life year (QALYs) were estimated by the EQ-5D tool. Telemonitoring was not significantly more costly than usual care (mean difference per patient £2065.90 ( P < 0.18). The increased costs were predominantly due to telemonitoring service costs and non-significantly higher secondary care costs. Telemonitoring for COPD was not cost-effective at a base case of £137,277 per QALY with only 15% probability of being cost-effective at the usual threshold of £30,000 per QALY. Although there was some statistical and methodological uncertainty in the measures used, telemonitoring was not cost-effective in the sensitivity analyses performed. It seems unlikely that a telemonitoring service of the kind that was trialled would be cost-effective in providing care for people with COPD.
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Affiliation(s)
- Andrew Stoddart
- Edinburgh Health Services Research Unit
(HSRU), Centre for Population Health Sciences, University of Edinburgh Medical School,
Teviot Place Edinburgh, UK
| | | | - Hilary Pinnock
- Allergy and Respiratory Research Group, Centre
for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Janet Hanley
- School of Nursing, Midwifery and Social Care,
Edinburgh Napier University, Edinburgh, UK
| | - Lucy McCloughan
- E-health Research Group, Centre for Population
Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Allison Todd
- E-health Research Group, Centre for Population
Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Ashma Krishan
- Edinburgh Clinical Trials Unit, University of
Edinburgh, Edinburgh, UK
| | - Brian McKinstry
- E-health Research Group, Centre for Population
Health Sciences, University of Edinburgh, Edinburgh, UK
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O’Gorman C, Bukhari W, Todd A, Freeman S, Broadley S. Smoking increases the risk of multiple sclerosis in Queensland, Australia. J Clin Neurosci 2014; 21:1730-3. [DOI: 10.1016/j.jocn.2014.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 12/11/2013] [Accepted: 01/13/2014] [Indexed: 10/25/2022]
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Jones R, Todd A. The influence of soccer-specific fatigue on the risk of thigh injuries in amateur Black African players. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, Lewis S, Stoddart A, van der Pol M, MacNee W, Sheikh A, Pagliari C, McKinstry B. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ 2013; 347:f6070. [PMID: 24136634 PMCID: PMC3805483 DOI: 10.1136/bmj.f6070] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To test the effectiveness of telemonitoring integrated into existing clinical services such that intervention and control groups have access to the same clinical care. DESIGN Researcher blind, multicentre, randomised controlled trial. SETTING UK primary care (Lothian, Scotland). PARTICIPANTS Adults with at least one admission for chronic obstructive pulmonary disease (COPD) in the year before randomisation. We excluded people who had other significant lung disease, who were unable to provide informed consent or complete the study, or who had other significant social or clinical problems. INTERVENTIONS Participants were recruited between 21 May 2009 and 28 March 2011, and centrally randomised to receive telemonitoring or conventional self monitoring. Using a touch screen, telemonitoring participants recorded a daily questionnaire about symptoms and treatment use, and monitored oxygen saturation using linked instruments. Algorithms, based on the symptom score, generated alerts if readings were omitted or breached thresholds. Both groups received similar care from existing clinical services. MAIN OUTCOME MEASURES The primary outcome was time to hospital admission due to COPD exacerbation up to one year after randomisation. Other outcomes included number and duration of admissions, and validated questionnaire assessments of health related quality of life (using St George's respiratory questionnaire (SGRQ)), anxiety or depression (or both), self efficacy, knowledge, and adherence to treatment. Analysis was intention to treat. RESULTS Of 256 patients completing the study, 128 patients were randomised to telemonitoring and 128 to usual care; baseline characteristics of each group were similar. The number of days to admission did not differ significantly between groups (adjusted hazard ratio 0.98, 95% confidence interval 0.66 to 1.44). Over one year, the mean number of COPD admissions was similar in both groups (telemonitoring 1.2 admissions per person (standard deviation 1.9) v control 1.1 (1.6); P=0.59). Mean duration of COPD admissions over one year was also similar between groups (9.5 days per person (standard deviation 19.1) v 8.8 days (15.9); P=0.88). The intervention had no significant effect on SGRQ scores between groups (68.2 (standard deviation 16.3) v 67.3 (17.3); adjusted mean difference 1.39 (95% confidence interval -1.57 to 4.35)), or on other questionnaire outcomes. Conclusions In participants with a history of admission for exacerbations of COPD, telemonitoring was not effective in postponing admissions and did not improve quality of life. The positive effect of telemonitoring seen in previous trials could be due to enhancement of the underpinning clinical service rather than the telemonitoring communication. TRIAL REGISTRATION ISRCTN96634935. FUNDING The trial was funded by an NHS applied research programme grant from the Chief Scientist Office of the Scottish government (ARPG/07/03). The funder had no role in study design and the collection, analysis, and interpretation of data and the writing of the article and the decision to submit it for publication. NHS Lothian supported the telemonitoring service and the clinical services.
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Affiliation(s)
- Hilary Pinnock
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK
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Baxter CG, Denning DW, Jones AM, Todd A, Moore CB, Richardson MD. Performance of two Aspergillus IgG EIA assays compared with the precipitin test in chronic and allergic aspergillosis. Clin Microbiol Infect 2013; 19:E197-204. [PMID: 23331929 DOI: 10.1111/1469-0691.12133] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 12/25/2022]
Abstract
Detection of Aspergillus IgG antibodies is important in the diagnosis of chronic pulmonary aspergillosis and allergic bronchopulmonary aspergillosis. Immunoprecipitation techniques to detect these antibodies appear to lack sensitivity and accurate quantitation compared with enzyme immunoassays (EIA). This study assessed the performance of two commercial EIAs compared with counterimmunoelectrophoresis (CIE). This was a prospective cohort study of 175 adult patients with chronic or allergic pulmonary aspergillosis. Aspergillus IgG antibodies were detected using CIE, Phadia ImmunoCap Aspergillus IgG and Bio-Rad Platelia Aspergillus IgG. Inter-assay reproducibility was determined for each method and 25 patients had two serum samples analysed within a 6-month interval. When compared with CIE, both ImmunoCap and Platelia Aspergillus IgG had good sensitivity (97 and 93%, respectively) for detection of Aspergillus IgG antibodies. The level of agreement between the two EIAs for positive results was good, but the concentration of antibodies was not correlated between the tests or with CIE titre. ImmunoCap IgG inter-assay coefficient of variation was 5%, whereas Platelia IgG was 33%. Median ImmunoCap IgG values for CPA and allergic aspergillosis were 95 and 32 mg/L, respectively, whereas Platelia IgG values were >80 and 6 AU/mL. The direction of CIE titre change over 6 months was mirrored by ImmunoCap IgG levels in 92% of patients, and by Platelia IgG in 72% of patients. Both ImmunoCap and Platelia Aspergillus IgG EIAs are sensitive measures of Aspergillus IgG antibodies compared with CIE. However, ImmunoCap appears to have better reproducibility and may be more suitable for monitoring patient disease.
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Affiliation(s)
- C G Baxter
- The National Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK.
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Pinnock H, Fairbrother P, Hanley J, McCloughlan L, Todd A, McKinstry B. P186 Perspectives of Patient and Professional Participants on Telehealthcare and the Impact on Self-Management: Qualitative Study Nested in the TELESCOT COPD Trial. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pinnock H, McCloughlan L, Todd A, Hanley J, Lewis S, Krishan A, MacNee W, Pagliari C, Sheikh A, McKinstry B. S52 Clinical Effectiveness of Telemonitoring For Chronic Obstructive Pulmonary Disease (COPD): Randomised Controlled Trial. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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