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Sousa Filho LF, Farlie MK, Haines T, Borrelli B, Carroll C, Mathews C, Ribeiro DC, Fritz JM, Underwood M, Foster NE, Lamb SE, Sanchez ZM, Malliaras P. Developing an international consensus Reporting guideline for intervention Fidelity in Non-Drug, non-surgical trials: The ReFiND protocol. Contemp Clin Trials 2024; 142:107575. [PMID: 38750951 DOI: 10.1016/j.cct.2024.107575] [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: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/11/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Inadequate reporting of fidelity to interventions in trials limits the transparency and interpretation of trial findings. Despite this, most trials of non-drug, non-surgical interventions lack comprehensive reporting of fidelity. If fidelity is poorly reported, it is unclear which intervention components were tested or implemented within the trial, which also hinders research reproducibility. This protocol describes the development process of a reporting guideline for fidelity of non-drug, non-surgical interventions (ReFiND) in the context of trials. METHODS The ReFiND guideline will be developed in six stages. Stage one: a guideline development group has been formed to oversee the guideline methodology. Stage two: a scoping review will be conducted to identify and summarize existing guidance documents on the fidelity of non-drug, non-surgical interventions. Stage three: a Delphi study will be conducted to reach consensus on reporting items. Stage four: a consensus meeting will be held to consolidate the reporting items and discuss the wording and structure of the guideline. Stage five: a guidance statement, an elaboration and explanation document, and a reporting checklist will be developed. Stage six: different strategies will be used to disseminate and implement the ReFiND guideline. DISCUSSION The ReFiND guideline will provide a set of items developed through international consensus to improve the reporting of intervention fidelity in trials of non-drug, non-surgical interventions. This reporting guideline will enhance transparency and reproducibility in future non-drug, non-surgical intervention research.
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Affiliation(s)
| | - Melanie K Farlie
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
| | | | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Daniel C Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Julie M Fritz
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, USA.
| | - Martin Underwood
- Warwick Clinical Trials Unit, University of Warwick, Warwick, UK.; University Hospitals of Coventry and Warwickshire, Coventry, UK.
| | - Nadine E Foster
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Australia; School of Medicine, Keele University, Keele, UK.
| | - Sarah E Lamb
- University of Exeter, St Luke's Campus, Exeter, UK.
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Peter Malliaras
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
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Lees J, Crowther J, Hanlon P, Butterly EW, Wild SH, Mair F, Guthrie B, Gillies K, Dias S, Welton NJ, Katikireddi SV, McAllister DA. Participant characteristics and exclusion from phase 3/4 industry funded trials of chronic medical conditions: meta-analysis of individual participant level data. BMJ Med 2024; 3:e000732. [PMID: 38737200 PMCID: PMC11085787 DOI: 10.1136/bmjmed-2023-000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/05/2024] [Indexed: 05/14/2024]
Abstract
Objectives To assess whether age, sex, comorbidity count, and race and ethnic group are associated with the likelihood of trial participants not being enrolled in a trial for any reason (ie, screen failure). Design Bayesian meta-analysis of individual participant level data. Setting Industry funded phase 3/4 trials of chronic medical conditions. Participants Participants were identified using individual participant level data to be in either the enrolled group or screen failure group. Data were available for 52 trials involving 72 178 screened individuals of whom 24 733 (34%) were excluded from the trial at the screening stage. Main outcome measures For each trial, logistic regression models were constructed to assess likelihood of screen failure in people who had been invited to screening, and were regressed on age (per 10 year increment), sex (male v female), comorbidity count (per one additional comorbidity), and race or ethnic group. Trial level analyses were combined in Bayesian hierarchical models with pooling across condition. Results In age and sex adjusted models across all trials, neither age nor sex was associated with increased odds of screen failure, although weak associations were detected after additionally adjusting for comorbidity (odds ratio of age, per 10 year increment was 1.02 (95% credibility interval 1.01 to 1.04) and male sex (0.95 (0.91 to 1.00)). Comorbidity count was weakly associated with screen failure, but in an unexpected direction (0.97 per additional comorbidity (0.94 to 1.00), adjusted for age and sex). People who self-reported as black seemed to be slightly more likely to fail screening than people reporting as white (1.04 (0.99 to 1.09)); a weak effect that seemed to persist after adjustment for age, sex, and comorbidity count (1.05 (0.98 to 1.12)). The between-trial heterogeneity was generally low, evidence of heterogeneity by sex was noted across conditions (variation in odds ratios on log scale of 0.01-0.13). Conclusions Although the conclusions are limited by uncertainty about the completeness or accuracy of data collection among participants who were not randomised, we identified mostly weak associations with an increased likelihood of screen failure for age, sex, comorbidity count, and black race or ethnic group. Proportionate increases in screening these underserved populations may improve representation in trials. Trial registration number PROSPERO CRD42018048202.
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Affiliation(s)
- Jennifer Lees
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Jamie Crowther
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Peter Hanlon
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Elaine W Butterly
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Sarah H Wild
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Frances Mair
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Bruce Guthrie
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Sofia Dias
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Nicky J Welton
- Population Health Sciences, University of Bristol, Bristol, UK
| | | | - David A McAllister
- College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
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Zoellner JM, You W, Porter K, Kirkpatrick B, Reid A, Brock D, Chow P, Ritterband L. Kids SIPsmartER reduces sugar-sweetened beverages among Appalachian middle-school students and their caregivers: a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2024; 21:46. [PMID: 38664715 PMCID: PMC11046896 DOI: 10.1186/s12966-024-01594-7] [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: 04/20/2023] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND High consumption of sugar-sweetened beverages (SSB) is a global health concern. Additionally, sugar-sweetened beverage (SSB) consumption is disproportionately high among adolescents and adults in rural Appalachia. The primary study objective is to determine the intervention effects of Kids SIPsmartER on students' SSB consumption. Secondary objectives focus on caregivers' SSB consumption and secondary student and caregiver outcomes [e.g, body mass index (BMI), quality of life (QOL)]. METHODS This Type 1 hybrid, cluster randomized controlled trial includes 12 Appalachian middle schools (6 randomized to Kids SIPsmartER and 6 to control). Kids SIPsmartER is a 6-month, 12 lesson, multi-level, school-based, behavior and health literacy program aimed at reducing SSB among 7th grade middle school students. The program also incorporates a two-way text message strategy for caregivers. In this primary prevention intervention, all 7th grade students and their caregivers from participating schools were eligible to participate, regardless of baseline SSB consumption. Validated instruments were used to assess SSB behaviors and QOL. Height and weight were objectively measured in students and self-reported by caregivers. Analyses included modified two-part models with time fixed effects that controlled for relevant demographics and included school cluster robust standard errors. RESULTS Of the 526 students and 220 caregivers, mean (SD) ages were 12.7 (0.5) and 40.6 (6.7) years, respectively. Students were 55% female. Caregivers were mostly female (95%) and White (93%); 25% had a high school education or less and 33% had an annual household income less than $50,000. Regardless of SSB intake at baseline and relative to control participants, SSB significantly decreased among students [-7.2 ounces/day (95% CI = -10.7, -3.7); p < 0.001, effect size (ES) = 0.35] and caregivers [-6.3 ounces/day (95% CI = -11.3, -1.3); p = 0.014, ES = 0.33]. Among students (42%) and caregivers (28%) who consumed > 24 SSB ounces/day at baseline (i.e., high consumers), the ES increased to 0.45 and 0.95, respectively. There were no significant effects for student or caregiver QOL indicators or objectively measured student BMI; however, caregiver self-reported BMI significantly decreased in the intervention versus control schools (p = 0.001). CONCLUSIONS Kids SIPsmartER was effective at reducing SSB consumption among students and their caregivers in the rural, medically underserved Appalachian region. Importantly, SSB effects were even stronger among students and caregivers who were high consumers at baseline. TRIAL REGISTRATION Clincialtrials.gov: NCT03740113. Registered 14 November 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03740113 .
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Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, University of Virginia, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073, USA.
| | - Wen You
- Department of Public Health Sciences, University of Virginia, 560 Ray C Hunt Drive, Charlottesville, VA, 22908, USA
| | - Kathleen Porter
- Department of Public Health Sciences, University of Virginia, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073, USA
| | - Brittany Kirkpatrick
- Department of Public Health Sciences, University of Virginia, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073, USA
| | - Annie Reid
- Department of Public Health Sciences, University of Virginia, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073, USA
| | - Donna Brock
- Department of Public Health Sciences, University of Virginia, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073, USA
| | - Phillip Chow
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 560 Ray C Hunt Drive, Charlottesville, VA, 22908, USA
| | - Lee Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 560 Ray C Hunt Drive, Charlottesville, VA, 22908, USA
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Gionfriddo MR, McClendon C, Nolfi DA, Kalarchian MA, Covvey JR. Back to the basics: Guidance for designing good literature searches. Res Social Adm Pharm 2024; 20:463-468. [PMID: 38272775 DOI: 10.1016/j.sapharm.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
The number of scientific publications is growing at an unprecedented rate. Failure to properly evaluate existing literature at the start of a project may result in a researcher wasting time and resources. As pharmacy researchers and scholars look to conceptualize new studies, it is imperative to begin with a high-quality literature review that reveals what is known and unknown about a given topic. The purpose of this commentary is to provide useful guidance on conducting rigorous searches of the literature that inform the design and execution of research. Guidance for less formal literature reviews can be adapted from best practices utilized within the formalized field of evidence synthesis. Additionally, researchers can draw on guidance from PRESS (Peer Review of Electronic Search Strategies) to engage in self-evaluation of their search strategies. Finally, developing an awareness of common pitfalls when designing literature searches can provide researchers with confidence that their research is designed to fill clearly articulated gaps in knowledge.
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Affiliation(s)
| | | | - David A Nolfi
- Duquesne University Gumberg Library, Pittsburgh, PA, USA
| | | | - Jordan R Covvey
- Duquesne University School of Pharmacy, Pittsburgh, PA, USA.
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Arons A, Seligman HK. The emerging adulthood gap in diabetes prevention research. Lancet Reg Health Am 2024; 32:100699. [PMID: 38425415 PMCID: PMC10904267 DOI: 10.1016/j.lana.2024.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/09/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
Emerging adulthood, the period between ages 18 and 25, is distinct from older and younger populations in terms of both physiology and social circumstances. As a critical developmental window with long-lasting repercussions, emerging adulthood presents a key opportunity for prevention of cardiovascular disease. Despite significant advances in diabetes and cardiovascular disease prevention for other age groups, 18-25 year-olds remain underrepresented in research. Using diabetes prevention as an example, we analyzed the cited evidence behind four major guidelines that influence US clinical practice on screening and management of prediabetes in children and adults, revealing that the majority of these studies in both the pediatric and adult literature do not include emerging adults in their study populations. This gap between the pediatric and adult diabetes prevention literature creates a missing link connecting childhood risks to adult chronic disease. In this article, we draw attention to this often overlooked age group, and provide tangible recommendations as a path forward for both pediatric and adult researchers to increase the representation of emerging adults in diabetes prevention and other cardiovascular disease prevention studies.
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Affiliation(s)
- Abigail Arons
- Division of General Internal Medicine and Department of Pediatrics, UCSF, 490 Illinois Ave, Floor 7, San Francisco, CA, 94158, USA
| | - Hilary K. Seligman
- Center for Vulnerable Populations and Division of General Internal Medicine, UCSF, 490 Illinois Ave, Floor 7, San Francisco, CA, 94158, USA
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Kozelka EE, Acquilano SC, Al-Abdulmunem M, Guarino S, Elwyn G, Drake RE, Carpenter-Song E. Digital Mental Health and Its Discontents: Assumptions About Technology That Create Barriers to Equitable Access. Psychiatr Serv 2024; 75:299-302. [PMID: 38050440 DOI: 10.1176/appi.ps.20230238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Despite the potential of digital mental health interventions to aid recovery for people with serious mental illness, access to these digital tools remains a key barrier. In this column, the authors discuss three key assumptions that shape the integration of digital mental health tools into community health settings: clinical context, digital literacy, and financial burden. Clinical contexts have shifted with the increased use of telehealth, altering intervention environments; access to a mobile device is not the same as digital literacy; and digital mental health care is not necessarily affordable. Context-centered study design through ethnography will facilitate transfer of digital resources to real-world settings.
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Affiliation(s)
- Ellen E Kozelka
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Stephanie C Acquilano
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Monirah Al-Abdulmunem
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Sue Guarino
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Glyn Elwyn
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Robert E Drake
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
| | - Elizabeth Carpenter-Song
- Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song)
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Ho L, Chen X, Kwok YL, Wu IXY, Mao C, Chung VCH. Methodological quality of systematic reviews on sepsis treatments: A cross-sectional study. Am J Emerg Med 2024; 77:21-28. [PMID: 38096636 DOI: 10.1016/j.ajem.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE Systematic reviews (SRs) offer updated evidence to support decision-making on sepsis treatments. However, the rigour of SRs may vary, and methodological flaws may limit their validity in guiding clinical practice. This cross-sectional study appraised the methodological quality of SRs on sepsis treatments. METHODS We searched MEDLINE, EMBASE, and Cochrane Database for eligible SRs on randomised controlled trials on sepsis treatments with at least one meta-analysis published between 2018 and 2023. We extracted SRs' bibliographical characteristics with a pre-designed form and appraised their methodological quality using AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. We applied logistic regressions to explore associations between bibliographical characteristics and methodological quality ratings. RESULTS Among the 102 SRs, two (2.0%) had high overall quality, while respectively four (3.9%), seven (6.9%) and 89 (87.3%) were of moderate, low, and critically low quality. Performance in several critical methodological domains was poor, with only 32 (31.4%) considering the risk of bias in primary studies in result interpretation, 22 (21.6%) explaining excluded primary studies, and 16 (15.7%) applying comprehensive searching strategies. SRs published in higher impact factor journals (adjusted odds ratio: 1.19; 95% confidence interval: 1.05 to 1.36) was associated with higher methodological quality. CONCLUSIONS The methodological quality of recent SRs on sepsis treatments is unsatisfactory. Future reviewers should address the above critical methodological aspects. More resources should also be allocated to support continuous training in critical appraisal among healthcare professionals and other evidence users.
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Affiliation(s)
- Leonard Ho
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Xi Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Yan Ling Kwok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Vincent Chi Ho Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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Dinesen B, Hansen ET, Refsgaard J, Lundsgaard SV, Dittmann L, Larsen K, Spindler H, Jochumsen M, Hollingdal M. "Future patient II" telerehabilitation for patients with heart failure: Protocol for a randomized controlled trial. Int J Cardiol Cardiovasc Risk Prev 2024; 20:200239. [PMID: 38328003 PMCID: PMC10847637 DOI: 10.1016/j.ijcrp.2024.200239] [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] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
Background Heart failure is a global problem affecting millions of people worldwide. Current care of heart failure patients follows standard protocols and often overlooks the patients' specific needs, which leads to low compliance in the rehabilitation phase. Telerehabilitation, where the patients communicate with health care professionals about their rehabilitation program and monitor their vital signs, aims to increase the degree of compliance as well as enhancing their quality of life. Objective The aim of this study is to investigate whether application of the Future Patient Telerehabilitation Program II can improve the health-related quality of life for patients with heart failure. Methods A randomized controlled trial will be conducted. A total of 70 patients will be enrolled, 35 in the intervention group, 35 in the control group. The intervention group will follow an add-on to traditional care, while the control group will follow the conventional Danish cardiac rehabilitation program, which is based on periodic visits to the clinic. The patients will be followed for a period of six months. The intervention group will have access to an online HeartPortal and will use various home-based devices for self-monitoring. The primary outcome to be investigated is health-related quality of life as measured by the EuroQol-5 Dimension. Secondary outcomes are the number of visits to the outpatient clinic, number of readmissions and number of tele-communications contacts (phone and video) with health care professionals. The primary and secondary outcomes will be assessed using questionnaires and through the data generated by digital technologies for self-monitoring. Results Enrolment began in August 2020. The results will be published in peer-reviewed journals. Results from the Future Patient II Telerehabilitation program are expected to be published in 2024. Discussion This study is a further development of the Future Patient Telerehabilitation I study, and it is expected to explore the use of video consultation and a weight calculator in relation to telerehabilitation as well as the quality of life for heart failure patients. Conclusion The expected outcomes are increased quality of life, increased number of phone- and video-consultations with health-care professionals, and the enhanced ability of patients to manage their own disease with the use of a calculator for weight.
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Affiliation(s)
- Birthe Dinesen
- Laboratory for Welfare Technology – Digital Health & Rehabilitation, ExerciseTech, Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9220, Aalborg, Denmark
| | - Emma Thunbo Hansen
- Laboratory for Welfare Technology – Digital Health & Rehabilitation, ExerciseTech, Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9220, Aalborg, Denmark
| | - Jens Refsgaard
- Department of Cardiology, Viborg Regional Hospital, Heibergs Alle 5A, 8800, Viborg, Denmark
| | - Søren Villumsen Lundsgaard
- Laboratory for Welfare Technology – Digital Health & Rehabilitation, ExerciseTech, Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9220, Aalborg, Denmark
| | - Lars Dittmann
- Department of Electrical and Photonics Engineering, Danish Technical University, Ørsteds Plads, 2800, Kgs. Lyngby, Denmark
| | - Knud Larsen
- Laboratory for Welfare Technology – Digital Health & Rehabilitation, ExerciseTech, Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9220, Aalborg, Denmark
| | - Helle Spindler
- Department of Psychology and Behavioral Sciences, Aarhus University, Bartholins Allé 11, 8000, Aarhus C, Denmark
| | - Mads Jochumsen
- Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9220, Aalborg, Denmark
| | - Malene Hollingdal
- Department of Cardiology, Viborg Regional Hospital, Heibergs Alle 5A, 8800, Viborg, Denmark
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Grock S, Weinreb J, Williams KC, Weimer A, Fadich S, Patel R, Geft A, Korenman S. Priorities for efficacy trials of gender-affirming hormone therapy with estrogen: collaborative design and results of a community survey. Hormones (Athens) 2024:10.1007/s42000-024-00532-3. [PMID: 38311658 DOI: 10.1007/s42000-024-00532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/17/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Treatment guidelines for gender-affirming hormone therapy with estrogen (GAHT-E) recommend specific dosing regimens based on limited data. Well-controlled efficacy trials are essential to tailoring treatment to patient goals as the guidelines recommend. The goal of this study was to take a foundational step toward designing community-centered effectiveness trials for gender-diverse individuals seeking GAHT-E. METHODS Our team developed a cross-sectional survey based on broad clinical experience and consultation with our community advisory board. The survey included 60 items covering demographics, transition history, goals and priorities for treatment, indicators of treatment success, sexual function goals, and future research priorities. The survey was distributed during the summer of 2021, primarily through social networks designed for gender-expansive individuals seeking treatment with estrogen. RESULTS A total of 1270 individuals completed the survey. Overall treatment goals most frequently rated "extremely important" or "very important" were the following: (1) improved satisfaction with life (81%), (2) appearing more feminine (80%), (3) appearing less masculine (77%), (4) improved mental health (76%), and (5) being seen as your true gender by others (75%). The three body characteristics most frequently rated "highest priority" or "high priority" among changes were the following: (1) facial hair (85%), (2) breast shape or size (84%), and (3) body shape (80%). The highest-rated research priority was comparing feminization with different routes of estrogen administration. CONCLUSION The goals and experiences of individuals seeking GAHT-E are diverse. Future clinical trials of GAHT-E should be grounded in the needs and priorities of community stakeholders.
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Affiliation(s)
- Shira Grock
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
| | - Jane Weinreb
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- Division of Endocrinology, Diabetes and Metabolism, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
| | - Kristen C Williams
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Amy Weimer
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Sarah Fadich
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Reema Patel
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Atara Geft
- Division of Endocrinology, Diabetes and Metabolism, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
- Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
| | - Stanley Korenman
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
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10
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Heyard R, Held L, Schneeweiss S, Wang SV. Design differences and variation in results between randomised trials and non-randomised emulations: meta-analysis of RCT-DUPLICATE data. BMJ Med 2024; 3:e000709. [PMID: 38348308 PMCID: PMC10860009 DOI: 10.1136/bmjmed-2023-000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024]
Abstract
Objective To explore how design emulation and population differences relate to variation in results between randomised controlled trials (RCT) and non-randomised real world evidence (RWE) studies, based on the RCT-DUPLICATE initiative (Randomised, Controlled Trials Duplicated Using Prospective Longitudinal Insurance Claims: Applying Techniques of Epidemiology). Design Meta-analysis of RCT-DUPLICATE data. Data sources Trials included in RCT-DUPLICATE, a demonstration project that emulated 32 randomised controlled trials using three real world data sources: Optum Clinformatics Data Mart, 2004-19; IBM MarketScan, 2003-17; and subsets of Medicare parts A, B, and D, 2009-17. Eligibility criteria for selecting studies Trials where the primary analysis resulted in a hazard ratio; 29 RCT-RWE study pairs from RCT-DUPLICATE. Results Differences and variation in effect sizes between the results from randomised controlled trials and real world evidence studies were investigated. Most of the heterogeneity in effect estimates between the RCT-RWE study pairs in this sample could be explained by three emulation differences in the meta-regression model: treatment started in hospital (which does not appear in health insurance claims data), discontinuation of some baseline treatments at randomisation (which would have been an unusual care decision in clinical practice), and delayed onset of drug effects (which would be under-reported in real world clinical practice because of the relatively short persistence of the treatment). Adding the three emulation differences to the meta-regression reduced heterogeneity from 1.9 to almost 1 (absence of heterogeneity). Conclusions This analysis suggests that a substantial proportion of the observed variation between results from randomised controlled trials and real world evidence studies can be attributed to differences in design emulation.
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Affiliation(s)
- Rachel Heyard
- Center for Reproducible Science, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Leonhard Held
- Center for Reproducible Science, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology, Brigham and Womems Hospital Harvard Medical School, Boston, Massachusetts, USA
| | - Shirley V Wang
- Division of Pharmacoepidemiology, Brigham and Womems Hospital Harvard Medical School, Boston, Massachusetts, USA
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11
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Jordan ES, Grover PL, Lin J, Starkey CA, Finley EA, Ni H, Hershberger RE. The DCM Project Portal: A direct-to-participant platform of The DCM Research Project. Am Heart J Plus 2024; 38:100356. [PMID: 38348286 PMCID: PMC10861184 DOI: 10.1016/j.ahjo.2023.100356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Study objective To develop a digital platform to conduct family-based, dilated cardiomyopathy (DCM) genetic research. Design The DCM Project Portal, a direct-to-participant electronic recruitment, consent, and communication tool, was designed using prior experience with traditional enrollment methods and characteristics and feedback of current participants. Participants DCM patients (probands) and their family members enrolled from June 7, 2016 to March 15, 2020 at 25 US advanced heart failure programs. Results The portal was designed as a self-guided, three module (registration, eligibility, and consent) process with supporting informational and messaging resources integrated throughout. The experience is tailored to user type and the format adaptable with programmatic growth. Characteristics of participants of the recently completed DCM Precision Medicine Study were assessed as an exemplary user population. A majority of the diverse (34 % non-Hispanic Black (NHE-B), 9.1 % Hispanic; 53.6 % female) proband (n = 1223) and family member (n = 1781) participants aged ≥18 years reported not at all or rarely having problems learning about their health from written information (81 %) and a high confidence in completing medical forms (77.2 % very much or often confident), supporting a self-guided model. A majority of participants across age and race-ethnicity groups reported internet access, with highest rates of no reported access in those ≥77 years (31.9 %), NHE-B (25.2 %), and Hispanic (22.9 %), a similar pattern to those reported by the US Census Bureau as of 2021. Conclusions The portal is an example of a digital approach to family-based genetic research that offers opportunity to improve access and efficiency of research operations.
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Affiliation(s)
- Elizabeth S. Jordan
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Phoenix L. Grover
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Jay Lin
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Carl A. Starkey
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Elizabeth A. Finley
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Hanyu Ni
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Ray E. Hershberger
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States of America
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States of America
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12
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Zhao N, Cuthel AM, Storms O, Zhang R, Yamarik RL, Hill J, Kaur R, Van Allen K, Flannery M, Chang A, Chung F, Randhawa S, Alvarez IC, Young-Brinn A, Kizzie-Gillett CL, Rosini D, Isaacs ED, Hopkins E, Chan GK, Booker-Vaughns J, Maguire M, Navarro M, Pidatala NR, Dunn P, Williams P, Galvin R, Batra R, Welsh S, Vaughan W, Bouillon-Minois JB, Grudzen CR. Advancing patient-centered research practices in a pragmatic patient-level randomized clinical trial: A thematic analysis of stakeholder engagement in Emergency Medicine Palliative Care Access (EMPallA). Res Involv Engagem 2024; 10:10. [PMID: 38263088 PMCID: PMC10807180 DOI: 10.1186/s40900-023-00539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Involving patient and community stakeholders in clinical trials adds value by ensuring research prioritizes patient goals both in conduct of the study and application of the research. The use of stakeholder committees and their impact on the conduct of a multicenter clinical trial have been underreported clinically and academically. The aim of this study is to describe how Study Advisory Committee (SAC) recommendations were implemented throughout the Emergency Medicine Palliative Care Access (EMPallA) trial. EMPallA is a multi-center, pragmatic two-arm randomized controlled trial (RCT) comparing the effectiveness of nurse-led telephonic case management and specialty, outpatient palliative care of older adults with advanced illness. METHODS A SAC consisting of 18 individuals, including patients with palliative care experience, members of healthcare organizations, and payers was convened for the EMPallA trial. The SAC engaged in community-based participatory research and assisted in all aspects from study design to dissemination. The SAC met with the research team quarterly and annually from project inception to dissemination. Using meeting notes and recordings we completed a qualitative thematic analysis using an iterative process to develop themes and subthemes to summarize SAC recommendations throughout the project's duration. RESULTS The SAC convened 16 times between 2017 and 2020. Over the course of the project, the SAC provided 41 unique recommendations. Twenty-six of the 41 (63%) recommendations were adapted into formal Institutional Review Board (IRB) study modifications. Recommendations were coded into four major themes: Scientific, Pragmatic, Resource and Dissemination. A majority of the recommendations were related to either the Scientific (46%) or Pragmatic (29%) themes. Recommendations were not mutually exclusive across three study phases: Preparatory, execution and translational. A vast majority (94%) of the recommendations made were related to the execution phase. Major IRB study modifications were made based on their recommendations including data collection of novel dependent variables and expanding recruitment to Spanish-speaking patients. CONCLUSIONS Our study provides an example of successful integration of a SAC in the conduct of a pragmatic, multi-center RCT. Future trials should engage with SACs in all study phases to ensure trials are relevant, inclusive, patient-focused, and attentive to gaps between health care and patient and family needs. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03325985, 10/30/2017.
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Affiliation(s)
- Nicole Zhao
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Allison M Cuthel
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
| | - Owen Storms
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Raina Zhang
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | | | - Jacob Hill
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
- Department of Wellness and Preventive Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Regina Kaur
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Kaitlyn Van Allen
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Alex Chang
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Frank Chung
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Sumeet Randhawa
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Isabel Castro Alvarez
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Angela Young-Brinn
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Dawn Rosini
- University of Florida Shands Hospital, Gainesville, FL, USA
- The University of Florida College of Medicine, Gainesville, FL, USA
| | - Eric D Isaacs
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Martha Navarro
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | | | - Pluscedia Williams
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- The Lundquist Institute/Harbor-UCLA Medical Center, Torrence, CA, USA
| | | | - Romilla Batra
- Senior Care Action Network (SCAN) Health Plan, Long Beach, CA, USA
| | - Sally Welsh
- Hospice and Palliative Nurses Association, Carnegie, PA, USA
| | | | - Jean-Baptiste Bouillon-Minois
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
- Emergency Department, University Hospital of Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Corita R Grudzen
- Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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13
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Ryf C, Hofstetter L, Clack L, Hincapié CA. Involving patients and clinicians in the development of a randomised clinical trial protocol to assess spinal manual therapy versus nerve root injection for patients with lumbar radiculopathy: a patient and public involvement project to inform the SALuBRITY trial design. Res Involv Engagem 2024; 10:8. [PMID: 38229190 DOI: 10.1186/s40900-023-00536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Spinal manual therapy and corticosteroid nerve root injection are commonly used to treat patients with lumbar radiculopathy. The SALuBRITY trial-a two parallel group, double sham controlled, randomised clinical trial-is being developed to compare their effectiveness. By gathering patients' and clinicians' perspectives and involving them in discussions related to the trial research question and objectives, proposed trial recruitment processes, methods, and outcome measures, we aimed to improve the relevance and quality of the SALuBRITY trial. METHODS We involved patients with lived experience of lumbar radiculopathy (n = 5) and primary care clinicians (n = 4) with experience in the treatment of these patients. Involvement activities included an initial kick-off event to introduce the project, establishing a shared purpose statement, and empowering patient and clinician advisors for their involvement, followed by semi-structured group and individual interviews, and questionnaires to evaluate the experience throughout the project. RESULTS Both patient and clinician advisors endorsed the significance and relevance of the trial's objectives. Patients assessed the proposed trial methods as acceptable within the context of a trusting patient-clinician relationship. A trial recruitment and enrolment target time of up to five days was regarded as acceptable, although patients with chronic radiculopathy may need more time to consider their trial participation decision. All advisors reached consensus on the acceptability of a medication washout phase of 12- to 24-h before pain outcome measurement, with the inclusion of a rescue medication protocol. Both advisory groups preferred leg pain over back pain as the primary clinical outcome, with patient advisors advocating for personalized primary pain localization. Furthermore, patients requested expanding the pain, enjoyment, and general activity scale with peak pain intensity, rather than average pain alone. Patient and clinician advisors evaluated their engagement in clinical research as meaningful and impactful. CONCLUSION Patient and public involvement resulted in important and relevant considerations for the SALuBRITY trial, spanning all research phases. These findings hold promise for enhancing the trial's quality and relevance and improving its translation into clinical practice.
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Affiliation(s)
- Corina Ryf
- Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Léonie Hofstetter
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Head of Musculoskeletal Epidemiology Research, Epidemiology, Biostatistics and Prevention Institute (EBPI) & University Spine Centre Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lauren Clack
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Cesar A Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Head of Musculoskeletal Epidemiology Research, Epidemiology, Biostatistics and Prevention Institute (EBPI) & University Spine Centre Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
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14
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Chiu CJ, Hou SY, Wang CL, Tang HH, Kuo PC, Liang SF, Kuo PF. The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T): protocol for a multidimensional dataset of health and lifestyle. BMC Public Health 2024; 24:87. [PMID: 38178012 PMCID: PMC10765675 DOI: 10.1186/s12889-023-17552-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults keep transforming with Baby Boomers and Gen Xers being the leading older population. Their lifestyle, however, is not well understood. The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T) collected both objective and subjective data to depict the health and lifestyle of this population. The objectives, design, and measures of the MOCHA-T study are introduced, and the caveats and future directions related to the use of the data are presented. METHODS People aged 50 and over were recruited from the community, with a subset of women aged 45-49 invited to supplement data on menopause and aging. Four instruments (i.e., self-reported questionnaires, diary, wrist actigraphy recorder, and GPS) were used to collect measures of sociodemographic, health, psychosocial, behavioral, temporal, and spatial data. RESULTS A total of 242 participants who returned the informed consent and questionnaires were recruited in the MOCHA-T study. Among them, 94.6%, 95.0%, and 25.2% also completed the diary, actigraphy, and GPS data, respectively. There was almost no difference in sociodemographic characteristics between those with and without a completed diary, actigraphy, and GPS data, except for age group and educational level for those who returned completed actigraphy data. CONCLUSION The MOCHA-T study is a multidimensional dataset that allows researchers to describe the health, behaviors, and lifestyle patterns, and their interactions with the environment of the newer generation of middle-aged and older adults in Taiwan. It can be compared with other countries with actigraphy and GPS-based lifestyle data of middle-aged and older adults in the future.
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Affiliation(s)
- Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Szu-Yu Hou
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Liang Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Han Tang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Ching Kuo
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Fu Liang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Fen Kuo
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
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15
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Dijk SW, Caulley LM, Hunink M, Labrecque J. From complexity to clarity: how directed acyclic graphs enhance the study design of systematic reviews and meta-analyses. Eur J Epidemiol 2024; 39:27-33. [PMID: 37650986 PMCID: PMC10811040 DOI: 10.1007/s10654-023-01042-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023]
Abstract
While frameworks to systematically assess bias in systematic reviews and meta-analyses (SRMAs) and frameworks on causal inference are well established, they are less frequently integrated beyond the data analysis stages. This paper proposes the use of Directed Acyclic Graphs (DAGs) in the design stage of SRMAs. We hypothesize that DAGs created and registered a priori can offer a useful approach to more effective and efficient evidence synthesis. DAGs provide a visual representation of the complex assumed relationships between variables within and beyond individual studies prior to data analysis, facilitating discussion among researchers, guiding data analysis, and may lead to more targeted inclusion criteria or set of data extraction items. We illustrate this argument through both experimental and observational case examples.
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Affiliation(s)
- Stijntje W Dijk
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Lisa M Caulley
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Myriam Hunink
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Centre for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jeremy Labrecque
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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16
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Smith D, Cartwright M, Dyson J, Aitken LM. Use of nominal group technique methods in the virtual setting: A reflective account and recommendations for practice. Aust Crit Care 2024; 37:158-165. [PMID: 37880060 DOI: 10.1016/j.aucc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/19/2023] [Accepted: 09/05/2023] [Indexed: 10/27/2023] Open
Abstract
Nominal group technique methods involve the use of structured activities within groups comprised of purposefully selected stakeholders (nominal groups), with the broad aim of achieving a level of consensus and prioritising information. In this paper, we will report how we facilitated nominal groups, using Microsoft Teams, to prioritise content for a theory-based behaviour change intervention to improve responses to clinically deteriorating patients. Our methods incorporated development and piloting of research materials, facilitation of online nominal groups with different stakeholders, and a structured approach to ranking behaviour change strategies. Practical suggestions are offered based on our experience of using this method in a virtual context.
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Affiliation(s)
- Duncan Smith
- City, University of London, School of Health Sciences, Northampton Square, London, EC1V 0HB, UK; Patient Emergency Response & Resuscitation Team (PERRT), University College London Hospitals NHS Foundation Trust, Euston Road, London, NW1 2BU, UK.
| | - Martin Cartwright
- City, University of London, School of Health Sciences, Northampton Square, London, EC1V 0HB, UK.
| | - Judith Dyson
- Birmingham City University, Westbourne Road, Edgbaston, Birmingham, B15 3TN, UK.
| | - Leanne M Aitken
- City, University of London, School of Health Sciences, Northampton Square, London, EC1V 0HB, UK; School of Nursing and Midwifery, Griffith University, Nathan, QLD 4111, Australia.
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Covvey JR, McClendon C, Gionfriddo MR. Back to the basics: Guidance for formulating good research questions. Res Social Adm Pharm 2024; 20:66-69. [PMID: 37838572 DOI: 10.1016/j.sapharm.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023]
Abstract
Good science is driven by rigorous questions. Much like the foundation of a house, a research question must be carefully constructed to prevent downstream problems in project execution. And yet, pharmacy researchers and scholars across all career stages may find themselves struggling when developing research questions. The purpose of this commentary is to provide useful guidance on composing and evaluating rigorous research questions. A variety of frameworks, such as PICO (Patient/population; Intervention; Comparison; Outcome), are available to researchers and can assist them in ensuring that their research question has covered all relevant components. Additionally, the FINER (Feasible; Interesting; Novel; Ethical; and Relevant) criteria can help researchers with evaluating their research questions for practical considerations. Finally, building awareness of common pitfalls when composing research questions can aid researchers to avoid issues that they may not otherwise discover until their manuscript undergoes peer review.
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Affiliation(s)
- Jordan R Covvey
- Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, USA
| | - Chyna McClendon
- Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, USA
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18
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Wurth R, Turgeon C, Stander Z, Oglesbee D. An evaluation of untargeted metabolomics methods to characterize inborn errors of metabolism. Mol Genet Metab 2024; 141:108115. [PMID: 38181458 PMCID: PMC10843816 DOI: 10.1016/j.ymgme.2023.108115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/19/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024]
Abstract
Inborn errors of metabolism (IEMs) encompass a diverse group of disorders that can be difficult to classify due to heterogenous clinical, molecular, and biochemical manifestations. Untargeted metabolomics platforms have become a popular approach to analyze IEM patient samples because of their ability to detect many metabolites at once, accelerating discovery of novel biomarkers, and metabolic mechanisms of disease. However, there are concerns about the reproducibility of untargeted metabolomics research due to the absence of uniform reporting practices, data analyses, and experimental design guidelines. Therefore, we critically evaluated published untargeted metabolomic platforms used to characterize IEMs to summarize the strengths and areas for improvement of this technology as it progresses towards the clinical laboratory. A total of 96 distinct IEMs were collectively evaluated by the included studies. However, most of these IEMs were evaluated by a single untargeted metabolomic method, in a single study, with a limited cohort size (55/96, 57%). The goals of the included studies generally fell into two, often overlapping, categories: detecting known biomarkers from many biochemically distinct IEMs using a single platform, and detecting novel metabolites or metabolic pathways. There was notable diversity in the design of the untargeted metabolomic platforms. Importantly, the majority of studies reported adherence to quality metrics, including the use of quality control samples and internal standards in their experiments, as well as confirmation of at least some of their feature annotations with commercial reference standards. Future applications of untargeted metabolomics platforms to the study of IEMs should move beyond single-subject analyses, and evaluate reproducibility using a prospective, or validation cohort.
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Affiliation(s)
- Rachel Wurth
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, 200 1(st) St SW, Rochester, MN 55905, USA
| | - Coleman Turgeon
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Zinandré Stander
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Devin Oglesbee
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
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Agrawal AA, Prakash N, Almagbol M, Alobaid M, Alqarni A, Altamni H. Synoptic review on existing and potential sources for bias in dental research methodology with methods on their prevention and remedies. World J Methodol 2023; 13:426-438. [PMID: 38229948 PMCID: PMC10789105 DOI: 10.5662/wjm.v13.i5.426] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 12/20/2023] Open
Abstract
The results of years of dental study serve as the foundation for the practise of medicine and, for that matter, dentistry. Doctors may have their own preferences for techniques and materials, but whether directly or indirectly, their decisions are influenced by systematic reviews and meta-analyses. However, due to poorly conducted or presented research, this very basic foundation may not be reliable. Bias in research is one of several factors that might make study results or research itself unreliable. Bias can be introduced into research at many stages, deliberately or unknowingly. Bias can appear at any point during the research process, even before the study itself begins. There are many biases in research, but some of them are more relevant to dentistry research than others. Because it is said that "eyes see what the mind knows", it is essential to have a complete understanding of the different types of bias, how and when they get entrenched, and what steps may be taken to prevent or lessen them if they do occur. This comprehensive summary of bias in dentistry research is provided by this synoptic review. The goal is to identify gaps and measures that have been taken-or that should have been taken-by providing both descriptive and evaluative summaries, as well as examples from the literature, when needed.
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Affiliation(s)
- Amit Arvind Agrawal
- Department of Peridontology and Implantology, Mahatma Gandhi Vidyamandir’s Karmaveer Bhausaheb Hiray Dental College and Hospital, Nasik 422003, Maharashtra, India
| | - Nilima Prakash
- Department of Oral and Maxillofacial Pathology, Mahatma Gandhi Vidyamandir’s Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik 422003, Maharashtra, India
| | - Mohammad Almagbol
- Department of Periodontics Community Dental Sciences, King Khalid University, Abha 62217, Saudi Arabia
| | - Mohammed Alobaid
- Department of Restorative Dental Science and Dental Education, King Khalid University, Abha 62217, Saudi Arabia
| | - Abdullah Alqarni
- Department of Diagnostics Sciences and Oral Biology, King Khalid University, Abha 62217, Saudi Arabia
| | - Hammam Altamni
- Department of Orthodontic, Assir Specialist Dental Center, Abha, Ministry of Health, Abha 62217, Saudi Arabia
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Audulv Å, Westergren T, Ludvigsen MS, Pedersen MK, Fegran L, Hall EOC, Aagaard H, Robstad N, Kneck Å. Time and change: a typology for presenting research findings in qualitative longitudinal research. BMC Med Res Methodol 2023; 23:284. [PMID: 38057741 PMCID: PMC10698947 DOI: 10.1186/s12874-023-02105-1] [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: 01/06/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Qualitative longitudinal research (QLR) is an emerging methodology used in health research. The method literature states that the change in a phenomenon through time should be the focus of any QLR study, but in empirical studies, the analysis of changes through time is often poorly described, and the emphasis on time/change in the findings varies greatly. This inconsistency might depend on limitations in the existing method literature in terms of describing how QLR studies can present findings. The aim of this study was to develop and describe a typology of alternative approaches for integrating time and/or change in QLR findings. METHODS In this method study, we used an adapted scoping review design. Articles were identified using EBSCOhost. In total, methods and results sections from 299 QLR articles in the field of health research were analyzed with inspiration from content analysis. RESULTS We constructed a typology of three types and seven subtypes. The types were based on the underlying structural principles of how time/change was presented: Type A) Findings have a low utilization of longitudinal data, Type B) Findings are structured according to chronological time, and Type C) Findings focus on changes through time. These types differed in 1) the way the main focus was on time, change or neither; 2) the level of interpretation in the findings; and 3) how theoretical understandings of time/change were articulated in the articles. Each type encompassed two or three subtypes that represented distinct approaches to the aim and results presentation of QLR findings. CONCLUSIONS This method study is the first to describe a coherent and comprehensive typology of alternative approaches for integrating time/change into QLR findings in health research. By providing examples of various subtypes that can be used for results presentations, it can help researchers make informed decisions suitable to their research intent.
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Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Thomas Westergren
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Aarhus University, Aarhus, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Mona Kyndi Pedersen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Elisabeth O C Hall
- Faculty of Health, Aarhus University, Aarhus, Denmark
- Faculty of Health Sciences and Nursing, University of Faroe Islands, Torshavn, Faroe Islands
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Nastasja Robstad
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Åsa Kneck
- Department of Health Care Sciences, Marie Cederschöld University, Stockholm, Sweden
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Jarus T, Leclair LL, Ghahari S, Chen SP, Leung A, Shaw L. Profiling the Research Activities of Canadian Occupational Therapy and Occupational Science Faculty Members. Can J Occup Ther 2023; 90:344-352. [PMID: 36658768 PMCID: PMC10647890 DOI: 10.1177/00084174221145820] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 01/21/2023]
Abstract
Background. There is a lack of knowledge on the scope and nature of the research by faculty members in occupational science (OS) and/or occupational therapy (OT) programs in Canada. Purpose. To describe the research activities of faculty members in these programs and directions. Method. A cross-sectional survey was distributed to 173 faculty members across all 14 Canadian OT that addressed: 1) research topics and methods, 2) populations, and 3) funding. Findings. Based on respondents (N = 121), research is focused on a range of topics and populations with most conducting qualitative research. Many conduct research examining the effectiveness of interventions, with few respondents focused on OS research. Federal and provincial grants agencies were the largest source of funding. Implications. Research topics studied were not always proportional to practice although emerging areas were being investigated that can expand the evidence base and scope of practice. Despite limited occupation-specific funding options, respondents were accessing funding from varied sources. Collaborations among faculty members, clinicians, and individuals with lived experience can create priorities for future OS and/or OT research in Canada.
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Affiliation(s)
- Tal Jarus
- Tal Jarus, Occupational Science & Occupational Therapy Department, Faculty of Medicine, the University of British Columbia, T325-2211 Wesbrook Mall, Musqueam Territory, Vancouver, British Columbia, Canada V6T 2B5.
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Fossey E, Bonnamy J, Dart J, Petrakis M, Buus N, Soh SE, Diug B, Ayton D, Brand G. What does consumer and community involvement in health-related education look like? A mixed methods study. Adv Health Sci Educ Theory Pract 2023:10.1007/s10459-023-10301-3. [PMID: 38032400 DOI: 10.1007/s10459-023-10301-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations. Drawing on a mixed methods design, we explored consumer and community involvement practices in the design and delivery of health-related education using the capability, opportunity, motivation and behaviour framework (COM-B). In our results, we describe educator capabilities, opportunities and motivations, including identifying barriers and enablers to consumer and community involvement in health-related education. Educators have varying philosophical reasons and approaches for involving consumers and community. There is a focus on augmenting student learning through inclusion of lived and living experience, and on mutual transformative learning through embedding lived experience and co-creating learning. How these philosophical positionings and motivations shape the degree by which educators involve consumers and community members in health-related curricula is important for further understanding these educational partnerships within universities.
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Affiliation(s)
- Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
| | - James Bonnamy
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Janeane Dart
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Melissa Petrakis
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Caulfield, Melbourne, Victoria, Australia
| | - Niels Buus
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sze-Ee Soh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Melbourne, Victoria, Australia
| | - Basia Diug
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dashini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Gabrielle Brand
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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23
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Adjognon OL, Brady JE, Iverson KM, Stolzmann K, Dichter ME, Lew RA, Gerber MR, Portnoy GA, Iqbal S, Haskell SG, Bruce LAE, Miller CJ. Using the Matrixed Multiple Case Study approach to identify factors affecting the uptake of IPV screening programs following the use of implementation facilitation. Implement Sci Commun 2023; 4:145. [PMID: 37990345 PMCID: PMC10664531 DOI: 10.1186/s43058-023-00528-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent social determinant of health. The US Preventive Services Task Force recommends routine IPV screening of women, but uptake remains variable. The Veterans Health Administration (VHA) initiated implementation facilitation (IF) to support integration of IPV screening programs into primary care clinics. An evaluation of IF efforts showed variability in IPV screening rates across sites. The follow-up study presented here used a Matrixed Multiple Case Study (MMCS) approach to examine the multilevel factors impacting IPV screening program implementation across sites with varying levels of implementation success. METHODS This mixed methods study is part of a larger cluster randomized stepped wedge Hybrid-II program evaluation. In the larger trial, participating sites received 6 months of IF consisting of an external facilitator from VHA's Office of Women's Health working closely with an internal facilitator and key site personnel. Recognizing the heterogeneity in implementation outcomes across sites, the MMCS approach was used to enable interpretation of qualitative and quantitative data within and across sites to help contextualize the primary findings from the larger study. Qualitative data collection was guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and included interviews with key informants involved in IPV screening implementation at eight sites. Quantitative data on IPV screening uptake was derived from medical records and surveys completed by key personnel at the same eight sites to understand implementation facilitation activities. RESULTS Fifteen factors influencing IPV screening implementation spanning all four i-PARIHS domains were identified and categorized into three distinct categories: (1) factors with enabling influence across all sites, (2) factors deemed important to implementation success, and (3) factors differentiating sites with high/medium versus low implementation success. CONCLUSIONS Understanding the influencing factors across multi-level domains contributing to variable success of IPV screening implementation can inform the tailoring of IF efforts to promote spread and quality of screening. Implementation of IPV screening programs in primary care with IF should consider consistent engagement of internal facilitators with clinic staff involved in implementation, the resourcefulness of external facilitators, and appending resources to IPV screening tools to help key personnel address positive screens. TRIAL REGISTRATION ClinicalTrials.gov NCT04106193. Registered on September 26, 2019.
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Affiliation(s)
- Omonyêlé L Adjognon
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA.
| | - Julianne E Brady
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA
| | - Katherine M Iverson
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Kelly Stolzmann
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA
| | - Melissa E Dichter
- Center for Health Equity Research and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, PA, USA
- School of Social Work, Temple University, Philadelphia, PA, USA
| | - Robert A Lew
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, USA
| | - Megan R Gerber
- Division of General Internal Medicine, Albany Medical College, Albany, NY, USA
- Albany Stratton VA Medical Center, Albany, NY, USA
| | - Galina A Portnoy
- Pain Research Informatics Multi-morbidity Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Samina Iqbal
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Sally G Haskell
- Pain Research Informatics Multi-morbidity Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, USA
- Office of Women's Health, Department of Veterans Affairs, Washington, DC, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Le Ann E Bruce
- Intimate Partner Violence Assistance Program, Care Management and Social Work Services, Department of Veterans Affairs, Washington, DC, USA
- Department of Social Work, Western Kentucky University, Bowling Green, KY, USA
| | - Christopher J Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
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24
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Haley RW, Dever JA, Kramer G, Teiber JF. The effect of disease misclassification on the ability to detect a gene-environment interaction: implications of the specificity of case definitions for research on Gulf War illness. BMC Med Res Methodol 2023; 23:273. [PMID: 37986147 PMCID: PMC10659093 DOI: 10.1186/s12874-023-02092-3] [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: 08/11/2022] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Since 1997, research on Gulf War illness (GWI) has predominantly used 3 case definitions-the original Research definition, the CDC definition, and modifications of the Kansas definition-but they have not been compared against an objective standard. METHODS All 3 case definitions were measured in the U.S. Military Health Survey by a computer-assisted telephone interview in a random sample (n = 6,497) of the 1991 deployed U.S. military force. The interview asked whether participants had heard nerve agent alarms during the conflict. A random subsample (n = 1,698) provided DNA for genotyping the PON1 Q192R polymorphism. RESULTS The CDC and the Modified Kansas definition without exclusions were satisfied by 41.7% and 39.0% of the deployed force, respectively, and were highly overlapping. The Research definition, a subset of the others, was satisfied by 13.6%. The majority of veterans meeting CDC and Modified Kansas endorsed fewer and milder symptoms; whereas, those meeting Research endorsed more symptoms of greater severity. The group meeting Research was more highly enriched with the PON1 192R risk allele than those meeting CDC and Modified Kansas, and Research had twice the power to detect the previously described gene-environment interaction between hearing alarms and RR homozygosity (adjusted relative excess risk due to interaction [aRERI] = 7.69; 95% CI 2.71-19.13) than CDC (aRERI = 2.92; 95% CI 0.96-6.38) or Modified Kansas without exclusions (aRERI = 3.84; 95% CI 1.30-8.52) or with exclusions (aRERI = 3.42; 95% CI 1.20-7.56). The lower power of CDC and Modified Kansas relative to Research was due to greater false-positive disease misclassification from lower diagnostic specificity. CONCLUSIONS The original Research case definition had greater statistical power to detect a genetic predisposition to GWI. Its greater specificity favors its use in hypothesis-driven research; whereas, the greater sensitivity of the others favor their use in clinical screening for application of future diagnostic biomarkers and clinical care.
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Grants
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
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Affiliation(s)
- Robert W Haley
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | | - Gerald Kramer
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John F Teiber
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Blanchard J, Vigen C, Mallinson T, Carlson M, Garber SL, Bates-Jensen B. Pressure Injury Data Reconciliation in a Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:1833-1839. [PMID: 37121533 PMCID: PMC10611896 DOI: 10.1016/j.apmr.2023.04.009] [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: 10/03/2022] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To advance pressure injury (PrI) research in individuals with spinal cord injury (SCI) by describing lessons learned and recommendations for future research, ultimately promoting PrI prevention and more effective wound care. This paper describes the detailed procedures undertaken to collect and reconcile PrI data and summarizes the types of discrepancies identified. DESIGN Secondary analyses of PrI data collected between 2009 and 2014 in a randomized controlled trial (parent study). SETTING Participants in the parent study were recruited from a large rehabilitation center in the Los Angeles area that serves primarily individuals with limited resources. PARTICIPANTS 232 participants with SCI and a history of 1 or more medically serious PrI (MSPrI) in the previous 5 years. INTERVENTIONS Participants in the parent study were randomized to a 12-month PrI prevention intervention led by an occupational therapist, or to usual care. MAIN OUTCOME MEASURES Relations among PrI characteristics, data sources (phone interviews, skin checks, paper and electronic medical records [MRs]), and treatment condition, and sensitivity of 6 different data sources in detecting MSPrIs. RESULTS The majority (62%) of MSPrIs were in the pelvic region. MRs detected 82% of the MSPrIs overall, making it the most sensitive data source, and scheduled skin checks were the second-most sensitive data source, finding 37% of the MSPrIs. CONCLUSIONS MR review is the preferred method for ascertaining MSPrIs in clinical trials of interventions designed to reduce the incidence of these injuries. When multiple sources of information are used, careful reconciliation of reports is necessary to ensure accuracy.
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Affiliation(s)
- Jeanine Blanchard
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA.
| | - Cheryl Vigen
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
| | - Trudy Mallinson
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
| | - Mike Carlson
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
| | - Susan L Garber
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Barbara Bates-Jensen
- School of Nursing and David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
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Abstract
Personalized interventions are regarded as a next-generation approach in almost all fields of biomedicine, such as clinical medicine, exercise, nutrition and pharmacology. At the same time, an increasing body of evidence indicates that redox processes regulate, at least in part, multiple aspects of human physiology and pathology. As a result, the idea of applying personalized redox treatments to improve their efficacy has gained popularity among researchers in recent years. The aim of the present primer-style review was to highlight some crucial yet underappreciated methodological, statistical, and interpretative concepts within the redox biology literature, while also providing a physiology-oriented perspective on personalized redox biology. The topics addressed are: (i) the critical issue of investigating the potential existence of inter-individual variability; (ii) the importance of distinguishing a genuine and consistent response of a subject from a chance finding; (iii) the challenge of accurately quantifying the effect of a redox treatment when dealing with 'extreme' groups due to mathematical coupling and regression to the mean; and (iv) research designs and analyses that have been implemented in other fields, and can be reframed and exploited in a redox biology context.
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Affiliation(s)
- Nikos V Margaritelis
- Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Agios Ioannis, 62122, Serres, Greece.
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27
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Palese A, Chiappinotto S, Fonda F, Visintini E, Peghin M, Colizzi M, Balestrieri M, De Martino M, Isola M, Tascini C. Lessons learnt while designing and conducting a longitudinal study from the first Italian COVID-19 pandemic wave up to 3 years. Health Res Policy Syst 2023; 21:111. [PMID: 37907957 PMCID: PMC10617212 DOI: 10.1186/s12961-023-01055-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/23/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Several scientific contributions have summarized the "lessons learnt" during the coronavirus disease 2019 (COVID-19) pandemic, but only a few authors have discussed what we have learnt on how to design and conduct research during a pandemic. The main intent of this study was to summarize the lessons learnt by an Italian multidisciplinary research group that developed and conducted a longitudinal study on COVID-19 patients infected during the first wave in March 2020 and followed-up for 3 years. METHODS A qualitative research approach embedded into the primary CORonavirus MOnitoRing study (CORMOR) study was developed, according to the the consolidated criteria for reporting qualitative research. Multiple data collection strategies were performed: each member was invited to report the main lessons learnt according to his/her perspective and experience from the study design throughout its conduction. The narratives collected were summarized and discussed in face-to-face rounds. The narratives were then thematically analysed according to their main topic in a list that was resent to all members to check the content and their organization. The list of the final "lessons learnt" has been agreed by all members, as described in a detailed fashion. RESULTS Several lessons were learnt while designing and conducting a longitudinal study during the COVID-19 pandemic and summarised into ten main themes: some are methodological, while others concern how to conduct research in pandemics/epidemics/infectious disease emergencies. CONCLUSIONS The multidisciplinary approach, which also included patients' perspective, helped us to protect the consistency and quality of the research provided in pandemic times. The lesson learnt suggest that our research approach may benefit from changes in education, clinical practice and policies.
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Affiliation(s)
- Alvisa Palese
- Department of Medicine (DAME), University of Udine, Udine, Italy.
| | | | - Federico Fonda
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Erica Visintini
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maria De Martino
- Medical Statistics Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Miriam Isola
- Medical Statistics Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, Udine, Italy
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Song X, Fu Y, Lai Z, Di X, Zeng R, Shao J, Ni L, Liu Z, Song X, Ye W, Liu C, Liu B, Zheng Y, Chen Y. Drug-coated balloon for treatment of non-atherosclerotic renal artery stenosis-a multi-center study. BMC Cardiovasc Disord 2023; 23:510. [PMID: 37845604 PMCID: PMC10577992 DOI: 10.1186/s12872-023-03484-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/30/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Renal artery stenosis (RAS) is a significant reason for secondary hypertension. Impaired renal function and subsequent cardiopulmonary dysfunction could also occur. Patients of non-atherosclerotic RAS has a relatively young age and long life expectancy. Revascularization with percutaneous transluminal angioplasty (PTA) is a viable treatment option. However, restenosis is unavoidable which limits its use. Drug-coated balloon (DCB) has been proven to be effective in restenosis prevention in femoropopliteal arterial diseases and in patients with renal artery stenosis. And PTA for Renal artery fibromuscular dysplasia is safe and clinically successful. Therefore, we could speculate that DCB might have potential efficacy in non-atherosclerotic RAS treatment. METHODS AND ANALYSIS This will be a randomized multi-center-controlled trial. Eighty-four eligible participants will be assigned randomly in a 1:1 ratio to the control group (plain old balloon, POB) and the experimental group (DCB). Subjects in the former group will receive balloon dilatation alone, and in the latter group will undergo the DCB angioplasty. The DCB used in this study will be a paclitaxel-coated balloon (Orchid, Acotec Scientific Holdings Limited, Beijing, China). Follow-up visits will be scheduled 1, 3, 6, 9, and 12 months after the intervention. Primary outcomes will include controlled blood pressure and primary patency in the 9-month follow-up. Secondary outcomes will include technical success rate, complication rate, and bail-out stenting rate. TRIAL REGISTRATION ClinicalTrials.gov (number NCT05858190). Protocol version V.4 (3 May 2023).
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Affiliation(s)
- Xitao Song
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Yining Fu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Zhichao Lai
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Xiao Di
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Rong Zeng
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Jiang Shao
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Leng Ni
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Zhili Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Xiaojun Song
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Wei Ye
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Changwei Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Bao Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Yuehong Zheng
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China
| | - Yuexin Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing, 100730, China.
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Genuis SK, Luth W, Weber G, Bubela T, Johnston WS. Asynchronous online focus groups for research with people living with amyotrophic lateral sclerosis and family caregivers: usefulness, acceptability and lessons learned. BMC Med Res Methodol 2023; 23:222. [PMID: 37803257 PMCID: PMC10557269 DOI: 10.1186/s12874-023-02051-y] [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: 09/29/2022] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND People with amyotrophic lateral sclerosis (ALS) face disability- and travel-related barriers to research participation. We investigate the usefulness and acceptability of asynchronous, online focus groups (AOFGs) for research involving people affected by ALS (patients and family caregivers) and outline lessons learned. METHODS The ALS Talk Project, consisting of seven AOFGs and 100 participants affected by ALS, provided context for this investigation. Hosted on the secure itracks Board™ platform, participants interacted in a threaded web forum structure. Moderators posted weekly discussion questions and facilitated discussion. Data pertaining to methodology, participant interaction and experience, and moderator technique were analyzed using itracks and NVivo 12 analytics (quantitative) and conventional content analysis and the constant-comparative approach (qualitative). RESULTS There was active engagement within groups, with post lengths averaging 111.48 words and a complex network of branching interactions between participants. One third of participant responses included individual reflections without further interaction. Participants affirmed their co-group members, offered practical advice, and discussed shared and differing perspectives. Moderators responded to all posts, indicating presence and probing answers. AOFGs facilitated qualitative and quantitative data-gathering and flexible response to unanticipated events. Although total participation fell below 50% after 10-12 weeks, participants valued interacting with peers in an inclusive, confidential forum. Participants used a variety of personal devices, browsers, and operating systems when interacting on the online platform. CONCLUSIONS This methodological examination of AOFGs for patient-centred investigations involving people affected by ALS demonstrates their usefulness and acceptability, and advances knowledge of online research methodologies. Lessons learned include: early identification of research goals and participant needs is critical to selecting an AOFG platform; although duration longer than 10-12 weeks may be burdensome in this population, participants were positive about AOFGs; AOFGs offer real world flexibility enabling response to research challenges and opportunities; and, AOGFs can effectively foster safe spaces for sharing personal perspectives and discussing sensitive topics. With moderators playing an important role in fostering engagement, AOFGs facilitated rich data gathering and promoted reciprocity by fostering the exchange of ideas and interaction between peers. Findings may have implications for research involving other neurologically impaired and/or medically vulnerable populations.
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Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada
| | | | - Tania Bubela
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11328 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada.
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Kocak B, Yuzkan S, Mutlu S, Bulut E, Kavukoglu I. Publications poorly report the essential RadiOmics ParametERs (PROPER): A meta-research on quality of reporting. Eur J Radiol 2023; 167:111088. [PMID: 37713968 DOI: 10.1016/j.ejrad.2023.111088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/15/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To investigate the quality of reporting in radiomics research, with a focus on the most basic technical parameters. METHODS A PubMed literature search was conducted to identify original studies on radiomics (last search: January 2, 2023). Following a sample size calculation with an a priori power analysis, a random sample of the radiomic literature was collected. In addition to baseline characteristics, the key aspects of radiomic software, resampling, and discretization were evaluated. Agreement between raters was analyzed. Disagreements were resolved through consensus. RESULTS A sample of 87 publications was evaluated. Most publications (89%; 77/87) were retrospective. They were conducted predominantly with private data (87%; 76/87) at a single institution (77%; 67/87) without external validation (90%; 78/87). 69% (60/87) of the papers reported the radiomic software used (p < 0.001), with nearly half (43%; 26/60) omitting the version. 37% (32/87) reported the resampling size (p = 0.018), while 22% (7/32) did not report using iso-voxel resampling. 34% (30/87) reported the discretization parameters (p < 0.01), but more than three-quarters (77%; 23/30) did not experiment with different discretization parameters. A wide range of discretization parameter values were reported. Most papers (79%; 69/87) failed to report all three essential items simultaneously (p < 0.001). CONCLUSION Even the essential radiomic parameters that are usually displayed on the user interface of radiomic software tools were poorly reported in radiomics-related publications. This issue of transparency may require additional action from researchers, editors, and reviewers in the form of adopting more stringent reporting standards (e.g., checklists, guidelines).
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
| | - Sabahattin Yuzkan
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Samet Mutlu
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Elif Bulut
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Irem Kavukoglu
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
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Seidler AL, Willson ML, Aberoumand M, Williams JG, Hunter KE, Barba A, Simes RJ, Webster A. The changing landscape of clinical trials in Australia. Med J Aust 2023; 219:192-196. [PMID: 37573518 PMCID: PMC10952960 DOI: 10.5694/mja2.52059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 08/15/2023]
Affiliation(s)
| | | | | | | | - Kylie E Hunter
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - Angie Barba
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - R John Simes
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - Angela Webster
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
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Heron L, Buitrago-Garcia D, Ipekci AM, Baumann R, Imeri H, Salanti G, Counotte MJ, Low N. How to update a living systematic review and keep it alive during a pandemic: a practical guide. Syst Rev 2023; 12:156. [PMID: 37660117 PMCID: PMC10474670 DOI: 10.1186/s13643-023-02325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 08/17/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND The covid-19 pandemic has highlighted the role of living systematic reviews. The speed of evidence generated during the covid-19 pandemic accentuated the challenges of managing high volumes of research literature. METHODS In this article, we summarise the characteristics of ongoing living systematic reviews on covid-19, and we follow a life cycle approach to describe key steps in a living systematic review. RESULTS We identified 97 living systematic reviews on covid-19, published up to 7th November 2022, which focused mostly on the effects of pharmacological interventions (n = 46, 47%) or the prevalence of associated conditions or risk factors (n = 30, 31%). The scopes of several reviews overlapped considerably. Most living systematic reviews included both observational and randomised study designs (n = 45, 46%). Only one-third of the reviews has been updated at least once (n = 34, 35%). We address practical aspects of living systematic reviews including how to judge whether to start a living systematic review, methods for study identification and selection, data extraction and evaluation, and give recommendations at each step, drawing from our own experience. We also discuss when it is time to stop and how to publish updates. CONCLUSIONS Methods to improve the efficiency of searching, study selection, and data extraction using machine learning technologies are being developed, their performance and applicability, particularly for reviews based on observational study designs should improve, and ways of publishing living systematic reviews and their updates will continue to evolve. Finally, knowing when to end a living systematic review is as important as knowing when to start.
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Affiliation(s)
- Leonie Heron
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Aziz Mert Ipekci
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Rico Baumann
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Hira Imeri
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zürich, Switzerland
| | - Georgia Salanti
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Michel Jacques Counotte
- Wageningen Bioveterinary Research, Wageningen University & Research, Lelystad, The Netherlands
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
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Raman SR, Qualls LG, Hammill BG, Nelson AJ, Nilles EK, Marsolo K, O'Brien EC. Optimizing data integration in trials that use EHR data: lessons learned from a multi-center randomized clinical trial. Trials 2023; 24:566. [PMID: 37658391 PMCID: PMC10474626 DOI: 10.1186/s13063-023-07563-y] [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: 03/14/2023] [Accepted: 07/31/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Despite great promise, trials that ascertain patient clinical data from electronic health records (EHR), referred to here as "EHR-sourced" trials, are limited by uncertainty about how existing trial sites and infrastructure can be best used to operationalize study goals. Evidence is needed to support the practical use of EHRs in contemporary clinical trial settings. MAIN TEXT We describe a demonstration project that used EHR data to complement data collected for a contemporary multi-center pharmaceutical industry outcomes trial, and how a central coordinating center supported participating sites through the technical, governance, and operational aspects of this type of activity. We discuss operational considerations related to site selection, data extraction, site performance, and data transfer and quality review, and we outline challenges and lessons learned. We surveyed potential sites and used their responses to assess feasibility, determine the potential capabilities of sites and choose an appropriate data extraction strategy. We designed a flexible, multimodal approach for data extraction, enabling each site to either leverage an existing data source, create a new research datamart, or send all data to the central coordinating center to produce the requisite data elements. We evaluated site performance, as reflected by the speed of contracting and IRB approval, total patients enrolled, enrollment yield, data quality, and compared performance by data collection strategy. CONCLUSION While broadening the type of sites able to participate in EHR-sourced trials may lead to greater generalizability and improved enrollment, sites with fewer technical resources may require additional support to participate. Central coordinating center support is essential to facilitate the execution of operational processes. Future work should focus on sharing lessons learned and creating reusable tools to facilitate participation of heterogeneous trial sites.
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Affiliation(s)
- Sudha R Raman
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | | | - Bradley G Hammill
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Adam J Nelson
- Duke Clinical Research Institute, Durham, NC, USA
- Monash Heart, Monash University, Melbourne, VIC, Australia
| | | | - Keith Marsolo
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Emily C O'Brien
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
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Poupin P, Caille A, Gana W, Fougère B, Giraudeau B. Cluster randomized trials in nursing homes should better be planned as open-cohort than as closed-cohort. J Clin Epidemiol 2023; 161:1-7. [PMID: 37364621 DOI: 10.1016/j.jclinepi.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Two designs are frequently used in cluster randomized trials in nursing homes: closed cohort and open cohort. The former design includes residents at the beginning of the trial and then follows them. In the latter design, participants are enrolled at the beginning of the trial or although it is ongoing; at dates of assessment, all residents present in the nursing home are assessed. The open-cohort design is much less used than the closed-cohort design, but it offers several advantages such as less exposure to individual attrition. Objective was to assess whether an open-cohort design could have been feasible in trials with a closed-cohort design. STUDY DESIGN AND SETTING Twenty-two closed-cohort trials in nursing homes. RESULTS An open-cohort design was considered a relevant alternative for 20 trials. For 16 trials, a resident newly admitted could not opt out of the intervention, and for all trials, the resident could benefit from an intervention effect if it existed. For two trials, newly admitted residents could not benefit from the intervention effect, if it existed. CONCLUSION The open-cohort design is well-adapted for most of the interventions assessed in nursing homes by means of a cluster randomized trial and should be considered more often.
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Affiliation(s)
- Pierre Poupin
- INSERM, SPHERE, U1246, Tours University, Nantes University, Tours, France; INSERM CIC 1415, Tours University Hospital, Tours, France.
| | - Agnès Caille
- INSERM, SPHERE, U1246, Tours University, Nantes University, Tours, France; INSERM CIC 1415, Tours University Hospital, Tours, France
| | - Wassim Gana
- Division of Geriatric Medicine, Tours University Medical Center, Tours, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Medical Center, Tours, France; Education, Ethics, Health (EA 7505), Tours University, Tours, France
| | - Bruno Giraudeau
- INSERM, SPHERE, U1246, Tours University, Nantes University, Tours, France; INSERM CIC 1415, Tours University Hospital, Tours, France
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Myung SK. How to review and assess a systematic review and meta-analysis article: a methodological study (secondary publication). J Educ Eval Health Prof 2023; 20:24. [PMID: 37619974 PMCID: PMC10449599 DOI: 10.3352/jeehp.2023.20.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Systematic reviews and meta-analyses have become central in many research fields, particularly medicine. They offer the highest level of evidence in evidence-based medicine and support the development and revision of clinical practice guidelines, which offer recommendations for clinicians caring for patients with specific diseases and conditions. This review summarizes the concepts of systematic reviews and meta-analyses and provides guidance on reviewing and assessing such papers. A systematic review refers to a review of a research question that uses explicit and systematic methods to identify, select, and critically appraise relevant research. In contrast, a meta-analysis is a quantitative statistical analysis that combines individual results on the same research question to estimate the common or mean effect. Conducting a meta-analysis involves defining a research topic, selecting a study design, searching literature in electronic databases, selecting relevant studies, and conducting the analysis. One can assess the findings of a meta-analysis by interpreting a forest plot and a funnel plot and by examining heterogeneity. When reviewing systematic reviews and meta-analyses, several essential points must be considered, including the originality and significance of the work, the comprehensiveness of the database search, the selection of studies based on inclusion and exclusion criteria, subgroup analyses by various factors, and the interpretation of the results based on the levels of evidence. This review will provide readers with helpful guidance to help them read, understand, and evaluate these articles.
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Affiliation(s)
- Seung-Kwon Myung
- Department of Cancer AI & Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
- Cancer Epidemiology Branch, Division of Cancer Data Science, National Cancer Center Research Institute, Goyang, Korea
- Department of Family Medicine and Center for Cancer Prevention and Detection, National Cancer Center Hospital, Goyang, Korea
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Rogés J, González-Casals H, Bosque-Prous M, Folch C, Colom J, Casabona J, Drou-Roget G, Teixidó-Compañó E, Fernández E, Vives-Cases C, Espelt A. Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol. Gac Sanit 2023; 37:102316. [PMID: 37413897 DOI: 10.1016/j.gaceta.2023.102316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023]
Abstract
The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.
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Affiliation(s)
- Judit Rogés
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Helena González-Casals
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Marina Bosque-Prous
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Facultat de Ciències de la Salut, Universitat Oberta de Catalunya (UOC), Barcelona, Spain; Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Agència de Salut Pública de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Joan Colom
- Subdirecció General d'Addiccions, VIH, Infeccions de Transmissió Sexual i Hepatitis Víriques, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Agència de Salut Pública de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Drou-Roget
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain; Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Universitat d'Alacant, San Vicente del Raspeig (Alacant), Spain
| | - Ester Teixidó-Compañó
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain; Tobacco Control Research Group, Epidemiology and Public Health Programme (EPIBELL), Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - Carmen Vives-Cases
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Universitat d'Alacant, San Vicente del Raspeig (Alacant), Spain
| | - Albert Espelt
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain; Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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Jordan ES, Grover PL, Lin J, Starkey CA, Finley EA, Ni H, Hershberger RE. The DCM Project Portal: A direct-to-participant platform of The DCM Research Project. medRxiv 2023:2023.06.22.23291764. [PMID: 37425710 PMCID: PMC10327249 DOI: 10.1101/2023.06.22.23291764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Study Objective To develop a digital platform to conduct family-based, dilated cardiomyopathy (DCM) genetic research. Design Innovative approaches are needed to achieve large family enrollment targets. The DCM Project Portal, a direct-to-participant electronic recruitment, consent, and communication tool, was designed using prior experience with traditional enrollment methods, characteristics and feedback of current participants, and internet access of the US population. Participants DCM patients (probands) and their family members. Results The portal was designed as a self-guided, three module (registration, eligibility, and consent) process with internally created supporting informational and messaging resources integrated throughout. The experience can be tailored to user type and the format adapted with programmatic growth. Characteristics of participants of the recently completed DCM Precision Medicine Study were assessed as an exemplary user population. A majority of the diverse (34% non-Hispanic Black (NHE-B), 9.1% Hispanic; 53.6% female) proband (n=1223) and family members (n=1781) participants aged ≥18 years reported not at all or rarely having problems learning about their health from written information (81%) and a high confidence in completing medical forms (77.2% very much or often confident). A majority of participants across age and race-ethnicity groups reported internet access, with highest rates of no reported access in those ≥77 years, NHE-B, and Hispanic, which reflects patterns similar to rates reported by the US Census Bureau as of 2021. Conclusions Digital enrollment tools offer opportunity to improve access and efficiency. The portal is an example of a digital approach to family-based genetic research.
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Affiliation(s)
- Elizabeth S Jordan
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Phoenix L Grover
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Jay Lin
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Carl A Starkey
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Elizabeth A Finley
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Hanyu Ni
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Ray E Hershberger
- The Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH
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Plenkovic M, Civljak M, Puljak L. Authors arbitrarily used methodological approaches to analyze the quality of reporting in research reports: a meta-research study. J Clin Epidemiol 2023; 158:53-61. [PMID: 36907252 DOI: 10.1016/j.jclinepi.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/14/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES Many authors used reporting checklists as an assessment tool to analyze the reporting quality of diverse types of evidence. We aimed to analyze methodological approaches used by researchers assessing reporting quality of evidence in randomized controlled trials, systematic reviews, and observational studies. STUDY DESIGN AND SETTING We analyzed articles reporting quality assessment of evidence with Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA), CONsolidated Standards of Reporting Trials (CONSORT), or the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklists published up to 18 July 2021. We analyzed methods used for assessing reporting quality. RESULTS Among 356 analyzed articles, 293 (88%) investigated a specific thematic field. The CONSORT checklist (N = 225; 67%) was most often used, in its original, modified, partial form, or its extension. Numerical scores were given for adherence to checklist items in 252 articles (75%), of which 36 articles (11%) used various reporting quality thresholds. In 158 (47%) articles, predictors of adherence to reporting checklist were analyzed. The most studied factor associated with adherence to reporting checklist was the year of article publication (N = 82; 52%). CONCLUSION The methodology used for assessing reporting quality of evidence varied considerably. The research community needs a consensus on a consistent methodology for assessing the quality of reporting.
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Affiliation(s)
- Mia Plenkovic
- Center for Evidence-Based Medicine, Catholic University of Croatia, Ilica 242, Zagreb, Croatia, 10000
| | - Marta Civljak
- Center for Evidence-Based Medicine, Catholic University of Croatia, Ilica 242, Zagreb, Croatia, 10000
| | - Livia Puljak
- Center for Evidence-Based Medicine, Catholic University of Croatia, Ilica 242, Zagreb, Croatia, 10000.
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Rudolph JE, Zhong Y, Duggal P, Mehta SH, Lau B. Defining representativeness of study samples in medical and population health research. BMJ Med 2023; 2:e000399. [PMID: 37215072 PMCID: PMC10193086 DOI: 10.1136/bmjmed-2022-000399] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/28/2023] [Indexed: 05/24/2023]
Abstract
Medical and population health science researchers frequently make ambiguous statements about whether they believe their study sample or results are representative of some (implicit or explicit) target population. This article provides a comprehensive definition of representativeness, with the goal of capturing the different ways in which a study can be representative of a target population. It is proposed that a study is representative if the estimate obtained in the study sample is generalisable to the target population (owing to representative sampling, estimation of stratum specific effects, or quantitative methods to generalise or transport estimates) or the interpretation of the results is generalisable to the target population (based on fundamental scientific premises and substantive background knowledge). This definition is explored in the context of four covid-19 studies, ranging from laboratory science to descriptive epidemiology. All statements regarding representativeness should make clear the way in which the study results generalise, the target population the results are being generalised to, and the assumptions that must hold for that generalisation to be scientifically or statistically justifiable.
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Affiliation(s)
- Jacqueline E Rudolph
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yongqi Zhong
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Priya Duggal
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Bryan Lau
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Stahl AC, Tietz AS, Dewey M, Kendziora B. Has the quality of reporting improved since it became mandatory to use the Standards for Reporting Diagnostic Accuracy? Insights Imaging 2023; 14:85. [PMID: 37184759 PMCID: PMC10184623 DOI: 10.1186/s13244-023-01432-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES To investigate whether making the Standards for Reporting Diagnostic Accuracy (STARD) mandatory by the leading journal 'Radiology' in 2016 improved the quality of reporting of diagnostic accuracy studies. METHODS A validated search term was used to identify diagnostic accuracy studies published in Radiology in 2015 and 2019. STARD adherence was assessed by two independent reviewers. Each item was scored as yes (1 point) if adequately reported or as no (0 points) if not. The total STARD score per article was calculated. Wilcoxon-Mann-Whitney tests were used to evaluate differences of the total STARD scores between 2015 and 2019. In addition, the total STARD score was compared between studies stratified by study design, citation rate, and data collection. RESULTS The median number of reported STARD items for the total of 66 diagnostic accuracy studies from 2015 to 2019 was 18.5 (interquartile range [IQR] 17.5-20.0) of 29. Adherence to the STARD checklist significantly improved the STARD score from a median of 18.0 (IQR 15.5-19.5) in 2015 to a median of 19.5 (IQR 18.5-21.5) in 2019 (p < 0.001). No significant differences were found between studies stratified by mode of data collection (prospective vs. retrospective studies, p = 0.68), study design (cohort vs. case-control studies, p = 0.81), and citation rate (two groups divided by median split [< 0.56 citations/month vs. ≥ 0.56 citations/month], p = 0.54). CONCLUSIONS Making use of the STARD checklist mandatory significantly increased the adherence with reporting standards for diagnostic accuracy studies and should be considered by editors and publishers for widespread implementation. CRITICAL RELEVANCE STATEMENT Editors may consider making reporting guidelines mandatory to improve the scientific quality.
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Affiliation(s)
- Ann-Christine Stahl
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Anne-Sophie Tietz
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Benjamin Kendziora
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany.
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany.
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Kowall B, Stang A. Estimates of excess mortality during the COVID-19 pandemic strongly depend on subjective methodological choices. Herz 2023:10.1007/s00059-023-05166-6. [PMID: 37142834 PMCID: PMC10158684 DOI: 10.1007/s00059-023-05166-6] [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] [Accepted: 02/24/2023] [Indexed: 05/06/2023]
Abstract
Excess mortality is often used to assess the health impact of the COVID-19 pandemic. It involves comparing the number of deaths observed during the pandemic with the number of deaths that would counterfactually have been expected in the absence of the pandemic. However, published data on excess mortality often vary even for the same country. The reason for these discrepancies is that the estimation of excess mortality involves a number of subjective methodological choices. The aim of this paper was to summarize these subjective choices. In several publications, excess mortality was overestimated because population aging was not adjusted for. Another important reason for different estimates of excess mortality is the choice of different pre-pandemic reference periods that are used to estimate the expected number of deaths (e.g., only 2019 or 2015-2019). Other reasons for divergent results include different choices of index periods (e.g., 2020 or 2020-2021), different modeling to determine expected mortality rates (e.g., averaging mortality rates from previous years or using linear trends), the issue of accounting for irregular risk factors such as heat waves and seasonal influenza, and differences in the quality of the data used. We suggest that future studies present the results not only for a single set of analytic choices, but also for sets with different analytic choices, so that the dependence of the results on these choices becomes explicit.
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Affiliation(s)
- Bernd Kowall
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- School of Public Health, Department of Epidemiology, Boston University, Boston, USA
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Drosdowsky A, Lamb KE, Bergin RJ, Boyd L, Milley K, IJzerman MJ, Emery JD. A systematic review of methodological considerations in time to diagnosis and treatment in colorectal cancer research. Cancer Epidemiol 2023; 83:102323. [PMID: 36701982 DOI: 10.1016/j.canep.2023.102323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/26/2023]
Abstract
Research focusing on timely diagnosis and treatment of colorectal cancer is necessary to improve outcomes for people with cancer. Previous attempts to consolidate research on time to diagnosis and treatment have noted varied methodological approaches and quality, limiting the comparability of findings. This systematic review was conducted to comprehensively assess the scope of methodological issues in this field and provide recommendations for future research. Eligible articles had to assess the role of any interval up to treatment, on any outcome in colorectal cancer, in English, with no limits on publication time. Four databases were searched (Ovid Medline, EMBASE, EMCARE and PsycInfo). Papers were screened by two independent reviewers using a two-stage process of title and abstract followed by full text review. In total, 130 papers were included and had data extracted on specific methodological and statistical features. Several methodological problems were identified across the evidence base. Common issues included arbitrary categorisation of intervals (n = 107, 83%), no adjustment for potential confounders (n = 65, 50%), and lack of justification for included covariates where there was adjustment (n = 40 of 65 papers that performed an adjusted analysis, 62%). Many articles introduced epidemiological biases such as immortal time bias (n = 37 of 80 papers that used survival as an outcome, 46%) and confounding by indication (n = 73, 56%), as well as other biases arising from inclusion of factors outside of their temporal sequence. However, determination of the full extent of these problems was hampered by insufficient reporting. Recommendations include avoiding artificial categorisation of intervals, ensuring bias has not been introduced due to out-of-sequence use of key events and increased use of theoretical frameworks to detect and reduce bias. The development of reporting guidelines and domain-specific risk of bias tools may aid in ensuring future research can reliably contribute to recommendations regarding optimal timing and strengthen the evidence base.
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Affiliation(s)
- Allison Drosdowsky
- Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia.
| | - Karen E Lamb
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Rebecca J Bergin
- Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Lucy Boyd
- Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia
| | - Kristi Milley
- Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia; Primary Care Collaborative Cancer Clinical Trials Group (PC4), Carlton, Australia
| | - Maarten J IJzerman
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Jon D Emery
- Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia; Primary Care Collaborative Cancer Clinical Trials Group (PC4), Carlton, Australia
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Casagrande A, Fabris F, Girometti R. An information-oriented paradigm in evaluating accuracy and agreement in radiology. Eur Radiol Exp 2023; 7:14. [PMID: 36939967 PMCID: PMC10027965 DOI: 10.1186/s41747-023-00327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/26/2023] [Indexed: 03/21/2023] Open
Abstract
The goal of any radiological diagnostic process is to gain information about the patient's status. However, the mathematical notion of information is usually not adopted to measure the performance of a diagnostic test or the agreement among readers in providing a certain diagnosis. Indeed, commonly used metrics for assessing diagnostic accuracy (e.g., sensitivity and specificity) or inter-reader agreement (Cohen [Formula: see text] statistics) use confusion matrices containing the number of true- and false positives/negatives results of a test, or the number of concordant/discordant categorizations, respectively, thus lacking proper information content. We present a methodological paradigm, based on Shannon's information theory, aiming to measure both accuracy and agreement in diagnostic radiology. This approach models the information flow as a "diagnostic channel" connecting the state of the patient's disease and the radiologist or, in the case of agreement analysis, as an "agreement channel" linking two or more radiologists evaluating the same set of images. For both cases, we proposed some measures, derived from Shannon's mutual information, which can represent an alternative way to express diagnostic accuracy and agreement in radiology.Key points• Diagnostic processes can be modeled with information theory (IT).• IT metrics of diagnostic accuracy are independent from disease prevalence.• IT metrics of inter-reader agreements can overcome Cohen κ pitfalls.
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Affiliation(s)
- Alberto Casagrande
- Dipartimento di Matematica e Geoscienze, Università degli Studi di Trieste, Trieste, Italy
| | - Francesco Fabris
- Dipartimento di Matematica e Geoscienze, Università degli Studi di Trieste, Trieste, Italy.
| | - Rossano Girometti
- Istituto di Radiologia, Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
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Affiliation(s)
- Howard Bauchner
- Boston University School of Medicine, Boston, Massachusetts (H.B.)
| | | | - Atul J Butte
- University of California, San Francisco, San Francisco, California (A.J.B.)
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Batista RCP, Solans-Domènech M, Angulo-Tuesta A. The quality of gender and sex integration in scientific articles resulting from health research funded by the Brazilian Ministry of Health 2004-2016. Z Gesundh Wiss 2023:1-10. [PMID: 37361267 PMCID: PMC9969035 DOI: 10.1007/s10389-023-01844-1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/04/2023] [Indexed: 03/01/2023]
Abstract
Aim Integrating sex and gender into health research is critical to contributing to an ethical and more responsible science to address significant knowledge gaps, resulting in higher-quality evidence for all. Subject and methods Using the Essential Metrics for Assessing Sex and Gender Integration in Health Research Proposals Involving Human Participants, we evaluate the quality of the integration of sex and gender in the 350 scientific articles produced by 144 health studies funded by the Department of Science and Technology of the Brazilian Ministry of Health between 2004 and 2016. Results The results show that clinical research articles are the type of studies that most frequently report on sex differences, while population and public health research articles most frequently report on gender differences. Analysis of the quality of sex and gender integration reveals low levels of qualification in the items of the literature review and research objectives (section 1) and participant recruitment and retention (section 2). However, the data collection tools, data analysis, and knowledge translation (section 3) items were rated as excellent and good. Conclusion Funding agencies and public institutions should recognize the importance of the integration of sex and gender at all stages of the research process, for instance, through awareness and training for researchers and reviewers, clear requirements, and the possibility to use metrics in the evaluations process.
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Affiliation(s)
| | - Maite Solans-Domènech
- Barcelona – Catalonia, Agency of Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
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Lithander FE, Tenison E, Ypinga J, Halteren A, Smith MD, Lloyd K, Richfield EW, Brazier DE, Breasail MÓ, Smink AJ, Metcalfe C, Hollingworth W, Bloem B, Munneke M, Ben-Shlomo Y, Darweesh SKL, Henderson EJ. Proactive and Integrated Management and Empowerment in Parkinson's Disease protocol for a randomised controlled trial (PRIME-UK) to evaluate a new model of care. Trials 2023; 24:147. [PMID: 36849987 PMCID: PMC9969590 DOI: 10.1186/s13063-023-07084-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/20/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND People living with Parkinson's disease experience progressive motor and non-motor symptoms, which negatively impact on health-related quality of life and can lead to an increased risk of hospitalisation. It is increasingly recognised that the current care models are not suitable for the needs of people with parkinsonism whose care needs evolve and change as the disease progresses. This trial aims to evaluate whether a complex and innovative model of integrated care will increase an individual's ability to achieve their personal goals, have a positive impact on health and symptom burden and be more cost-effective when compared with usual care. METHODS This is a single-centre, randomised controlled trial where people with parkinsonism and their informal caregivers are randomised into one of two groups: either PRIME Parkinson multi-component model of care or usual care. Adults ≥18 years with a diagnosis of parkinsonism, able to provide informed consent or the availability of a close friend or relative to act as a personal consultee if capacity to do so is absent and living in the trial geographical area are eligible. Up to three caregivers per patient can also take part, must be ≥18 years, provide informal, unpaid care and able to give informed consent. The primary outcome measure is goal attainment, as measured using the Bangor Goal Setting Interview. The duration of enrolment is 24 months. The total recruitment target is n=214, and the main analyses will be intention to treat. DISCUSSION This trial tests whether a novel model of care improves health and disease-related metrics including goal attainment and decreases hospitalisations whilst being more cost-effective than the current usual care. Subject to successful implementation of this intervention within one centre, the PRIME Parkinson model of care could then be evaluated within a cluster-randomised trial at multiple centres.
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Affiliation(s)
- Fiona E. Lithander
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.9654.e0000 0004 0372 3343Liggins Institute, University of Auckland, Auckland, 1142 New Zealand ,grid.9654.e0000 0004 0372 3343Department of Nutrition and Dietetics, University of Auckland, Auckland, 1142 New Zealand
| | - Emma Tenison
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Jan Ypinga
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Angelika Halteren
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Matthew D. Smith
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Katherine Lloyd
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Edward W. Richfield
- grid.416201.00000 0004 0417 1173North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB UK
| | - Danielle E. Brazier
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Mícheál Ó. Breasail
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Agnes J. Smink
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Chris Metcalfe
- grid.5337.20000 0004 1936 7603Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, BS8 2PS UK
| | - William Hollingworth
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.5337.20000 0004 1936 7603Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, BS8 2PS UK
| | - Bas Bloem
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marten Munneke
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Yoav Ben-Shlomo
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Sirwan K. L. Darweesh
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Emily J. Henderson
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.413029.d0000 0004 0374 2907Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG UK
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McKenzie C, Bandler LG. Aboriginal and Torres Strait Islander health research leadership. Med J Aust 2023; 218:75-76. [PMID: 36567665 DOI: 10.5694/mja2.51827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Affiliation(s)
| | - Lilon G Bandler
- Leaders in Indigenous Medical Education (LIME) Network, the University of Melbourne, Melbourne, VIC
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Stahl AC, Tietz AS, Kendziora B, Dewey M. Has the STARD statement improved the quality of reporting of diagnostic accuracy studies published in European Radiology? Eur Radiol 2023; 33:97-105. [PMID: 35907025 PMCID: PMC9362582 DOI: 10.1007/s00330-022-09008-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 04/02/2022] [Revised: 06/19/2022] [Accepted: 06/30/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To investigate whether encouraging authors to follow the Standards for Reporting Diagnostic Accuracy (STARD) guidelines improves the quality of reporting of diagnostic accuracy studies. METHODS In mid-2017, European Radiology started encouraging its authors to follow the STARD guidelines. Our MEDLINE search identified 114 diagnostic accuracy studies published in European Radiology in 2015 and 2019. The quality of reporting was evaluated by two independent reviewers using the revised STARD statement. Item 11 was excluded because a meaningful decision about adherence was not possible. Student's t test for independent samples was used to analyze differences in the mean number of reported STARD items between studies published in 2015 and in 2019. In addition, we calculated differences related to the study design, data collection, and citation rate. RESULTS The mean total number of reported STARD items for all 114 diagnostic accuracy studies analyzed was 15.9 ± 2.6 (54.8%) of 29 items (range 9.5-22.5). The quality of reporting of diagnostic accuracy studies was significantly better in 2019 (mean ± standard deviation (SD), 16.3 ± 2.7) than in 2015 (mean ± SD, 15.1 ± 2.3; p < 0.02). No significant differences in the reported STARD items were identified in relation to study design (p = 0.13), data collection (p = 0.87), and citation rate (p = 0.09). CONCLUSION The quality of reporting of diagnostic accuracy studies according to the STARD statement was moderate with a slight improvement since European Radiology started to recommend its authors to follow the STARD guidelines. KEY POINTS • The quality of reporting of diagnostic accuracy studies was moderate with a mean total number of reported STARD items of 15.9 ± 2.6. • The adherence to STARD was significantly better in 2019 than in 2015 (16.3 ± 2.7 vs. 15.1 ± 2.3; p = 0.016). • No significant differences in the reported STARD items were identified in relation to study design (p = 0.13), data collection (p = 0.87), and citation rate (p = 0.09).
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Affiliation(s)
- Ann-Christine Stahl
- Department of Radiology, Charité - Universitätsmedizin Berlin, joint Medical Faculty of Humboldt-Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
| | - Anne-Sophie Tietz
- Department of Radiology, Charité - Universitätsmedizin Berlin, joint Medical Faculty of Humboldt-Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
| | - Benjamin Kendziora
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin, joint Medical Faculty of Humboldt-Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
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49
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Kim SY. Suggestion of more suitable study designs and the corresponding reporting guidelines in articles published in the Journal of Educational Evaluation for Health Professions from 2021 to September 2022: a descriptive study. J Educ Eval Health Prof 2022; 19:36. [PMID: 36567310 PMCID: PMC9889887 DOI: 10.3352/jeehp.2022.19.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to suggest a more suitable study design and the corresponding reporting guidelines in the papers published in the Journal of Educational Evaluation for Health Professionals from January 2021 to September 2022. METHODS Among 59 papers published in the Journal of Educational Evaluation for Health Professionals from January 2021 to September 2022, research articles, review articles, and brief reports were selected. The followings were analyzed: first, the percentage of articles describing the study design in the title, abstracts, or methods; second, the portion of articles describing reporting guidelines; third, the types of study design and corresponding reporting guidelines; and fourth, the suggestion of a more suitable study design based on the study design algorithm for medical literature on interventions, systematic reviews & other review types, and epidemiological studies overview. RESULTS Out of 45 articles, 44 described study designs (97.8%). Out of 44, 19 articles were suggested to be described with more suitable study designs, which mainly occurred in before-and-after studies, diagnostic research, and non-randomized trials. Of the 18 reporting guidelines mentioned, 8 (44.4%) were considered perfect. STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was used for descriptive studies, before-and-after studies, and randomized controlled trials; however, its use should be reconsidered. CONCLUSION Some declarations of study design and reporting guidelines were suggested to be described with more suitable ones. Education and training on study design and reporting guidelines for researchers are needed, and reporting guideline policies for descriptive studies should also be implemented.
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Affiliation(s)
- Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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50
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Parker R, Tomlinson E, Concannon TW, Akl E, Petkovic J, Welch VA, Crowe S, Palm M, Marusic A, Ekanem C, Akl IB, Saginur M, Moja L, Kuchenmüller T, Slingers N, Teixeira L, Dormer L, Lang E, Arayssi T, Greer-Smith R, Brahem AB, Avey M, Tugwell P. Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership. J Gen Intern Med 2022; 37:4047-53. [PMID: 35132560 DOI: 10.1007/s11606-022-07411-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification. OBJECTIVE We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams. DESIGN Consensus development. PARTICIPANTS We involved 16 stakeholders from the international Multi-Stakeholder Engagement (MuSE) Consortium, including patients and the public, providers, payers of health services/purchasers, policy makers, programme managers, peer review editors, and principal investigators. APPROACH We engaged stakeholders in factor development and as co-authors of this manuscript. Using a modified Delphi approach, we gathered stakeholder views concerning a preliminary list of 18 factors. Over two feedback rounds, using qualitative and quantitative analysis, we concentrated these into ten factors. KEY RESULTS We present seven highly desirable factors: 'expertise or experience', 'ability and willingness to represent the stakeholder group', 'inclusivity (equity, diversity and intersectionality)', 'communication skills', 'commitment and time capacity', 'financial and non-financial relationships and activities, and conflict of interest', 'training support and funding needs'. Additionally, three factors are desirable: 'influence', 'research relevant values', 'previous stakeholder engagement'. CONCLUSIONS We present factors for research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership. Policy makers and guideline developers may benefit from considering the factors in stakeholder identification and invitation. Research funders may consider stipulating consideration of the factors in funding applications. We outline how these factors can be implemented and exemplify how their use has the potential to improve the quality and relevancy of health research.
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