1
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Harman KE, Barha J, Chalmers JR, Dart JKG, Davies I, Ellis P, Grindlay D, Hampton PJ, Hill S, Hockey S, Lloyd-Lavery A, McPhee M, Murphy R, Rauz S, Setterfield JF, Thompson I, Westmoreland M, Waistell C. The top 10 research priorities for the treatment of bullous pemphigoid, mucous membrane pemphigoid and pemphigus vulgaris in the UK: results of a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2023; 189:469-498. [PMID: 37201904 DOI: 10.1093/bjd/ljad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/25/2023] [Accepted: 07/06/2023] [Indexed: 05/20/2023]
Abstract
To identify priorities for future research into the treatment of bullous pemphigoid, mucous membrane pemphigoid and pemphigus vulgaris, we conducted a Priority Setting Partnership (PSP) using James Lind Alliance methodology. The top 10 priorities identified in this PSP represent the key questions that patients, carers and healthcare professionals have about the treatment of these diseases and which future research will hopefully address.
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Affiliation(s)
- Karen E Harman
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham
- University Hospitals Leicester NHS Trust, Leicester
| | - Jag Barha
- Patient research partner, PEM Friends patient support group
| | - Jo R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham
| | - John K G Dart
- Moorfields Eye Hospital NHS Foundation Trust, London
- National Institute of Health Research (NIHR), Moorfields Biomedical Research Centre, London
| | - Isobel Davies
- Patient research partner, PEM Friends patient support group
| | | | - Douglas Grindlay
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham
| | | | - Sharleen Hill
- Chelsea and Westminster Hospital NHS Foundation Trust
| | - Sharon Hockey
- Patient research partner, PEM Friends patient support group
| | - Antonia Lloyd-Lavery
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford
| | - Maggie McPhee
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham
| | - Ruth Murphy
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - Saaeha Rauz
- Institute of Inflammation and Ageing, University of Birmingham
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust
| | - Jane F Setterfield
- Host Microbiome Interaction (CHMI), Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London
- St John's Institute of Dermatology & Dept Oral Medicine, Guy's and St Thomas's NHS Foundation Trust, London; all in theUK
| | | | - Melanie Westmoreland
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford
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2
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Abstract
Metacarpal shaft fractures are common hand injuries that predominantly affect younger patients. There is wide variability in their treatment with no consensus on best practice. We performed a systematic review to assess the breadth and quality of available evidence supporting different treatment modalities for metacarpal shaft fractures of the finger digits in adults. A comprehensive search was conducted across multiple databases, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1600 records were identified; 7 studies fulfilled eligibility criteria and were included. No randomized controlled trials directly comparing surgery with nonsurgical treatment were found. One retrospective study compared nonsurgical with surgical treatment, whereas 6 compared surgical or nonsurgical treatments. Considerable heterogeneity between studies along with a high or critical risk of bias restricts direct comparison and conclusions. There is a lack of high-quality evidence to guide treatment, supporting the need for well-designed, multicenter trials to identify the most effective and cost-efficient treatment for metacarpal shaft fractures in adults.
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Affiliation(s)
| | | | | | | | | | - Alexia Karantana
- University of Nottingham, UK
- Nottingham University Hospitals NHS
Trust, UK
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3
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Russell EA, Bennett SD, Ali R, Baron S, Flohr C, Grindlay D, Heyman I, McPherson T, Ravenscroft JC. Identifying mental health needs of children and youth with skin disease: A systematic review of screening and assessment tools. Pediatr Dermatol 2022; 39:541-546. [PMID: 35416327 DOI: 10.1111/pde.14991] [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] [Received: 11/24/2021] [Revised: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES (1) To identify patient reported outcome measures (PROMs) which have been used to screen and assess mental health symptoms in studies of youth with skin disease. (2) To critically appraise their evidence base in this population. METHODS A systematic literature search was conducted within PubMed and PsycINFO combining search terms for pediatric populations, dermatology, screening and assessment tools, and psychological and psychiatric conditions, to identify PROMs which screened or assessed for mental health symptoms in youth with skin disease. PROMs which had undergone validation within this population were assessed for quality and evidence base using the COSMIN risk of bias tool. RESULTS One hundred eleven PROMs which assess mental health symptoms in studies of youth with skin disease were identified. These included generic mental health scales which are extensively validated in different populations. Only one PROM, the "Skin Picking Scale-Revised" has undergone specific validation in youth with skin disease. This showed poor quality of evidence for content validity and therefore cannot be recommended. CONCLUSION There is an urgent need to identify mental health problems early and treat proactively to improve outcomes in youth with skin disease. This review highlights the current lack of consensus around the best way to assess our patients. It is likely that existing generic mental health methods and PROMS will be appropriate for our needs. More work is required to examine the utility, feasibility, and acceptability of existing generic, validated mental health screening tools in youth with skin disease.
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Affiliation(s)
| | | | | | | | | | - Douglas Grindlay
- Centre for Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children, London, UK
| | | | - Jane C Ravenscroft
- Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK
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4
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Haw WY, Al-Janabi A, Arents BWM, Asfour L, Exton LS, Grindlay D, Khan SS, Manounah L, Yen H, Chi CC, van Zuuren EJ, Flohr C, Yiu ZZN. Global Guidelines in Dermatology Mapping Project (GUIDEMAP): a scoping review of dermatology clinical practice guidelines. Br J Dermatol 2021; 185:736-744. [PMID: 33937976 DOI: 10.1111/bjd.20428] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Clinical practice guidelines (CPGs) play a critical role in standardizing and improving treatment outcomes based on the available evidence. It is unclear how many CPGs are available globally to assist clinicians in the management of patients with skin disease. OBJECTIVES To search for and identify CPGs for dermatological conditions with the highest burden globally. METHODS We adapted a list of 12 dermatological conditions with the highest burden from the Global Burden of Disease (GBD) study 2019. A systematic literature search was done to identify CPGs published between October 2014 to October 2019. The scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. RESULTS A total of 226 CPGs were included. Melanoma had the greatest representation in the CPGs, followed by dermatitis and psoriasis. Skin cancers had a relatively high CPG representation but with lower GBD disease burden ranking. There was an uneven distribution by geographical region, with resource-poor settings being under-represented. The skin disease categories of the CPGs correlated weakly with the GBD disability-adjusted life-years metrics. Eighty-nine CPGs did not have funding disclosures and 34 CPGs were behind a paywall. CONCLUSIONS The global production of dermatology CPGs showed wide variation in geographical representation, article accessibility and reporting of funding. The number of skin disease CPGs were not commensurate with its disease burden. Future work will critically appraise the methodology and quality of dermatology CPGs and lead to the production of an accessible online resource summarizing these findings.
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Affiliation(s)
- W Y Haw
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - A Al-Janabi
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - B W M Arents
- Skin Patients Netherlands, Nieuwerkerk a/d IJssel, the Netherlands
| | - L Asfour
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - L S Exton
- Clinical Standards Unit, British Association of Dermatologists, London, UK
| | - D Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, UK
| | - S S Khan
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - L Manounah
- Clinical Standards Unit, British Association of Dermatologists, London, UK
| | - H Yen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - C-C Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - E J van Zuuren
- Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Z Z N Yiu
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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5
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Hasanaj A, Zaki F, Harman KE, Grindlay D, Gran S. Cause-specific mortality in people with bullous pemphigoid and pemphigus vulgaris: a systematic review and meta-analysis. Br J Dermatol 2021; 186:359-361. [PMID: 34510412 DOI: 10.1111/bjd.20759] [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] [Received: 04/29/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- A Hasanaj
- School of Medicine, University of Nottingham, Nottingham, UK
| | - F Zaki
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - K E Harman
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - D Grindlay
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Gran
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
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6
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Persson MSM, Begum N, Grainge MJ, Harman KE, Grindlay D, Gran S. The global incidence of bullous pemphigoid: a systematic review and meta-analysis. Br J Dermatol 2021; 186:414-425. [PMID: 34480482 DOI: 10.1111/bjd.20743] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is an autoimmune blistering disorder that mainly affects older people. Although the disease is associated with considerable morbidity and mortality, the burden of disease worldwide is unclear. OBJECTIVES The study aim is to pool the global incidence of BP and determine whether this varies according to geographic area, age group, setting and study quality. METHODS Ovid MEDLINE, Ovid Embase and grey literature were systematically searched on 7 April 2020. Two reviewers independently screened, extracted data and appraised each study's quality using the Joanna Briggs Institute critical appraisal tool. Two domains, indicative of selection and survey bias, were used to identify high-quality studies. The cumulative incidence was standardized to 1 year and pooled in a random-effects meta-analysis. Subgroup and sensitivity analyses were conducted. RESULTS Twenty-seven studies were identified, of which 23 provided cumulative incidence and four provided incidence rates. The cumulative incidence of BP was 8·2 [95% confidence interval (CI) 4·8-13.7] per million people whereas the incidence rate was 34·2 (95% CI 19·2-60·7) per million person-years. Of the continents that contributed more than one study, the cumulative incidence was 10·3 (95% CI 5·8-18·2) and 5·6 (95% CI 3·5-9·0) per million people in Europe and Asia, respectively. The incidence was highest in studies including adults only (n = 2), in population-based studies (n = 9) and in more recent years. The cumulative incidence was higher (13·3 per million people, 95% CI 6·0-29·5) when restricting the analysis to higher-quality studies (n = 11). High heterogeneity (I2 > 82%) was observed across all pooled estimates. CONCLUSIONS The incidence of BP varies globally, is generally low but appears to be increasing over time. The burden of disease is likely to be underestimated.
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Affiliation(s)
| | - N Begum
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - M J Grainge
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - K E Harman
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - D Grindlay
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - S Gran
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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7
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Cunliffe A, Gran S, Ali U, Grindlay D, Lax SJ, Williams HC, Burden-Teh E. Can atopic eczema and psoriasis coexist? A systematic review and meta-analysis. Skin Health Dis 2021; 1:e29. [PMID: 35664974 PMCID: PMC9060081 DOI: 10.1002/ski2.29] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/03/2022]
Abstract
Importance Previous studies report both coexistence and mutual exclusivity of atopic eczema (AE) and psoriasis, but these have not been appraised systematically. Knowledge of such disease association throws light on disease mechanisms and may influence therapeutic choices. Objective To summarise evidence for AE and psoriasis occurring in the same person at the same point in time. Planned primary outcome was the incidence, prevalence or risk of psoriasis or eczema. Methods Ovid MEDLINE and Ovid Embase were searched from inception to 1st February 2020. The search strategy was built around the key terms ‘atopic eczema’, ‘psoriasis’ and ‘co‐existence’. Observational studies (cohort, case‐control, cross‐sectional and case‐series) with a minimum of 10 consecutive patients were included. There were no restrictions on participants, geography or language. Studies were selected, data extracted and critically appraised by two independent reviewers. Data were extracted on the method of diagnosis: health professional (dermatologist, criteria, other), self‐reported, not specified. Study quality was assessed using validated Joanna Brigg's Institute critical appraisal tools. A random‐effects model was used to combine studies. The effect of study quality on the pooled estimate was investigated using stratification. Heterogeneity was explored by subgroup analysis. Results This review included 31 studies and 20 523 individuals with psoriasis and 1 405 911 with AE. Eight studies reported the prevalence of AE in those with psoriasis and values ranged from 0.17% to 20%: the pooled prevalence was 2% (95% confidence interval [CI]: 1, 3). Seven studies reported the prevalence of psoriasis in those with AE and values ranged from 0.3% to 12.6%; the pooled prevalence was 2% (95% CI: 1, 3). Ten studies were assessed as low risk of bias. Geographical area, method of diagnosis, setting and whether the assessment of diagnosis was blinded, partly contributed to the heterogeneity. Conclusions This review provides some evidence for the coexistence of AE and psoriasis. Clinicians should be aware of coexistence at diagnosis, when selecting therapies and when reviewing poor response to treatment.
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Affiliation(s)
- A Cunliffe
- Nottingham University Hospitals NHS Trust Nottingham UK
| | - S Gran
- Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
| | - U Ali
- Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
| | - D Grindlay
- Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
| | - S J Lax
- Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
| | - H C Williams
- Nottingham University Hospitals NHS Trust Nottingham UK.,Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
| | - E Burden-Teh
- Nottingham University Hospitals NHS Trust Nottingham UK.,Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK
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8
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Stuart BL, Howells L, Pattinson RL, Chalmers JR, Grindlay D, Rogers NK, Grinich E, Pawlitschek T, Simpson EL, Thomas KS. Measurement properties of patient-reported outcome measures for eczema control: a systematic review. J Eur Acad Dermatol Venereol 2021; 35:1987-1993. [PMID: 33977561 DOI: 10.1111/jdv.17335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/23/2021] [Indexed: 12/20/2022]
Abstract
Atopic eczema (herein referred to as 'eczema') is a skin disease characterized by remitting and relapsing symptoms. The Harmonising Outcome Measures for Eczema (HOME) initiative was developed to establish a core outcome set (COS) for eczema to be measured for all future eczema trials. The core outcome set for atopic eczema clinical trials includes the domain for patient-reported eczema control, but a review of the validation of available eczema control instruments was lacking. We aimed to review the literature and systematically assess the measurement properties of validated patient-reported outcome instruments that capture eczema control. PubMed and Ovid EMBASE were searched up to 24 January 2020 for any study that reported on PROM instrument development or validation. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria were used to assess the quality of eligible studies. We screened 12 036 titles and abstracts and 58 full texts. A total of 12 papers were included, reporting on seven PROMS. These were assessed with respect to development, reliability, construct validity and responsiveness. Two instruments, Recap of Atopic Eczema (RECAP) and the Atopic Dermatitis Control Tool (ADCT), have been developed and validated to a sufficient standard to support their recommendation as patient-reported outcome instruments for measuring control of atopic eczema as part of the HOME Core Outcome Set.
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Affiliation(s)
- B L Stuart
- Aldermoor Health Centre, University of Southampton, Southampton, UK
| | - L Howells
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - R L Pattinson
- College of Biomedical and Life Sciences, School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - J R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - D Grindlay
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - N K Rogers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - E Grinich
- Oregon Health and Science University, Portland, OR, USA
| | - T Pawlitschek
- Oregon Health and Science University, Portland, OR, USA
| | - E L Simpson
- Oregon Health and Science University, Portland, OR, USA
| | - K S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
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9
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Deshmukh SR, Mousoulis C, Marson BA, Grindlay D, Karantana A. Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review. J Hand Surg Eur Vol 2021; 46:1753193420983719. [PMID: 33487059 DOI: 10.1177/1753193420983719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study identifies the treatment outcome domains used in recently published studies on the treatment of hand fractures and joint injuries with the aim to inform development of a core outcome set. Seven databases were searched from January 2014 to March 2019 for randomized and quasi-randomized studies and large prospective observational studies. We identified 1777 verbatim outcomes in 160 eligible studies. From the verbatim outcomes we distinguished 639 unique outcomes, which we categorized into 74 outcome domains based on the World Health Organization International Classification of Functioning, Disability, and Health framework. The primary outcome was appropriately identified in only 65% (72/110) of randomized and quasi-randomized controlled trials. Of the 72 studies with a primary outcome identified, 74% (53/72) had an appropriate power calculation. The vast heterogeneity in outcome selection across studies highlights the need for a core outcome set of what outcomes to measure in future clinical research on hand fractures and joint injuries.
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Affiliation(s)
- Sandeep Rajiv Deshmukh
- Centre for Evidence Based Hand Surgery, Academic Orthopaedics, Trauma and Sports Medicine, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK
| | - Christos Mousoulis
- Centre for Evidence Based Hand Surgery, Academic Orthopaedics, Trauma and Sports Medicine, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK
| | - Ben A Marson
- Trauma Outcomes Group, University of Nottingham, Queen's Medical Centre, Nottingham, UK *Authors' details are listed in the acknowledgements section
| | - Douglas Grindlay
- Centre for Evidence Based Hand Surgery, Academic Orthopaedics, Trauma and Sports Medicine, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK
| | - Alexia Karantana
- Centre for Evidence Based Hand Surgery, Academic Orthopaedics, Trauma and Sports Medicine, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK
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10
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Smires S, Afach S, Mazaud C, Phan C, Garcia Doval I, Boyle R, Dellavalle R, Williams HC, Grindlay D, Sbidian E, Le Cleach L. Quality and Reporting Completeness of Systematic Reviews and Meta-Analyses in Dermatology. J Invest Dermatol 2021; 141:64-71. [DOI: 10.1016/j.jid.2020.05.109] [Citation(s) in RCA: 3] [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: 02/20/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
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11
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Mistry K, Sharma S, Patel M, Grindlay D, Janjuha R, Smart P, Levell NJ. Clinical response to antibiotic regimens in lower limb cellulitis: a systematic review. Clin Exp Dermatol 2020; 46:42-49. [PMID: 32860230 DOI: 10.1111/ced.14398] [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] [Received: 05/02/2020] [Revised: 06/02/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022]
Abstract
There is variation in the treatment of lower limb cellulitis (LLC) with no agreement on the most effective antibiotic regimen. Many patients with cellulitis fail to respond to first-line antibiotics. This can negatively affect patient care and result in unnecessary hospital admissions. The aim of this systematic review was to determine the clinical response and safety of antibiotic regimens for the management of LLC. A systematic review for randomized controlled trials (RCTs) was conducted using OVID MEDLINE, Ovid Embase and Cochrane Central Register of Controlled Trials in January 2019. Outcomes of interest included the clinical response to antibiotic regimens (type, dose, route, duration) and the safety of antibiotics in LLC. Trial quality was identified using the Cochrane Risk of Bias tool. Four RCTs were included. All included studies showed no significant differences between the clinical response to different antibiotic type, administration route, treatment duration or dose. LLC may be overtreated and shorter courses of oral antibiotics, possibly with lower doses, may be more suitable. There is a lack of published data on the clinical response and safety of antibiotics in LLC. Three studies were high risk for bias overall. Further high-quality studies may help determine whether less intensive antibiotic regimens can effectively treat LLC.
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Affiliation(s)
- K Mistry
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - S Sharma
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - M Patel
- Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, UK
| | - D Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - R Janjuha
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - P Smart
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - N J Levell
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
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12
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Abstract
Aims To analyze outcomes reported in trials of childhood fractures. Methods OVID MEDLINE, Embase, and Cochrane CENTRAL databases were searched on the eighth August 2019. A manual search of trial registries, bibliographic review and internet search was used to identify additional studies. 11,476 studies were screened following PRISMA guidelines. 100 trials were included in the analysis. Data extraction was completed by two researchers for each trial. Study quality was not evaluated. Outcomes reported by trials were mapped onto domains in the World Health Organization (WHO) International Classification of Function framework. Results In all, 525 outcomes were identified representing 52 WHO domains. Four domains were reported in more than 50% of trials: structure of upper/lower limb, sensation of pain, mobility of joint function, and health services, systems and policies. The Activities Scale for Kids performance (ASK-p) score was the most common outcome score reported in 6/72 upper limb and 4/28 lower limb trials. Conclusion There is a diverse range of outcomes reported in trials of childhood fractures covering all areas in the International Classification of Functioning, Disability and Health (ICF) framework. There were three common upper limb and three common lower limb outcomes. In the absence of a core outcome set, we recommend that upper limb trials report pain, range of movement and radiograph appearance of the arm and lower limb trials report pain, radiograph appearance of the leg and healthcare costs to improve consistency of reporting in future trials. Cite this article: Bone Joint Open 2020;1-5:167–174.
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Affiliation(s)
- Ben A Marson
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Simon Craxford
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Sandeep R Deshmukh
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Douglas Grindlay
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Joseph Manning
- School of Health Sciences, University of Nottingham; Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust Queens' Medical Centre, Nottingham, UK
| | - Benjamin J Ollivere
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
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13
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Abstract
Background: Peripheral 1B tears of the triangular fibrocartilage complex (TFCC) can result in distal radioulnar joint (DRUJ) instability. In the context of associated DRUJ instability, combined evidence supports successful outcomes for peripheral tear repair. Methods: The aim of this systematic review (SR) was to compare the surgical treatment of 1B TFCC tears via arthroscopic versus open methods of repair. The primary outcome measure was restored DRUJ stability. The secondary outcome measures included patient-reported outcomes and clinical outcome measures. An electronic database search of Ovid Embase, PubMed, and the Cochrane Central Register of Controlled Trials was performed to cover a 20-year period. Two authors independently screened records for eligibility and extracted data. Results: Only 3 studies met the strict inclusion criteria, highlighting the poor evidence base for TFCC 1B repairs. Hence, a "secondary analysis" group was developed with modified inclusion criteria which included a further 7 studies for analysis. Pooled data from the primary and secondary analysis groups demonstrated that postoperative DRUJ stability was achieved following open repair in 84% (76/90) of cases and following arthroscopic repair in 86% (129/150) of cases. Conclusions: This SR demonstrates a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears. There is no scientific evidence to suggest superiority of one technique over the other, albeit some surgeons and authors may express a strong personal view.
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Thiagarajan P, Chalmers J, Ban L, Grindlay D, Aithal GP. L-carnitine supplementation in non-alcoholic fatty liver disease: A systematic review and meta-analysis. World J Meta-Anal 2020; 8:4-14. [DOI: 10.13105/wjma.v8.i1.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/17/2019] [Accepted: 02/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) dominates the landscape of modern hepatology. Affecting 25% of the general population, there is critical unmet need to identify broadly available, safe and cost-effective treatments. Cumulative evidence in animal and human models suggests that intrahepatic and skeletal muscle fatty acid oxidation is impaired in NAFLD, such that lipid accretion is not matched by efficient utilisation. L-carnitine is a crucial mediator of fatty acid metabolism in vivo, promoting mitochondrial lipid β-oxidation and enhancing tissue metabolic flexibility. These physiological properties have generated research interest in L-carnitine as a potentially effective adjunctive therapy in NAFLD.
AIM To systematically review randomised trials reporting effects of dietary L-carnitine supplementation on liver biochemistry, liver fat and insulin sensitivity in NAFLD.
METHODS Search strategies, eligibility criteria and analytic methods were specified a priori (PROSPERO reference: CRD42018107063). Ovid MEDLINE, Ovid EMBASE, PubMed, Web of Science and the Cochrane Library were searched from their inception until April 2019. Outcome measures included serum concentrations of alanine and aspartate aminotransferase (ALT and AST), liver fat and insulin sensitivity assessed by the homeostasis model of insulin resistance (HOMA-IR). A random effects meta-analysis was performed for, ALT, AST and HOMA-IR measures separately. Between-study heterogeneity was measured using I2 statistics.
RESULTS Five eligible randomised trials were included in the qualitative and quantitative synthesis (n = 338). All of the 5 included trials assessed the effect of L-carnitine on serum ALT, identified from Italy, South Korea and Iran. Weighted mean difference (WMD) for ALT between L-carnitine and control groups after intervention was -25.34 IU/L [95%CI: -41.74-(-8.94); P = 0.002]. WMD for AST between L-carnitine and control groups was -13.68 IU/L (95%CI: -28.26-0.89; P = 0.066). In three studies (n = 204), HOMA-IR was evaluated. WMD for HOMA-IR between L-carnitine and control groups was -0.74 units [95%CI: -1.02-(-0.46); P < 0.001]. Two studies using validated outcome measures reported a significant reduction in liver fat in L-carnitine vs control groups post-intervention (P < 0.001).
CONCLUSION Pooled results indicate that L-carnitine supplementation attenuates ALT, liver fat and insulin resistance in NAFLD cohorts, confirming a beneficial effect of L-carnitine for a highly prevalent condition with a growing economic burden.
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Affiliation(s)
- Prarthana Thiagarajan
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, United Kingdom
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Jane Chalmers
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, United Kingdom
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Lu Ban
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, United Kingdom
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Douglas Grindlay
- Centre for Evidence Based Dermatology, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Guruprasad P Aithal
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, United Kingdom
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
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15
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Mousoulis C, Thomas K, Leighton P, Deshmukh S, Grindlay D, Karantana A. Treatment interventions for hand fractures and joint injuries: a scoping review of randomized controlled trials. J Hand Surg Eur Vol 2020; 45:111-118. [PMID: 31382799 PMCID: PMC6974775 DOI: 10.1177/1753193419865897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of this study was to identify and assess all existing randomized studies on treatment interventions for hand fractures and joint injuries, to inform practice and plan future research. PubMed, Cochrane CENTRAL, MEDLINE and Embase were searched. We identified 78 randomized controlled trials published over 35 years, covering seven anatomical areas of the hand. We report on sources of bias, sample size, follow-up length and retention, outcome measures and reporting. In terms of interventions studied, the trials were extremely heterogeneous, so it is difficult to draw conclusions on individual treatments. The published randomized controlled clinical trial evidence for hand fractures and joint injuries is narrow in scope and of generally low methodological quality. Mapping provides a useful resource and stepping-stone for planning further research. There is a need for high-quality, collaborative research to guide management of a wider range of common hand injuries.
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Affiliation(s)
- Christos Mousoulis
- Centre for Evidence Based Hand Surgery,
University of Nottingham, Nottingham, UK,Christos Mousoulis, Academic Orthopaedics,
Trauma and Sports Medicine, School of Medicine, Faculty of Medicine and Health
Sciences, C Floor, West Block, Queen's Medical Centre, Nottingham NG7 2UH, UK.
| | - Kim Thomas
- Centre of Evidence Based Dermatology,
University of Nottingham, Nottingham, UK
| | - Paul Leighton
- Centre of Evidence Based Dermatology,
University of Nottingham, Nottingham, UK
| | - Sandeep Deshmukh
- Centre for Evidence Based Hand Surgery,
University of Nottingham, Nottingham, UK
| | - Douglas Grindlay
- Centre for Evidence Based Hand Surgery,
University of Nottingham, Nottingham, UK,Centre of Evidence Based Dermatology,
University of Nottingham, Nottingham, UK
| | - Alexia Karantana
- Centre for Evidence Based Hand Surgery,
University of Nottingham, Nottingham, UK
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16
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Boksh K, Sharma A, Grindlay D, Divall P, Mangwani J. Dorsal bridge plating versus. Transarticular screw fixation for lisfranc injuries: A systematic review and meta-analysis. J Clin Orthop Trauma 2020; 11:508-513. [PMID: 32581491 PMCID: PMC7303533 DOI: 10.1016/j.jcot.2020.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 03/23/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 01/30/2023] Open
Abstract
Lisfranc injuries are relatively uncommon but carry devastating consequences if left untreated. Although many surgical techniques have been proposed for best operative management, there is an ongoing debate over which procedure is superior. We performed a systematic review and meta-analysis comparing the outcomes of transarticular screw fixation and dorsal bridge plating in management of Lisfranc injuries. Ovid MEDLINE, Ovid Embase and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify randomised controlled trials (RCTs) and cohort studies comparing the outcomes between screw and dorsal plate fixation. The pooled outcome data were calculated by random and fixed effect models. One prospective cohort and three retrospective studies were identified with a total of 210 patients with mean follow up of 40.6 months. All papers were analysed for quality using the modified Newcastle Ottawa score. The results show that dorsal bridge plating is associated with better American Orthopaedic Foot and Ankle Society score (AOFAS) compared with transarticular screw fixation (OR - 0.71, 95% CI -1.31 to -0.10, p = 0.02). Dorsal plating may also be associated with fewer cases of arthritis, although this was not significant (OR 2.46, 95% CI 0.89 to 6.80, p = 0.08). We found no significant differences between the groups in terms of Foot Function Index (FFI), post traumatic arthritis and failure of hardware material. Although our results suggest dorsal bridge plating may provide superior functional outcomes, there is a scarcity of literature with little robustness to make definitive conclusions. High quality randomised trials are required.
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Affiliation(s)
- Khalis Boksh
- Department of Trauma and Orthopaedics, Leicester Royal Infirmary, United Kingdom,Corresponding author.
| | - Ashwini Sharma
- Department of Trauma and Orthopaedics, Leicester Royal Infirmary, United Kingdom
| | - Douglas Grindlay
- Centre for Evidence Based Hand Surgery, University of Nottingham, United Kingdom
| | - Pip Divall
- Department of Trauma and Orthopaedics, Leicester Royal Infirmary, United Kingdom
| | - Jitendra Mangwani
- Department of Trauma and Orthopaedics, Leicester Royal Infirmary, United Kingdom
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17
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Smires S, Afach S, Mazaud C, Phan C, Garcia Doval I, Boyle R, Dellavalle R, Williams H, Grindlay D, Sbidian E, Le Cleach L. Méthodologie et description des revues systématiques et méta-analyses en dermatologie. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.374] [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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18
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Patel M, Lee S, Akyea R, Grindlay D, Francis N, Levell N, Smart P, Kai J, Thomas K. 针对下肢蜂窝织炎开发的诊断辅助. Br J Dermatol 2019. [DOI: 10.1111/bjd.18581] [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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19
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Patel M, Lee S, Akyea R, Grindlay D, Francis N, Levell N, Smart P, Kai J, Thomas K. Diagnostic aids developed for lower‐limb cellulitis. Br J Dermatol 2019. [DOI: 10.1111/bjd.18569] [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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20
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Affiliation(s)
- Matthew J Ridd
- Population Health Sciences, University of Bristol, Bristol BS8 2PS, UK
| | - Amanda Roberts
- Nottingham Eczema Support Group for Carers of Children with Eczema, Nottingham, UK
| | - Douglas Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, UK
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21
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Patel M, Lee SI, Akyea RK, Grindlay D, Francis N, Levell NJ, Smart P, Kai J, Thomas KS. A systematic review showing the lack of diagnostic criteria and tools developed for lower-limb cellulitis. Br J Dermatol 2019; 181:1156-1165. [PMID: 30844076 PMCID: PMC6916392 DOI: 10.1111/bjd.17857] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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] [Accepted: 03/02/2019] [Indexed: 01/07/2023]
Abstract
Background Cellulitis can be a difficult diagnosis to make. Furthermore, 31% of patients admitted from the emergency department with suspected lower‐limb cellulitis have been misdiagnosed, with incorrect treatment potentially resulting in avoidable hospital admission and the prescription of unnecessary antibiotics. Objectives We sought to identify diagnostic criteria or tools that have been developed for lower‐limb cellulitis. Methods We conducted a systematic review using Ovid MEDLINE and Embase databases in May 2018, with the aim of describing diagnostic criteria and tools developed for lower‐limb cellulitis, and we assessed the quality of the studies identified using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. We included all types of study that described diagnostic criteria or tools. Results Eight observational studies were included. Five studies examined biochemical markers, two studies assessed imaging and one study developed a diagnostic decision model. All eight studies were considered to have a high risk for bias in at least one domain. The quantity and quality of available data was low and results could not be pooled owing to the heterogeneity of the findings. Conclusions There is a lack of high‐quality publications describing criteria or tools for diagnosing lower‐limb cellulitis. Future studies using prospective designs, validated in both primary and secondary care settings, are needed. What's already known about this topic? Diagnosing lower‐limb cellulitis on first presentation is challenging. Approximately one in three patients admitted from the emergency department with suspected lower‐limb cellulitis do not have cellulitis and are given another diagnosis on discharge. Consequently, this results in potentially avoidable hospital admissions and the prescription of unnecessary antibiotics. There are no diagnostic criteria available for lower‐limb cellulitis in the U.K.
What does this study add? This systematic review has identified a key research gap in the diagnosis of lower‐limb cellulitis. There is a current lack of robustly developed and validated diagnostic criteria or tools for use in clinical practice.
Linked Comment: https://doi.org/10.1111/bjd.18317. https://doi.org/10.1111/bjd.18569 available online
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Affiliation(s)
- M Patel
- Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, U.K
| | - S I Lee
- Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, U.K
| | - R K Akyea
- Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, U.K
| | - D Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - N Francis
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, U.K
| | - N J Levell
- Dermatology Department, Norfolk and Norwich University Hospital NHS Trust, Norwich, U.K
| | - P Smart
- Patient representative, University of Nottingham, Nottingham, U.K
| | - J Kai
- Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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22
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Abstract
BACKGROUND The purpose of the present study was to systematically evaluate the completeness of trial registration and the extent of outcome-reporting bias in modern randomized controlled trials (RCTs) relating to the treatment of distal radial fracture. METHODS With use of 4 databases (PubMed, Cochrane CENTRAL, Embase, and PEDro), this systematic review identified all RCTs of distal radial fracture treatment published from January 1, 2010, to December 31, 2015. We independently determined the registration status of these trials in a public trial registry and compared the characteristics of registered and non-registered trials. We assessed the quality and consistency of primary outcome measure (POM) reporting between the registration data and the final published studies. RESULTS Ninety studies met the inclusion criteria. Of those, only 28 (31%) were registered, and only 3 (3%) were "appropriately registered" (i.e., prospectively registered and identifying and fully describing the POM). Registered trials had larger sample sizes and were more likely to be multicenter, to report funding sources, and to be published in higher-impact-factor journals. Sixteen (18%) of the 90 registered RCTs named a POM in the registry; 7 (44%) of those 16 registered RCTs stated a different POM, an additional POM, or no POM at all in the final publication than was stated in the registry data. Additionally, 13 (81%) of those 16 registered RCTs had discrepancies in the time point reported for the POM. CONCLUSIONS In an attempt to address publication and outcome-reporting bias, prospective trial registration in a public registry has been deemed a condition for publication by the International Committee of Medical Journal Editors (ICMJE) since 2005. This study shows poor registration rates as well as inconsistencies in the reporting of POMs of recent trials relating to the treatment of distal radial fracture, one of the most common and most investigated injuries in orthopaedic practice. CLINICAL RELEVANCE The problems of registration and outcome-reporting bias in RCTs are important to highlight and address, and to find a solution will require the cooperation of researchers, reviewers, and journal editors. Increasing the transparency and consistency of reporting will help to increase the quality of research, which can impact patient care through evidence-based guidelines.
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Affiliation(s)
- Shiela Lee
- Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Tanvir Khan
- Department of Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Douglas Grindlay
- Department of Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Alexia Karantana
- Department of Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Nottingham, United Kingdom
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23
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Ban L, Labbouz S, Grindlay D, Batchelor JM, Ratib S. Risk of skin cancer in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol 2018; 179:971-972. [PMID: 29704869 DOI: 10.1111/bjd.16703] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L Ban
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, U.K
| | - S Labbouz
- Nottingham University Hospitals NHS Trust, Nottingham, U.K
| | - D Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - J M Batchelor
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - S Ratib
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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24
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Burden-Teh E, Phillips R, Thomas K, Ratib S, Grindlay D, Murphy R. 成人和儿童银屑病诊断标准系统论述:主要目的是为制定或验证诊断标准的研究而得出的证据. Br J Dermatol 2018. [DOI: 10.1111/bjd.16638] [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: 11/28/2022]
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25
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Burden-Teh E, Phillips R, Thomas K, Ratib S, Grindlay D, Murphy R. A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria. Br J Dermatol 2018. [DOI: 10.1111/bjd.16619] [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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26
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Osinubi O, Grainge M, Hong L, Ahmed A, Batchelor J, Grindlay D, Thompson A, Ratib S. The prevalence of psychological comorbidity in people with vitiligo: a systematic review and meta‐analysis. Br J Dermatol 2018. [DOI: 10.1111/bjd.16511] [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: 11/30/2022]
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27
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Osinubi O, Grainge M, Hong L, Ahmed A, Batchelor J, Grindlay D, Thompson A, Ratib S. 心理疾病在白癜风患者中的发病率:一项系统综述与元分析. Br J Dermatol 2018. [DOI: 10.1111/bjd.16580] [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: 11/28/2022]
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28
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Burden-Teh E, Phillips R, Thomas K, Ratib S, Grindlay D, Murphy R. A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria. Br J Dermatol 2018; 178:1035-1043. [DOI: 10.1111/bjd.16104] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 12/31/2022]
Affiliation(s)
- E. Burden-Teh
- Centre of Evidence Based Dermatology; King's Meadow Campus; University of Nottingham; Nottingham U.K
| | - R.C. Phillips
- Department of Paediatric Dermatology; Nottingham University Hospitals NHS Trust; Nottingham U.K
| | - K.S. Thomas
- Centre of Evidence Based Dermatology; King's Meadow Campus; University of Nottingham; Nottingham U.K
| | - S. Ratib
- Centre of Evidence Based Dermatology; King's Meadow Campus; University of Nottingham; Nottingham U.K
| | - D. Grindlay
- Centre of Evidence Based Dermatology; King's Meadow Campus; University of Nottingham; Nottingham U.K
| | - R. Murphy
- Department of Dermatology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield U.K
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29
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Osinubi O, Grainge MJ, Hong L, Ahmed A, Batchelor JM, Grindlay D, Thompson AR, Ratib S. The prevalence of psychological comorbidity in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol 2018; 178:863-878. [PMID: 28991357 DOI: 10.1111/bjd.16049] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitiligo is a chronic disorder causing skin depigmentation with global prevalence varying from 0·2% to 1·8%. U.K. guidelines recommend assessment of psychological state during clinical evaluation of vitiligo. However, the prevalence of psychological comorbidity in people with vitiligo has not been described. OBJECTIVES To establish the prevalence of psychological symptoms or disorders in people with vitiligo and describe the outcome measures used. METHODS We performed a comprehensive search of MEDLINE, Embase, CINAHL and PsycINFO to identify observational studies assessing the prevalence of psychological symptoms or disorders (December 2016). DerSimonian and Lard random-effects models were used to estimate the overall pooled prevalence. RESULTS We identified 29 studies with 2530 people with vitiligo. Most studies included a measure of either depression (n = 25) or anxiety (n = 13). The commonest tools were the Hospital Anxiety and Depression Scale and the Centre for Epidemiology Studies Depression Scale. Ten studies provided information on 13 other psychological outcomes. Pooled prevalence using depression-specific and anxiety-specific questionnaires was 0·29 [95% confidence interval (CI) 0·21-0·38] and 0·33 (95% CI 0·18-0·49), respectively. Prevalence was lower for clinically diagnosed depression (0·21, 95% CI 0·15-0·28) and anxiety (0·15, 95% CI 0·06-0·24). When nonspecific tools were used the prevalence remained similar for depression (0·27, 95% CI 0·08-0·46) but increased for anxiety (0·46, 95% CI 0·39-0·52). High heterogeneity was observed. CONCLUSIONS A range of psychological outcomes are common in people with vitiligo. The prevalence of anxiety was influenced by type of screening tool, suggesting the need for validation of psychological outcome screening tools in the field of dermatology.
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Affiliation(s)
- O Osinubi
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham, U.K
| | - M J Grainge
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham, U.K
| | - L Hong
- Nottingham University Hospitals NHS Trust, Nottingham, U.K
| | - A Ahmed
- Watford General Hospital, Watford, U.K
| | - J M Batchelor
- Centre of Evidence Based Dermatology, Division of Rheumatology & Orthopaedics, University of Nottingham, Nottingham, U.K
| | - D Grindlay
- Centre of Evidence Based Dermatology, Division of Rheumatology & Orthopaedics, University of Nottingham, Nottingham, U.K
| | - A R Thompson
- Department of Psychology, University of Sheffield, U.K
| | - S Ratib
- Centre of Evidence Based Dermatology, Division of Rheumatology & Orthopaedics, University of Nottingham, Nottingham, U.K
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30
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Robinson NJ, Lyons E, Grindlay D, Brennan ML. Veterinarian Nominated Common Conditions of Rabbits and Guinea Pigs Compared with Published Literature. Vet Sci 2017; 4:E58. [PMID: 29165371 PMCID: PMC5753638 DOI: 10.3390/vetsci4040058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/14/2017] [Accepted: 11/19/2017] [Indexed: 11/30/2022] Open
Abstract
Rabbits and guinea pigs are increasingly popular pets in the UK, yet little is known about their common ailments, or how these relate to what appears in the published literature. The aim of this study was to characterise the common conditions of rabbits and guinea pigs, and to compare these with the topics found in the published literature. Information about the common conditions seen in rabbits and guinea pigs in clinical practice was obtained from a survey of UK veterinarians. The common conditions seen were compared with results from a structured literature search. Conditions relating to the dental (29.9%), and skin (37.6%) body systems were commonly nominated by veterinarians for rabbits and guinea pigs, respectively. A total of 655 rabbit and 1086 guinea pig citations were examined and there appeared to be a mismatch between the conditions nominated in the veterinary questionnaire, and those found in the literature. This is the first time that the published literature has been compared to the nominated caseload of veterinarians in practice, and there is concern that the literature about rabbits and guinea pigs may not be representative of, or relevant to the caseload seen in clinical practice. This is of importance for clinicians being able to apply an objective, evidence-based approach. The publishing of clinically-relevant, research-based evidence should be prioritised.
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Affiliation(s)
- Natalie J Robinson
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Emma Lyons
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Douglas Grindlay
- Centre for Evidence-based Dermatology, University of Nottingham, Kings Meadow Campus, Nottingham NG7 2NR, UK.
| | - Marnie L Brennan
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
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31
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Morrison B, Burden-Teh E, Batchelor J, Mead E, Grindlay D, Ratib S. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol 2017; 177:e338-e339. [DOI: 10.1111/bjd.15933] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. Morrison
- Medical School; University of Nottingham; Nottingham U.K
| | - E. Burden-Teh
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - J.M. Batchelor
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - E. Mead
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - D. Grindlay
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - S. Ratib
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
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Wareham KJ, Hyde RM, Grindlay D, Brennan ML, Dean RS. Sample size and number of outcome measures of veterinary randomised controlled trials of pharmaceutical interventions funded by different sources, a cross-sectional study. BMC Vet Res 2017; 13:295. [PMID: 28978314 PMCID: PMC5628436 DOI: 10.1186/s12917-017-1207-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background Randomised controlled trials (RCTs) are a key component of the veterinary evidence base. Sample sizes and defined outcome measures are crucial components of RCTs. To describe the sample size and number of outcome measures of veterinary RCTs either funded by the pharmaceutical industry or not, published in 2011. Methods A structured search of PubMed identified RCTs examining the efficacy of pharmaceutical interventions. Number of outcome measures, number of animals enrolled per trial, whether a primary outcome was identified, and the presence of a sample size calculation were extracted from the RCTs. The source of funding was identified for each trial and groups compared on the above parameters. Results Literature searches returned 972 papers; 86 papers comprising 126 individual trials were analysed. The median number of outcomes per trial was 5.0; there were no significant differences across funding groups (p = 0.133). The median number of animals enrolled per trial was 30.0; this was similar across funding groups (p = 0.302). A primary outcome was identified in 40.5% of trials and was significantly more likely to be stated in trials funded by a pharmaceutical company. A very low percentage of trials reported a sample size calculation (14.3%). Conclusions Failure to report primary outcomes, justify sample sizes and the reporting of multiple outcome measures was a common feature in all of the clinical trials examined in this study. It is possible some of these factors may be affected by the source of funding of the studies, but the influence of funding needs to be explored with a larger number of trials. Some veterinary RCTs provide a weak evidence base and targeted strategies are required to improve the quality of veterinary RCTs to ensure there is reliable evidence on which to base clinical decisions. Electronic supplementary material The online version of this article (10.1186/s12917-017-1207-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K J Wareham
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - R M Hyde
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - D Grindlay
- Centre of Evidence Based Dermatology, The University of Nottingham, King's Meadow Campus Lenton Lane, Nottingham, NG7 2NR, UK
| | - M L Brennan
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - R S Dean
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK.
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Wareham KJ, Hyde RM, Grindlay D, Brennan ML, Dean RS. Sponsorship bias and quality of randomised controlled trials in veterinary medicine. BMC Vet Res 2017; 13:234. [PMID: 28807033 PMCID: PMC5557072 DOI: 10.1186/s12917-017-1146-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 07/23/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) are considered the gold standard form of evidence for assessing treatment efficacy, but many factors can influence their reliability including methodological quality, reporting quality and funding source. The aim of this study was to examine the relationship between funding source and positive outcome reporting in veterinary RCTs published in 2011 and to assess the risk of bias in the RCTs identified. METHODS A structured search of PubMed was used to identify feline, canine, equine, bovine and ovine clinical trials examining the efficacy of pharmaceutical interventions published in 2011. Funding source and outcomes were extracted from each RCT and an assessment of risk of bias made using the Cochrane risk of bias tool. RESULTS Literature searches returned 972 papers, with 86 papers (comprising 126 individual RCTs) included in the analysis. There was found to be a significantly higher proportion of positive outcomes reported in the pharmaceutical funding group (P) compared to the non-pharmaceutical (NP) and 'no funding source stated' (NF) groups (P = 56.9%, NP = 34.9%, NF = 29.1%, p < 0.05). A high proportion of trials had an unclear risk of bias across the five criteria examined. CONCLUSIONS We found evidence that veterinary RCTs were more likely to report positive outcomes if they have pharmaceutical industry funding or involvement. Consistently poor reporting of trials, including non-identification of funding source, was found which hinders the use of the available evidence.
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Affiliation(s)
- K J Wareham
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - R M Hyde
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - D Grindlay
- Centre of Evidence-based Dermatology, University ofNottingham, Kings Meadow campus, Lenton Lane, Nottingham, NG7 2NR, UK
| | - M L Brennan
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK
| | - R S Dean
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington campus, Loughborough, LE12 5RD, UK.
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Affiliation(s)
- D. Grindlay
- Centre of Evidence Based Dermatology; Division of Rheumatology, Orthopaedics and Dermatology; School of Medicine; University of Nottingham; Kings Meadow Campus Nottingham NG7 2NR U.K
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Khan T, Grindlay D, Ollivere BJ, Scammell BE, Manktelow ARJ, Pearson RG. A systematic review of Vancouver B2 and B3 periprosthetic femoral fractures. Bone Joint J 2017; 99-B:17-25. [DOI: 10.1302/0301-620x.99b4.bjj-2016-1311.r1] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/09/2017] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to investigate the outcomes of Vancouver type B2 and B3 fractures by performing a systematic review of the methods of surgical treatment which have been reported. Materials and Methods A systematic search was performed in Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials. For inclusion, studies required a minimum of ten patients with a Vancouver type B2 and/or ten patients with a Vancouver type B3 fracture, a minimum mean follow-up of two years and outcomes which were matched to the type of fracture. Studies were also required to report the rate of re-operation as an outcome measure. The protocol was registered in the PROSPERO database. Results A total of 22 studies were included based on the eligibility criteria, including 343 B2 fractures and 167 B3 fractures. The mean follow-up ranged from 32 months to 74 months. Of 343 Vancouver B2 fractures, the treatment in 298 (86.8%) involved revision arthroplasty and 45 (12.6%) were treated with internal fixation alone. A total of 37 patients (12.4%) treated with revision arthroplasty and six (13.3%) treated by internal fixation only underwent further re-operation. Of 167 Vancouver B3 fractures, the treatment in 160 (95.8%) involved revision arthroplasty and eight (4.8%) were treated with internal fixation without revision. A total of 23 patients (14.4%) treated with revision arthroplasty and two (28.6%) treated only with internal fixation required re-operation. Conclusion A significant proportion, particularly of B2 fractures, were treated without revision of the stem. These were associated with a higher rate of re-operation. The treatment of B3 fractures without revision of the stem resulted in a high rate of re-operation. This demonstrates the importance of careful evaluation and accurate characterisation of the fracture at the time of presentation to ensure the correct management. There is a need for improvement in the reporting of data in case series recording the outcome of the surgical treatment of periprosthetic fractures. We have suggested a minimum dataset to improve the quality of data in studies dealing with these fractures. Cite this article: Bone Joint J 2017;99-B(4 Supple B):17–25.
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Affiliation(s)
- T. Khan
- University of Nottingham, Nottingham
NG7 2NR, UK
| | - D. Grindlay
- University of Nottingham, Nottingham
NG7 2NR, UK
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Lloyd-Lavery A, Rogers NK, Hatfield SJ, Grindlay D, Barnett R, Thomas KS. What's new in atopic eczema? An analysis of systematic reviews published in 2014. Part 2. Treatment and prevention. Clin Exp Dermatol 2016; 42:3-7. [DOI: 10.1111/ced.12967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 12/16/2022]
Affiliation(s)
- A. Lloyd-Lavery
- Department of Dermatology; Churchill Hospital; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - N. K. Rogers
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | | | - D. Grindlay
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - R. Barnett
- Department of Dermatology; Churchill Hospital; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - K. S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
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Hatfield SJ, Rogers NK, Lloyd-Lavery A, Grindlay D, Barnett R, Thomas KS. What's new in atopic eczema? An analysis of systematic reviews published in 2014. Part 1. Epidemiology, risk factors and outcomes. Clin Exp Dermatol 2016; 41:843-846. [DOI: 10.1111/ced.12977] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - N. K. Rogers
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - A. Lloyd-Lavery
- Department of Dermatology; Churchill Hospital; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - D. Grindlay
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - R. Barnett
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - K. S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
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Wilkes S, Burden‐Teh E, Robertson F, Grindlay D, Selby N. Skin and soft tissue infections and acute kidney injury: a systematic review. Br J Dermatol 2016; 175:182-4. [DOI: 10.1111/bjd.14368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- S.R. Wilkes
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - E. Burden‐Teh
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - F. Robertson
- Division of Medical Sciences and Graduate Entry Medicine University of Nottingham Nottingham U.K
| | - D. Grindlay
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - N.M. Selby
- Division of Medical Sciences and Graduate Entry Medicine University of Nottingham Nottingham U.K
- Department of Renal Medicine Royal Derby Hospital Derby U.K
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Burden‐Teh E, Thomas K, Ratib S, Grindlay D, Adaji E, Murphy R. The epidemiology of childhood psoriasis: a scoping review. Br J Dermatol 2016; 174:1242-57. [DOI: 10.1111/bjd.14507] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 12/13/2022]
Affiliation(s)
- E. Burden‐Teh
- Centre of Evidence Based Dermatology University of Nottingham Nottingham U.K
| | - K.S. Thomas
- Centre of Evidence Based Dermatology University of Nottingham Nottingham U.K
| | - S. Ratib
- Centre of Evidence Based Dermatology University of Nottingham Nottingham U.K
| | - D. Grindlay
- Centre of Evidence Based Dermatology University of Nottingham Nottingham U.K
| | - E. Adaji
- Division of Epidemiology & Public Health University of Nottingham Nottingham U.K
| | - R. Murphy
- Sheffield Teaching Hospitals NHS Foundation Trust Sheffield U.K
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Affiliation(s)
- D Grindlay
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
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Dean R, Mackway-Jones K, Wareham K, Grindlay D, Brennan M. BestBETs for Vets: a way to improve the odds of delivering high-quality care. Vet Rec 2015; 176:354-6. [PMID: 25837948 DOI: 10.1136/vr.h1593] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Rachel Dean
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire LE12 5RD, UK
| | | | - Kathryn Wareham
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire LE12 5RD, UK
| | - Douglas Grindlay
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire LE12 5RD, UK
| | - Marnie Brennan
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire LE12 5RD, UK
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Schofield JK, Fleming D, Grindlay D, Williams H. Skin conditions are the commonest new reason people present to general practitioners in England and Wales. Br J Dermatol 2011; 165:1044-50. [PMID: 21692764 DOI: 10.1111/j.1365-2133.2011.10464.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Knowledge of the prevalence and incidence of skin conditions is a prerequisite for designing clinical services and providing appropriate training for primary health care professionals. In the U.K. the general practitioner and practice nurse are the first point of medical contact for persons with skin conditions. OBJECTIVES We aimed to obtain contemporary data in age-, gender- and diagnosis-specific detail on persons presenting to primary care with skin problems. Comparisons were made with similar data for other major disease groups and with similar data from other recent years. METHODS We used surveillance data collected in the Weekly Returns Service (WRS) of the Royal College of General Practitioners during 2006 and trend data for subsequent years. The WRS sentinel practices monitor all consultations by clinical diagnosis in a representative population of 950,000 in England and Wales. RESULTS For conditions included in chapter XII of the International Classification of Diseases Ninth Revision (ICD9), 15% of the population consulted; a further 9% presented with skin problems classified elsewhere in the ICD9, making a total of 24%. There was no evidence of increasing or decreasing trend since 2006. Skin infections were the commonest diagnostic group, while 20% of children < 12 months were diagnosed with atopic eczema. Considered collectively, the incidence of new episodes of skin disorders (including diagnoses outside chapter XII) exceeded incidences for all other major disease groupings. CONCLUSIONS Compared with other major disease groups, skin conditions are the most frequent reason for consultation in general practice. This result emphasizes the need for appropriate education and training for all medical students and particularly for continuing education in dermatology for all primary health care professionals.
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Affiliation(s)
- J K Schofield
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Nottingham NG7 2NR, UK.
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Grindlay D, Boulos MNK, Williams HC. Introducing the National Library for Health Skin Conditions Specialist Library. BMC Dermatol 2005; 5:4. [PMID: 15854224 PMCID: PMC1087837 DOI: 10.1186/1471-5945-5-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 04/26/2005] [Indexed: 11/10/2022]
Abstract
BACKGROUND This paper introduces the new National Library for Health Skin Conditions Specialist Library http://www.library.nhs.uk/skin. DESCRIPTION The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. CONCLUSION The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches.
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Affiliation(s)
- Douglas Grindlay
- National Library for Health Skin Conditions Specialist Library, Centre of Evidence-Based Dermatology, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
| | | | - Hywel C Williams
- National Library for Health Skin Conditions Specialist Library, Centre of Evidence-Based Dermatology, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
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Grindlay D, Reynolds T. The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel. J Ethnopharmacol 1986; 16:117-151. [PMID: 3528673 DOI: 10.1016/0378-8741(86)90085-1] [Citation(s) in RCA: 178] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The mucilaginous gel from the parenchymatous cells in the leaf pulp of Aloe vera has been used since early times for a host of curative purposes. This gel should be distinguished clearly from the bitter yellow exudate originating from the bundle sheath cells, which is used for its purgative effects. Aloe vera gel has come to play a prominent role as a contemporary folk remedy, and numerous optimistic, and in some cases extravagant, claims have been made for its medicinal properties. Modern clinical use of the gel began in the 1930s, with reports of successful treatment of X-ray and radium burns, which led to further experimental studies using laboratory animals in the following decades. The reports of these experiments and the numerous favourable case histories did not give conclusive evidence, since although positive results were usually described, much of the work suffered from poor experimental design and insufficiently large test samples. In addition some conflicting or inconsistent results were obtained. With the recent resurgence of interest in Aloe vera gel, however, new experimental work has indicated the possibility of distinct physiological effects. Chemical analysis has shown the gel to contain various carbohydrate polymers, notably either glucomannans or pectic acid, along with a range of other organic and inorganic components. Although many physiological properties of the gel have been described, there is no certain correlation between these and the identified gel components.
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