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Holden MA, Hattle M, Runhaar J, Riley RD, Healey EL, Quicke J, van der Windt DA, Dziedzic K, van Middelkoop M, Burke D, Corp N, Legha A, Bierma-Zeinstra S, Foster NE. Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. THE LANCET. RHEUMATOLOGY 2023; 5:e386-e400. [PMID: 38251550 DOI: 10.1016/s2665-9913(23)00122-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/08/2023] [Accepted: 04/17/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Many international clinical guidelines recommend therapeutic exercise as a core treatment for knee and hip osteoarthritis. We aimed to identify individual patient-level moderators of the effect of therapeutic exercise for reducing pain and improving physical function in people with knee osteoarthritis, hip osteoarthritis, or both. METHODS We did a systematic review and individual participant data (IPD) meta-analysis of randomised controlled trials comparing therapeutic exercise with non-exercise controls in people with knee osteoathritis, hip osteoarthritis, or both. We searched ten databases from March 1, 2012, to Feb 25, 2019, for randomised controlled trials comparing the effects of exercise with non-exercise or other exercise controls on pain and physical function outcomes among people with knee osteoarthritis, hip osteoarthritis, or both. IPD were requested from leads of all eligible randomised controlled trials. 12 potential moderators of interest were explored to ascertain whether they were associated with short-term (12 weeks), medium-term (6 months), and long-term (12 months) effects of exercise on self-reported pain and physical function, in comparison with non-exercise controls. Overall intervention effects were also summarised. This study is prospectively registered on PROSPERO (CRD42017054049). FINDINGS Of 91 eligible randomised controlled trials that compared exercise with non-exercise controls, IPD from 31 randomised controlled trials (n=4241 participants) were included in the meta-analysis. Randomised controlled trials included participants with knee osteoarthritis (18 [58%] of 31 trials), hip osteoarthritis (six [19%]), or both (seven [23%]) and tested heterogeneous exercise interventions versus heterogeneous non-exercise controls, with variable risk of bias. Summary meta-analysis results showed that, on average, compared with non-exercise controls, therapeutic exercise reduced pain on a standardised 0-100 scale (with 100 corresponding to worst pain), with a difference of -6·36 points (95% CI -8·45 to -4·27, borrowing of strength [BoS] 10·3%, between-study variance [τ2] 21·6) in the short term, -3·77 points (-5·97 to -1·57, BoS 30·0%, τ2 14·4) in the medium term, and -3·43 points (-5·18 to -1·69, BoS 31·7%, τ2 4·5) in the long term. Therapeutic exercise also improved physical function on a standardised 0-100 scale (with 100 corresponding to worst physical function), with a difference of -4·46 points in the short term (95% CI -5·95 to -2·98, BoS 10·5%, τ2 10·1), -2·71 points in the medium term (-4·63 to -0·78, BoS 33·6%, τ2 11·9), and -3·39 points in the long term (-4·97 to -1·81, BoS 34·1%, τ2 6·4). Baseline pain and physical function moderated the effect of exercise on pain and physical function outcomes. Those with higher self-reported pain and physical function scores at baseline (ie, poorer physical function) generally benefited more than those with lower self-reported pain and physical function scores at baseline, with the evidence most certain in the short term (12 weeks). INTERPRETATION There was evidence of a small, positive overall effect of therapeutic exercise on pain and physical function compared with non-exercise controls. However, this effect is of questionable clinical importance, particularly in the medium and long term. As individuals with higher pain severity and poorer physical function at baseline benefited more than those with lower pain severity and better physical function at baseline, targeting individuals with higher levels of osteoarthritis-related pain and disability for therapeutic exercise might be of merit. FUNDING Chartered Society of Physiotherapy Charitable Trust and the National Institute for Health and Care Research.
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Affiliation(s)
- Melanie A Holden
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK.
| | - Miriam Hattle
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Jos Runhaar
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK; Erasmus MC University, Medical Center, Rotterdam, Netherlands
| | - Richard D Riley
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK; University of Birmingham, Institute of Applied Health Research, Birmingham, UK
| | - Emma L Healey
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Jonathan Quicke
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK; Chartered Society of Physiotherapy, London, UK
| | | | - Krysia Dziedzic
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | | | - Danielle Burke
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Nadia Corp
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Amardeep Legha
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | | | - Nadine E Foster
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK; Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Herston, Brisbane, QLD, Australia
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2
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Fan J, Liu X, Li Y, Xia H, Yang R, Li J, Zhang Y. Quality problems of clinical trials in China: evidence from quality related studies. Trials 2022; 23:343. [PMID: 35461304 PMCID: PMC9034627 DOI: 10.1186/s13063-022-06281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 04/05/2022] [Indexed: 02/08/2023] Open
Abstract
Background Recently, the quality of clinical trials conducted in China has made considerable progress. However, clinical trials conducted in China still fall below the global average standard. The aim of this systematic review was to assess studies that investigated the quality of clinical trials conducted in China, summarize the issues, and provide suggestions for conducting high-quality clinical trials in China. Methods We comprehensively searched studies that investigated the quality of clinical trials conducted in China in the following databases from inception to December 1, 2021: National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, WanFang Data, China Biology Medicine, PubMed, and Embase. We then analyzed the issues in clinical trial registration, ethics review, implementation, and reporting. SPSS 25.0 software was used for data analysis. The data synthesis was conducted using summary statistics and a narrative format. Results A total of 90 studies were analyzed, there were 50 studies with 0–5 citation counts (55.56%), 18 studies with 5–10 citation counts (20%), 9 studies with 10–15 citation counts (10%), and 13 studies with more than 15 citation counts (14.44%). Eight (8.89%) studies were conducted by a supervision department, 38 (42.22%) by organizations with GCP qualification, and 44 (48.89%) by third parties. Additionally, there were some problems in the ethical review process of clinical trials, clinical trial registration process, clinical trial implementation process, and clinical trial reporting process. Conclusions The current study shows that the quality problems of clinical trials in China still exist. The reported problems are related to the process of clinical trials, including ethical review, registration, implementation, reporting. Due to the limited quantity and quality of included studies, the conclusions of this study need to be verified by high-quality studies. Review registration Not registerated in PROSPERO. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06281-1.
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Affiliation(s)
- Jin Fan
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiaobo Liu
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuxi Li
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Haisha Xia
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rong Yang
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Juan Li
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yonggang Zhang
- Department of Periodical Press, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China. .,Chinese Evidence-based Medicine Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China. .,Nursing Key Laboratory of Sichuan Province, Chengdu, China.
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3
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Practical Considerations and Challenges When Conducting an Individual Participant Data (IPD) Meta-Analysis. Methods Mol Biol 2021. [PMID: 34550596 DOI: 10.1007/978-1-0716-1566-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
This chapter provides a broad overview of the use of individual participant (sometimes referred to as patient) data (IPD ) within meta-analyses, the associated advantages of using IPD in meta-analysis compared to aggregate data, and when IPD should be used in meta-analysis.This chapter also outlines the steps of conducting an IPD meta-analysis, with practical guidance relating to requesting and obtaining IPD for meta-analysis. Challenges that can be associated with conducting an IPD meta-analysis are also discussed, including consideration of availability bias, when a subset of the relevant IPD is not available for meta-analysis.
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4
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Potential benefits and burdens of National Institutes of Health and National Institute of Mental Health clinical trial policies. Contemp Clin Trials 2021; 103:106328. [PMID: 33631358 PMCID: PMC9808662 DOI: 10.1016/j.cct.2021.106328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 01/05/2023]
Abstract
The National Institutes of Health (NIH) and the National Institute of Mental Health (NIMH) have implemented numerous clinical trial policies in recent years. These policies have well-intended goals but concerns of undue burden have been raised by professional societies. This study identified the new and revised NIH and NIMH clinical trial policies from 2005 to 2019 and summarized the publicly-identified potential benefits and burdens of those policies. Five new/revised NIH-wide and four NIMH-only clinical trial policies were identified. Potential benefits were improved identification, review, conduct, and reporting of publicly-funded clinical trials. Potential burdens were loss of researcher time, potential loss of future research funding opportunities for basic behavioral researchers, and researcher confusion resulting from perceived definition overlap between clinical trials and basic science. Future clinical trial policy development may benefit from early engagement of researchers as stakeholders. Policymakers may benefit from publicly incorporating benefit/burden analyses and outcome evaluations into future policy development.
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Devriendt T, Shabani M, Borry P. Data Sharing in Biomedical Sciences: A Systematic Review of Incentives. Biopreserv Biobank 2021; 19:219-227. [PMID: 33926229 DOI: 10.1089/bio.2020.0037] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The lack of incentives has been described as the rate-limiting step for data sharing. Currently, the evaluation of scientific productivity by academic institutions and funders has been heavily reliant upon the number of publications and citations, raising questions about the adequacy of such mechanisms to reward data generation and sharing. This article provides a systematic review of the current and proposed incentive mechanisms for researchers in biomedical sciences and discusses their strengths and weaknesses. Methods: PubMed, Web of Science, and Google Scholar were queried for original research articles, editorials, and opinion articles on incentives for data sharing. Articles were included if they discussed incentive mechanisms for data sharing, were applicable to biomedical sciences, and were written in English. Results: Although coauthorship in return for the sharing of data is common, this might be incompatible with authorship guidelines and raise concerns over the ability of secondary analysts to contest the proposed research methods or conclusions that are drawn. Data publication, citation, and altmetrics have been proposed as alternative routes to credit data generators, which could address these disadvantages. Their primary downsides are that they are not well-established, it is difficult to acquire evidence to support their implementation, and that they could be gamed or give rise to novel forms of research misconduct. Conclusions: Alternative recognition mechanisms need to be more commonly used to generate evidence on their power to stimulate data sharing, and to assess where they fall short. There is ample discussion in policy documents on alternative crediting systems to work toward Open Science, which indicates that that there is an interest in working out more elaborate metascience programs.
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Affiliation(s)
- Thijs Devriendt
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Mahsa Shabani
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.,Metamedica, Faculty of Law and Criminology, Ghent University, Gent, Belgium
| | - Pascal Borry
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
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6
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Hutchings E, Loomes M, Butow P, Boyle FM. A systematic literature review of researchers' and healthcare professionals' attitudes towards the secondary use and sharing of health administrative and clinical trial data. Syst Rev 2020; 9:240. [PMID: 33046097 PMCID: PMC7552458 DOI: 10.1186/s13643-020-01485-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
A systematic literature review of researchers and healthcare professionals' attitudes towards the secondary use and sharing of health administrative and clinical trial data was conducted using electronic data searching. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design, or disease setting. Two authors were involved in all stages of the review process; conflicts were resolved by consensus. Data was extracted independently using a pre-piloted data extraction template. Quality and bias were assessed using the QualSyst criteria for qualitative studies. Eighteen eligible articles were identified, and articles were categorised into four key themes: barriers, facilitators, access, and ownership; 14 subthemes were identified. While respondents were generally supportive of data sharing, concerns were expressed about access to data, data storage infrastructure, and consent. Perceptions of data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region. Young researchers were less willing to share data; they were willing to share in circumstances where they were acknowledged. While there is a general consensus that increased data sharing in health is beneficial to the wider scientific community, substantial barriers remain. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018110559.
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Affiliation(s)
- Elizabeth Hutchings
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Max Loomes
- Department of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Department of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), Sydney, Australia.,Psycho-Oncology Co-Operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
| | - Frances M Boyle
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.,Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, North Sydney, Sydney, Australia
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7
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Scutt P, Woodhouse LJ, Montgomery AA, Bath PM. Data sharing: experience of accessing individual patient data from completed randomised controlled trials in vascular and cognitive medicine. BMJ Open 2020; 10:e038765. [PMID: 32912955 PMCID: PMC7482449 DOI: 10.1136/bmjopen-2020-038765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/10/2020] [Accepted: 07/01/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Meta-analysis based on individual patient data (IPD) from randomised trials is superior to using published summary data since it facilitates subgroup and multiple variable analyses. Guidelines and funders expect that researchers share IPD for bona fide analyses, but in practice, this is done variably. Here, we report the experience of obtaining IPD for two collaborative analysis studies. SETTING Two linked studies required IPD from published randomised trials. The leading researchers for eligible trials were approached and asked to share IPD including trial characteristics, patient demographics, baseline clinical data and outcome measures. PARTICIPANTS Participants in eligible randomised controlled trials included patients with or at risk of cognitive decline/vascular events. PRIMARY AND SECONDARY OUTCOME MEASURES Numbers (%) of trials where the leading researcher responded favourably/negatively or did not respond. If negative, reasons behind the response were collected. If positive, methods used to share IPD were recorded. RESULTS Across the two studies, 391 completed trials were identified. Email addresses for researchers were found for 313 (80%) of the trials. One hundred and forty-eight (47%) researchers did not respond despite being sent multiple emails. Following contact, positive initial responses were received from 92 researchers, resulting in IPD being shared for 78 trials. Eighty-seven (28%) researchers declined to share data; justifications were recorded. The median time from first request to accessing data in one study was 241 (IQR 383.3) days. IPD sources included: direct from researcher, via academic trial funders repository and a website requiring remote analysis of commercial data. Where data were shared, a variety of methods were used to transfer data. CONCLUSION Sharing of IPD from trials is desirable and a requirement of many funding bodies. However, accessing IPD faces multiple challenges including refusals to share, delays in access to data and having to perform analyses on a remote website. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Polly Scutt
- Stroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
- Hearing Sciences, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Lisa J Woodhouse
- Stroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Philip M Bath
- Stroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
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8
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Affiliation(s)
- Howard Bauchner
- Dr Bauchner is Editor in Chief and Dr Fontanarosa is Executive Editor, JAMA
| | - Phil B Fontanarosa
- Dr Bauchner is Editor in Chief and Dr Fontanarosa is Executive Editor, JAMA
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9
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Howe N, Giles E, Newbury-Birch D, McColl E. Systematic review of participants' attitudes towards data sharing: a thematic synthesis. J Health Serv Res Policy 2019; 23:123-133. [PMID: 29653503 DOI: 10.1177/1355819617751555] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objectives Data sharing is well established in biological research, but evidence on sharing of clinical trial or public health research study data remains limited, in particular studies of research participants' perspectives of data sharing. This study systematically reviewed international evidence of research participants' attitudes towards the sharing of data for secondary research use. Methods Systematic search of seven databases, and author-, citation- and bibliography-follow up to identify studies examining research participants' attitudes towards data sharing. Studies were thematically analysed using NVivo v10 to identify recurring themes. Results Nine studies were eligible for inclusion. Thematic analysis identified four key themes: (1) benefits of data sharing, including benefit to participants or immediate community, benefits to the public and benefits to science or research; (2) fears and harms, such as fear of exploitation, stigmatization or repercussions, alongside concerns about confidentiality and misuse of data; (3) data sharing processes, in particular the role of consent in the process; and (4) the relationship between participants and research such as trust in different types of research or organization and the relationship with the original research team. Conclusions The available literature on attitudes towards sharing data from clinical trials or public health interventions remains scant. This study has identified four themes regarding research participants' attitudes and preferences, which should be considered by policy makers, and explored with further research.
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Affiliation(s)
- Nicola Howe
- 1 Database Manager, Newcastle Clinical Trials Unit, 5994 Newcastle University , Newcastle University, UK
| | - Emma Giles
- 2 Senior Research Lecturer in Public Health, School of Health and Social Care, Teesside University, UK
| | - Dorothy Newbury-Birch
- 3 Professor of Alcohol and Public Health Research, School of Health and Social Care, Teesside University, UK
| | - Elaine McColl
- 4 Professor of Health Service Research, Institute of Health and Society, 5994 Newcastle University , Newcastle University, UK
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10
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Devereaux PJ. Access to clinical trial data-Commentary. Clin Trials 2019; 16:552-554. [PMID: 31347396 DOI: 10.1177/1740774519865528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P J Devereaux
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada
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11
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Wieschowski S, Riedel N, Wollmann K, Kahrass H, Müller-Ohlraun S, Schürmann C, Kelley S, Kszuk U, Siegerink B, Dirnagl U, Meerpohl J, Strech D. Result dissemination from clinical trials conducted at German university medical centers was delayed and incomplete. J Clin Epidemiol 2019; 115:37-45. [PMID: 31195110 DOI: 10.1016/j.jclinepi.2019.06.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/22/2019] [Accepted: 06/03/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Timely and comprehensive reporting of clinical trial results builds the backbone of evidence-based medicine and responsible research. The proportion of timely disseminated trial results can inform alternative national and international benchmarking of university medical centers (UMCs). STUDY DESIGN AND SETTING For all German UMCs, we tracked all registered trials completed between 2009 and 2013. The results and an interactive website benchmark German UMCs regarding their performance in result dissemination. RESULTS We identified and tracked 2,132 clinical trials. For 1,509 trials, one of the German UMCs took the academic lead. Of these 1,509 "lead trials," 39% published their results (mostly via journal publications) in a timely manner (<24 months after completion). More than 6 years after study completion, 26% of all eligible lead trials still had not disseminated results. CONCLUSION Despite substantial attention from many stakeholders to the topic, there is still a strong delay or even absence of result dissemination for many trials. German UMCs have several opportunities to improve this situation. Further research should evaluate whether and how a transparent benchmarking of UMC performance in result dissemination helps to increase value and reduce waste in medical research.
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Affiliation(s)
- Susanne Wieschowski
- Institute for Ethics, History, and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | - Nico Riedel
- QUEST Center for Transforming Biomedical Research, Berlin Institute of Health, Berlin, Germany
| | - Katharina Wollmann
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Cochrane Germany Foundation, Freiburg, Germany
| | - Hannes Kahrass
- Institute for Ethics, History, and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | | | - Christopher Schürmann
- Institute for Ethics, History, and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | - Sean Kelley
- Department of Experimental Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ute Kszuk
- Cochrane Germany Foundation, Freiburg, Germany
| | - Bob Siegerink
- Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Dirnagl
- QUEST Center for Transforming Biomedical Research, Berlin Institute of Health, Berlin, Germany; Department of Experimental Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jörg Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daniel Strech
- Institute for Ethics, History, and Philosophy of Medicine, Hannover Medical School, Hannover, Germany; QUEST Center for Transforming Biomedical Research, Berlin Institute of Health, Berlin, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany.
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12
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Gay HC, Baldridge AS, Huffman MD. Feasibility, Process, and Outcomes of Cardiovascular Clinical Trial Data Sharing: A Reproduction Analysis of the SMART-AF Trial. JAMA Cardiol 2019; 2:1375-1379. [PMID: 29049540 DOI: 10.1001/jamacardio.2017.3808] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Data sharing is as an expanding initiative for enhancing trust in the clinical research enterprise. Objective To evaluate the feasibility, process, and outcomes of a reproduction analysis of the THERMOCOOL SMARTTOUCH Catheter for the Treatment of Symptomatic Paroxysmal Atrial Fibrillation (SMART-AF) trial using shared clinical trial data. Design, Setting, and Participants A reproduction analysis of the SMART-AF trial was performed using the data sets, data dictionary, case report file, and statistical analysis plan from the original trial accessed through the Yale Open Data Access Project using the SAS Clinical Trials Data Transparency platform. SMART-AF was a multicenter, single-arm trial evaluating the effectiveness and safety of an irrigated, contact force-sensing catheter for ablation of drug refractory, symptomatic paroxysmal atrial fibrillation in 172 participants recruited from 21 sites between June 2011 and December 2011. Analysis of the data was conducted between December 2016 and April 2017. Main Outcomes and Measures Effectiveness outcomes included freedom from atrial arrhythmias after ablation and proportion of participants without any arrhythmia recurrence over the 12 months of follow-up after a 3-month blanking period. Safety outcomes included major adverse device- or procedure-related events. Results The SMART AF trial participants' mean age was 58.7 (10.8) years, and 72% were men. The time from initial proposal submission to final analysis was 11 months. Freedom from atrial arrhythmias at 12 months postprocedure was similar compared with the primary study report (74.0%; 95% CI, 66.0-82.0 vs 76.4%; 95% CI, 68.7-84.1). The reproduction analysis success rate was higher than the primary study report (65.8%; 95% CI 56.5-74.2 vs 75.6%; 95% CI, 67.2-82.5). Adverse events were minimal and similar between the 2 analyses, but contact force range or regression models could not be reproduced. Conclusions and Relevance The feasibility of a reproduction analysis of the SMART-AF trial was demonstrated through an academic data-sharing platform. Data sharing can be facilitated through incentivizing collaboration, sharing statistical code, and creating more decentralized data sharing platforms with fewer restrictions to data access.
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Affiliation(s)
- Hawkins C Gay
- Department of Medicine, Northwestern University, Chicago, Illinois
| | - Abigail S Baldridge
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Mark D Huffman
- Department of Medicine, Northwestern University, Chicago, Illinois.,Department of Preventive Medicine, Northwestern University, Chicago, Illinois.,Associate Editor
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13
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Affiliation(s)
- Mark A Hlatky
- Stanford University School of Medicine, Stanford, California.
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14
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van der Windt DA, Burke DL, Babatunde O, Hattle M, McRobert C, Littlewood C, Wynne-Jones G, Chesterton L, van der Heijden GJMG, Winters JC, Rhon DI, Bennell K, Roddy E, Heneghan C, Beard D, Rees JL, Riley RD. Predictors of the effects of treatment for shoulder pain: protocol of an individual participant data meta-analysis. Diagn Progn Res 2019; 3:15. [PMID: 31410370 PMCID: PMC6686538 DOI: 10.1186/s41512-019-0061-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/16/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Shoulder pain is one of the most common presentations of musculoskeletal pain with a 1-month population prevalence of between 7 and 26%. The overall prognosis of shoulder pain is highly variable with 40% of patients reporting persistent pain 1 year after consulting their primary care clinician. Despite evidence for prognostic value of a range of patient and disease characteristics, it is not clear whether these factors also predict (moderate) the effect of specific treatments (such as corticosteroid injection, exercise, or surgery). OBJECTIVES This study aims to identify predictors of treatment effect (i.e. treatment moderators or effect modifiers) by investigating the association between a number of pre-defined individual-level factors and the effects of commonly used treatments on shoulder pain and disability outcomes. METHODS This will be a meta-analysis using individual participant data (IPD). Eligible trials investigating the effectiveness of advice and analgesics, corticosteroid injection, physiotherapy-led exercise, psychological interventions, and/or surgical treatment in patients with shoulder conditions will be identified from systematic reviews and an updated systematic search for trials, and risk of bias will be assessed. Authors of all eligible trials will be approached for data sharing. Outcomes measured will be shoulder pain and disability, and our previous work has identified candidate predictors. The main analysis will be conducted using hierarchical one-stage IPD meta-analysis models, examining the effect of treatment-predictor interaction on outcome for each of the candidate predictors and describing relevant subgroup effects where significant interaction effects are detected. Random effects will be used to account for clustering and heterogeneity. Sensitivity analyses will be based on (i) exclusion of trials at high risk of bias, (ii) use of restricted cubic splines to model potential non-linear associations for candidate predictors measured on a continuous scale, and (iii) the use of a two-stage IPD meta-analysis framework. DISCUSSION Our study will collate, appraise, and synthesise IPD from multiple studies to examine potential predictors of treatment effect in order to assess the potential for better and more efficient targeting of specific treatments for individuals with shoulder pain. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018088298.
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Affiliation(s)
- Danielle A. van der Windt
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Danielle L. Burke
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Opeyemi Babatunde
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Miriam Hattle
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Cliona McRobert
- 0000 0004 1936 8470grid.10025.36School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Chris Littlewood
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Gwenllian Wynne-Jones
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Linda Chesterton
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
| | - Geert J. M. G. van der Heijden
- 0000000084992262grid.7177.6Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan C. Winters
- 0000 0000 9558 4598grid.4494.dDepartment of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Daniel I. Rhon
- San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX USA
| | - Kim Bennell
- 0000 0001 2179 088Xgrid.1008.9Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Edward Roddy
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership Trust, Stoke-on-Trent, UK
| | - Carl Heneghan
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Primary Care and Health Science, University of Oxford, Oxford, UK
| | - David Beard
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Jonathan L. Rees
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Richard D. Riley
- 0000 0004 0415 6205grid.9757.cInstitute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Centre for Prognosis Research, Keele University, Keele, UK
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15
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Guo SW, Groothuis PG. Is it time for a paradigm shift in drug research and development in endometriosis/adenomyosis? Hum Reprod Update 2018; 24:577-598. [DOI: 10.1093/humupd/dmy020] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/21/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Sun-Wei Guo
- Shanghai OB/GYN Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University, Shanghai, China
| | - Patrick G Groothuis
- Principal Scientist Pharmacology, Preclinical Department, Synthon Biopharmaceuticals bv, Nijmegen, The Netherlands
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Bekiari E, Kitsios K, Thabit H, Tauschmann M, Athanasiadou E, Karagiannis T, Haidich AB, Hovorka R, Tsapas A. Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis. BMJ 2018; 361:k1310. [PMID: 29669716 PMCID: PMC5902803 DOI: 10.1136/bmj.k1310] [Citation(s) in RCA: 246] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of artificial pancreas treatment in non-pregnant outpatients with type 1 diabetes. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES Medline, Embase, Cochrane Library, and grey literature up to 2 February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials in non-pregnant outpatients with type 1 diabetes that compared the use of any artificial pancreas system with any type of insulin based treatment. Primary outcome was proportion (%) of time that sensor glucose level was within the near normoglycaemic range (3.9-10 mmol/L). Secondary outcomes included proportion (%) of time that sensor glucose level was above 10 mmol/L or below 3.9 mmol/L, low blood glucose index overnight, mean sensor glucose level, total daily insulin needs, and glycated haemoglobin. The Cochrane Collaboration risk of bias tool was used to assess study quality. RESULTS 40 studies (1027 participants with data for 44 comparisons) were included in the meta-analysis. 35 comparisons assessed a single hormone artificial pancreas system, whereas nine comparisons assessed a dual hormone system. Only nine studies were at low risk of bias. Proportion of time in the near normoglycaemic range (3.9-10.0 mmol/L) was significantly higher with artificial pancreas use, both overnight (weighted mean difference 15.15%, 95% confidence interval 12.21% to 18.09%) and over a 24 hour period (9.62%, 7.54% to 11.7%). Artificial pancreas systems had a favourable effect on the proportion of time with sensor glucose level above 10 mmol/L (-8.52%, -11.14% to -5.9%) or below 3.9 mmol/L (-1.49%, -1.86% to -1.11%) over 24 hours, compared with control treatment. Robustness of findings for the primary outcome was verified in sensitivity analyses, by including only trials at low risk of bias (11.64%, 9.1% to 14.18%) or trials under unsupervised, normal living conditions (10.42%, 8.63% to 12.2%). Results were consistent in a subgroup analysis both for single hormone and dual hormone artificial pancreas systems. CONCLUSIONS Artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reporting, small sample size, and short follow-up duration of individual trials.
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Affiliation(s)
- Eleni Bekiari
- Clinical Research and Evidence Based Medicine Unit, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Konstantinos Kitsios
- Diabetes Centre, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hood Thabit
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Martin Tauschmann
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Eleni Athanasiadou
- Clinical Research and Evidence Based Medicine Unit, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Thomas Karagiannis
- Clinical Research and Evidence Based Medicine Unit, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roman Hovorka
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Apostolos Tsapas
- Clinical Research and Evidence Based Medicine Unit, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Harris Manchester College, University of Oxford, Oxford, UK
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17
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Yang A, Baxi S, Korenstein D. ClinicalTrials.gov for Facilitating Rapid Understanding of Potential Harms of New Drugs: The Case of Checkpoint Inhibitors. J Oncol Pract 2018; 14:72-76. [PMID: 29298113 DOI: 10.1200/jop.2017.025114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Annie Yang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Shrujal Baxi
- Memorial Sloan Kettering Cancer Center, New York, NY
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18
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Holden MA, Burke DL, Runhaar J, van Der Windt D, Riley RD, Dziedzic K, Legha A, Evans AL, Abbott JH, Baker K, Brown J, Bennell KL, Bossen D, Brosseau L, Chaipinyo K, Christensen R, Cochrane T, de Rooij M, Doherty M, French HP, Hickson S, Hinman RS, Hopman-Rock M, Hurley MV, Ingram C, Knoop J, Krauss I, McCarthy C, Messier SP, Patrick DL, Sahin N, Talbot LA, Taylor R, Teirlinck CH, van Middelkoop M, Walker C, Foster NE. Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA): a systematic review update and individual participant data meta-analysis protocol. BMJ Open 2017; 7:e018971. [PMID: 29275348 PMCID: PMC5770908 DOI: 10.1136/bmjopen-2017-018971] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/09/2017] [Accepted: 10/19/2017] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Knee and hip osteoarthritis (OA) is a leading cause of disability worldwide. Therapeutic exercise is a recommended core treatment for people with knee and hip OA, however, the observed effect sizes for reducing pain and improving physical function are small to moderate. This may be due to insufficient targeting of exercise to subgroups of people who are most likely to respond and/or suboptimal content of exercise programmes. This study aims to identify: (1) subgroups of people with knee and hip OA that do/do not respond to therapeutic exercise and to different types of exercise and (2) mediators of the effect of therapeutic exercise for reducing pain and improving physical function. This will enable optimal targeting and refining the content of future exercise interventions. METHODS AND ANALYSIS Systematic review and individual participant data meta-analyses. A previous comprehensive systematic review will be updated to identify randomised controlled trials that compare the effects of therapeutic exercise for people with knee and hip OA on pain and physical function to a non-exercise control. Lead authors of eligible trials will be invited to share individual participant data. Trial-level and participant-level characteristics (for baseline variables and outcomes) of included studies will be summarised. Meta-analyses will use a two-stage approach, where effect estimates are obtained for each trial and then synthesised using a random effects model (to account for heterogeneity). All analyses will be on an intention-to-treat principle and all summary meta-analysis estimates will be reported as standardised mean differences with 95% CI. ETHICS AND DISSEMINATION Research ethical or governance approval is exempt as no new data are being collected and no identifiable participant information will be shared. Findings will be disseminated via national and international conferences, publication in peer-reviewed journals and summaries posted on websites accessed by the public and clinicians. PROSPERO REGISTRATION NUMBER CRD42017054049.
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Affiliation(s)
- Melanie A Holden
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Danielle L Burke
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Jos Runhaar
- Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Danielle van Der Windt
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Richard D Riley
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Krysia Dziedzic
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Amardeep Legha
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Amy L Evans
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - J Haxby Abbott
- Department of Surgical Sciences, Centre for Musculoskeletal Outcomes Research, Orthopaedic Surgery Section, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Kristin Baker
- Sargent College, Boston University, Boston, Massachusetts, USA
| | - Jenny Brown
- Research User Group, Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Kim L Bennell
- Department of Physiotherapy, Centre for Health, Exercise & Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Daniël Bossen
- Faculty of Health, ACHIEVE Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucie Brosseau
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Kanda Chaipinyo
- Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University, Bangkok, Thailand
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
| | - Tom Cochrane
- Centre for Research Action in Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Mariette de Rooij
- Amsterdam Rehabilitation Research Centre, Centre for Rehabilitation and Rheumatology, Reade, Amsterdam, The Netherlands
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Helen P French
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sheila Hickson
- Research User Group, Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Rana S Hinman
- Department of Physiotherapy, Centre for Health, Exercise & Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Marijke Hopman-Rock
- TNO Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Michael V Hurley
- Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK
- Health Innovation Network South London, London, UK
| | - Carol Ingram
- Research User Group, Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Jesper Knoop
- Amsterdam Rehabilitation Research Centre, Centre for Rehabilitation and Rheumatology, Reade, Amsterdam, The Netherlands
| | - Inga Krauss
- Department of Sports Medicine, Medical Clinic, University Hospital of Tübingen, Tübingen, Germany
| | - Chris McCarthy
- Manchester Movement Unit, Manchester School of Physiotherapy, Manchester Metropolitan University, Manchester, UK
| | - Stephen P Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Worrell Professional Center, Wake Forest University, Winston Salem, USA
| | - Donald L Patrick
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Nilay Sahin
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Balikesir University, Balikesir, Turkey
| | - Laura A Talbot
- Department of Neurology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA
| | - Robert Taylor
- Research User Group, Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Carolien H Teirlinck
- Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Christine Walker
- Research User Group, Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Nadine E Foster
- Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK
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19
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Figueiredo AS. Data Sharing: Convert Challenges into Opportunities. Front Public Health 2017; 5:327. [PMID: 29270401 PMCID: PMC5723929 DOI: 10.3389/fpubh.2017.00327] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/21/2017] [Indexed: 02/01/2023] Open
Abstract
Initiatives for sharing research data are opportunities to increase the pace of knowledge discovery and scientific progress. The reuse of research data has the potential to avoid the duplication of data sets and to bring new views from multiple analysis of the same data set. For example, the study of genomic variations associated with cancer profits from the universal collection of such data and helps in selecting the most appropriate therapy for a specific patient. However, data sharing poses challenges to the scientific community. These challenges are of ethical, cultural, legal, financial, or technical nature. This article reviews the impact that data sharing has in science and society and presents guidelines to improve the efficient sharing of research data.
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Affiliation(s)
- Ana Sofia Figueiredo
- Department of Anesthesiology and Surgical Intensive Care Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Institute for Experimental Internal Medicine, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
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20
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Gautier I, Janiaud P, Rollet N, André N, Tsimaratos M, Cornu C, Malik S, Gentile S, Kassaï B. Trends in the number and the quality of trial protocols involving children submitted to a French Institutional Review Board. BMC Med Res Methodol 2017; 17:130. [PMID: 28835231 PMCID: PMC5569539 DOI: 10.1186/s12874-017-0395-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 08/02/2017] [Indexed: 02/07/2023] Open
Abstract
Background There is a great need for high quality clinical research for children. The European Pediatric Regulation aimed to improve the quality of clinical trials in order to increase the availability of treatments for children. The main purpose of this study was to assess the evolution of both the number and the quality of pediatric trial protocols that were submitted to a French Institutional Review Board (IRB00009118) before and after the initiation of the EU Pediatric Regulation. Methods All protocols submitted to the IRB00009118 between 2003 and 2014 and conducting research on subjects under eighteen years of age were eligible. The quality of randomized clinical trials was assessed according to the guidelines developed by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and ranked using the Jadad score. Results Out of 622 protocols submitted to the Institutional Review Board (IRB), 21% (133/622) included children. Among these 133 pediatric protocols, the number of submitted pediatric protocols doubled between the two studied periods. From 2003 to 2008, 47 protocols including 21 institutionally sponsored were submitted to the IRB and from 2009 until 2014, 86 protocols including 48 institutionally sponsored were submitted. No significant trend was observed on the quality of RCTs. The overall median score of RCTs on the Jadad scale was high (3.5), 70.0% of protocols had a Jadad score ≥ 3, and 30.0% had a score < 3. Conclusion Following the EU Pediatric Regulation, the number of pediatric protocols submitted to the IRB00009118 tends to increase, but no change was noticed regarding their quality.
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Affiliation(s)
- Isabelle Gautier
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France. .,EA3279 - Santé Publique: Maladies Chroniques et Qualité de Vie, Aix-Marseille Université, 13385, Marseille, France.
| | - Perrine Janiaud
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France
| | - Nelly Rollet
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France
| | - Nicolas André
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France
| | - Michel Tsimaratos
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France
| | - Catherine Cornu
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
| | - Salma Malik
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
| | - Stéphanie Gentile
- EA3279 - Santé Publique: Maladies Chroniques et Qualité de Vie, Aix-Marseille Université, 13385, Marseille, France
| | - Behrouz Kassaï
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
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Jackson R, Psarelli EE, Berhane S, Khan H, Johnson P. Impact of Viral Status on Survival in Patients Receiving Sorafenib for Advanced Hepatocellular Cancer: A Meta-Analysis of Randomized Phase III Trials. J Clin Oncol 2017; 35:622-628. [PMID: 28045619 DOI: 10.1200/jco.2016.69.5197] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose Following the Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial, sorafenib has become the standard of care for patients with advanced unresectable hepatocellular carcinoma, but the relation between survival advantage and disease etiology remains unclear. To address this, we undertook an individual patient data meta-analysis of three large prospective randomized trials in which sorafenib was the control arm. Methods Of a total of 3,256 patients, 1,643 (50%) who received sorafenib were available. The primary end point was overall survival (OS). A Bayesian hierarchical approach for individual patient data meta-analyses was applied using a piecewise exponential model. Results are presented in terms of hazard ratios comparing sorafenib with alternative therapies according to hepatitis C virus (HCV) or hepatitis B virus (HBV) status. Results Hazard ratios show improved OS for sorafenib in patients who are both HBV negative and HCV positive (log [hazard ratio], -0.27; 95% CI, -0.46 to -0.06). Median unadjusted survival is 12.6 (11.15 to 13.8) months for sorafenib and 10.2 (8.88 to 12.2) months for "other" treatments in this subgroup. There was no evidence of improvement in OS for any other patient subgroups defined by HBV and HCV. Results were consistent across all trials with heterogeneity assessed using Cochran's Q statistic. Conclusion There is consistent evidence that the effect of sorafenib on OS is dependent on patients' hepatitis status. There is an improved OS for patients negative for HBV and positive for HCV when treated with sorafenib. There was no evidence of any improvement in OS attributable to sorafenib for patients positive for HBV and negative for HCV.
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Affiliation(s)
- Richard Jackson
- Richard Jackson and Eftychia-Eirini Psarelli, Liverpool Cancer Trials Unit; Sarah Berhane and Philip Johnson, University of Liverpool, Liverpool; Harun Khan, Imperial College London, London; and Philip Johnson, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Eftychia-Eirini Psarelli
- Richard Jackson and Eftychia-Eirini Psarelli, Liverpool Cancer Trials Unit; Sarah Berhane and Philip Johnson, University of Liverpool, Liverpool; Harun Khan, Imperial College London, London; and Philip Johnson, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Sarah Berhane
- Richard Jackson and Eftychia-Eirini Psarelli, Liverpool Cancer Trials Unit; Sarah Berhane and Philip Johnson, University of Liverpool, Liverpool; Harun Khan, Imperial College London, London; and Philip Johnson, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Harun Khan
- Richard Jackson and Eftychia-Eirini Psarelli, Liverpool Cancer Trials Unit; Sarah Berhane and Philip Johnson, University of Liverpool, Liverpool; Harun Khan, Imperial College London, London; and Philip Johnson, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Philip Johnson
- Richard Jackson and Eftychia-Eirini Psarelli, Liverpool Cancer Trials Unit; Sarah Berhane and Philip Johnson, University of Liverpool, Liverpool; Harun Khan, Imperial College London, London; and Philip Johnson, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
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Prieto JC, Paniagua B, Yatabe MS, Ruellas ACO, Fattori L, Muniz L, Styner M, Cevidanes L. Federating Heterogeneous Datasets to Enhance Data Sharing and Experiment Reproducibility. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2017; 10137:101372J. [PMID: 28690357 PMCID: PMC5497850 DOI: 10.1117/12.2254689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Recent studies have demonstrated the difficulties to replicate scientific findings and/or experiments published in past.1 The effects seen in the replicated experiments were smaller than previously reported. Some of the explanations for these findings include the complexity of the experimental design and the pressure on researches to report positive findings. The International Committee of Medical Journal Editors (ICMJE) suggests that every study considered for publication must submit a plan to share the de-identified patient data no later than 6 months after publication. There is a growing demand to enhance the management of clinical data, facilitate data sharing across institutions and also to keep track of the data from previous experiments. The ultimate goal is to assure the reproducibility of experiments in the future. This paper describes Shiny-tooth, a web based application created to improve clinical data acquisition during the clinical trial; data federation of such data as well as morphological data derived from medical images; Currently, this application is being used to store clinical data from an osteoarthritis (OA) study. This work is submitted to the SPIE Biomedical Applications in Molecular, Structural, and Functional Imaging conference.
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Affiliation(s)
- Juan C Prieto
- NIRAL, UNC, Chapel Hill, North Carolina, United States
| | | | | | | | | | | | - Martin Styner
- NIRAL, UNC, Chapel Hill, North Carolina, United States
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Brassington I. The ethics of reporting all the results of clinical trials. Br Med Bull 2017; 121:19-29. [PMID: 28104631 DOI: 10.1093/bmb/ldw058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 12/24/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION OR BACKGROUND The terms 'publication bias' and 'reporting bias' describe aspects of a phenomenon by which data from trials are not publicized, and so remain inaccessible. This may generate a false impression about the world; but those facts may have important implications for clinical decisions. Thus, the bias may leave patients worse off than they might be. SOURCES OF DATA Published journal articles. AREAS OF AGREEMENT There is general agreement that the phenomenon happens, and that to the extent that it happens, it is undesirable for moral rather than simply epistemic reasons. GROWING POINTS There is a growing demand across the board for data to be better publicized. AREAS TIMELY FOR DEVELOPING RESEARCH There is room for further work on how protocols requiring that data be publicized might be enforced; should it be statutory, or non-statutory? Who should decide what should be made public? There is also room for work on what it is necessary to share, and on whether and how IP law should be reformed.
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Affiliation(s)
- Iain Brassington
- CSEP/School of Law, University of Manchester, Oxford Road, Manchester M13 9PL, UK
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Lueza B, Lacas B, Pignon JP, Paoletti X. [New applications for individual participant data meta-analyses of randomized trials]. Bull Cancer 2016; 104:139-146. [PMID: 27908441 DOI: 10.1016/j.bulcan.2016.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
Meta-analyses of randomized trials using individual-participant data, which represent the highest level of evidence for the evaluation of a treatment effect, are now used in different contexts in clinical research. This article aims at reviewing some of these new applications. Meta-analyses are increasingly used in economic evaluation, which implies new measure outcomes of the treatment effect, as well as in biomarkers evaluations thanks to their higher statistical power and the possibility to validate findings on independent data. This article also considers the perspectives opened up by new data sources, such as randomized trials registers, and data sharing policies.
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Affiliation(s)
- Béranger Lueza
- Gustave-Roussy, université Paris-Saclay, service de biostatistique et d'épidémiologie, 94805 Villejuif, France; Oncostat CESP, INSERM, université Paris-Saclay, university Paris-Sud, UVSQ, 94085 Villejuif, France; Gustave-Roussy, plateforme Ligue nationale contre le cancer de méta-analyse en oncologie, 94085 Villejuif, France
| | - Benjamin Lacas
- Gustave-Roussy, université Paris-Saclay, service de biostatistique et d'épidémiologie, 94805 Villejuif, France; Oncostat CESP, INSERM, université Paris-Saclay, university Paris-Sud, UVSQ, 94085 Villejuif, France; Gustave-Roussy, plateforme Ligue nationale contre le cancer de méta-analyse en oncologie, 94085 Villejuif, France
| | - Jean-Pierre Pignon
- Gustave-Roussy, université Paris-Saclay, service de biostatistique et d'épidémiologie, 94805 Villejuif, France; Oncostat CESP, INSERM, université Paris-Saclay, university Paris-Sud, UVSQ, 94085 Villejuif, France; Gustave-Roussy, plateforme Ligue nationale contre le cancer de méta-analyse en oncologie, 94085 Villejuif, France
| | - Xavier Paoletti
- Gustave-Roussy, université Paris-Saclay, service de biostatistique et d'épidémiologie, 94805 Villejuif, France; Oncostat CESP, INSERM, université Paris-Saclay, university Paris-Sud, UVSQ, 94085 Villejuif, France; Gustave-Roussy, plateforme Ligue nationale contre le cancer de méta-analyse en oncologie, 94085 Villejuif, France.
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Nekka F, Csajka C, Wilbaux M, Sanduja S, Li J, Pfister M. Pharmacometrics-based decision tools facilitate mHealth implementation. Expert Rev Clin Pharmacol 2016; 10:39-46. [PMID: 27813436 DOI: 10.1080/17512433.2017.1251837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The healthcare system is experiencing a paradigm shift in delivering its services, evolving from a reactive 'one size-fits-all' structure to a patient-centric model focusing on individualized medicine. This change is driven by scientific progress, including quantitative evaluation and optimization of treatment strategies through pharmacometric approaches, harnessing the power of the digital revolution. Areas covered: This review describes four main steps to apply pharmacometrics-based decision support tools, consisting of validated scientific components, available technical options, consideration of regulatory aspects, and achievement of efficient commercialization. Examples of pharmacometrics-based decision tools that support monitoring of patients and individualization of treatment strategies in neonates, children and adults are presented. Expert commentary: We envision that user-friendly decision support tools will facilitate implementation of mobile health approaches (mHealth) realizing benefits to paediatric and adult patients and their caregivers.
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Affiliation(s)
- Fahima Nekka
- a NSERC-Industrial Chair in Pharmacometrics, Full Professor, Faculty of Pharmacy , Université de Montréal , Montreal , Qc , Canada
| | - Chantal Csajka
- b Division of Pharmacology and Toxicology , Lausanne University Hospital, Head Research Unit , Lausanne , Switzerland
| | - Mélanie Wilbaux
- c Pharmacometrician , University Children's Hospital Basel (UKBB), Paediatric Pharmacology and Pharmacometrics , Basel , Switzerland
| | | | - Jun Li
- e Faculty of Pharmacy , Université de Montréal , Montreal , Qc , Canada
| | - Marc Pfister
- f Vice-Chair Paediatric Pharmacology and Pharmacometrics , University Children's Hospital Basel (UKBB) , Basel , Switzerland
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Abstract
BACKGROUND A large number of stakeholders have accepted the need for greater transparency in clinical research and, in the context of various initiatives and systems, have developed a diverse and expanding number of repositories for storing the data and documents created by clinical studies (collectively known as data objects). To make the best use of such resources, we assert that it is also necessary for stakeholders to agree and deploy a simple, consistent metadata scheme. METHODS The relevant data objects and their likely storage are described, and the requirements for metadata to support data sharing in clinical research are identified. Issues concerning persistent identifiers, for both studies and data objects, are explored. RESULTS A scheme is proposed that is based on the DataCite standard, with extensions to cover the needs of clinical researchers, specifically to provide (a) study identification data, including links to clinical trial registries; (b) data object characteristics and identifiers; and (c) data covering location, ownership and access to the data object. The components of the metadata scheme are described. CONCLUSIONS The metadata schema is proposed as a natural extension of a widely agreed standard to fill a gap not tackled by other standards related to clinical research (e.g., Clinical Data Interchange Standards Consortium, Biomedical Research Integrated Domain Group). The proposal could be integrated with, but is not dependent on, other moves to better structure data in clinical research.
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Affiliation(s)
- Steve Canham
- European Clinical Research Infrastructure Network (ECRIN), Kings Avenue, Redhill, RH16QH UK
| | - Christian Ohmann
- European Clinical Research Infrastructure Network (ECRIN), Kaiserswerther Strasse 70, 40477 Düsseldorf, Germany
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Abstract
BACKGROUND A large number of stakeholders have accepted the need for greater transparency in clinical research and, in the context of various initiatives and systems, have developed a diverse and expanding number of repositories for storing the data and documents created by clinical studies (collectively known as data objects). To make the best use of such resources, we assert that it is also necessary for stakeholders to agree and deploy a simple, consistent metadata scheme. METHODS The relevant data objects and their likely storage are described, and the requirements for metadata to support data sharing in clinical research are identified. Issues concerning persistent identifiers, for both studies and data objects, are explored. RESULTS A scheme is proposed that is based on the DataCite standard, with extensions to cover the needs of clinical researchers, specifically to provide (a) study identification data, including links to clinical trial registries; (b) data object characteristics and identifiers; and (c) data covering location, ownership and access to the data object. The components of the metadata scheme are described. CONCLUSIONS The metadata schema is proposed as a natural extension of a widely agreed standard to fill a gap not tackled by other standards related to clinical research (e.g., Clinical Data Interchange Standards Consortium, Biomedical Research Integrated Domain Group). The proposal could be integrated with, but is not dependent on, other moves to better structure data in clinical research.
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Affiliation(s)
- Steve Canham
- European Clinical Research Infrastructure Network (ECRIN), Kings Avenue, Redhill, RH16QH, UK
| | - Christian Ohmann
- European Clinical Research Infrastructure Network (ECRIN), Kaiserswerther Strasse 70, 40477, Düsseldorf, Germany.
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Pisani E, Aaby P, Breugelmans JG, Carr D, Groves T, Helinski M, Kamuya D, Kern S, Littler K, Marsh V, Mboup S, Merson L, Sankoh O, Serafini M, Schneider M, Schoenenberger V, Guerin PJ. Beyond open data: realising the health benefits of sharing data. BMJ 2016; 355:i5295. [PMID: 27758792 PMCID: PMC6616027 DOI: 10.1136/bmj.i5295] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | | | | | | | | | - Michelle Helinski
- European and Developing Countries Clinical Trials Partnership, The Hague, Netherlands
| | - Dorcas Kamuya
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Steven Kern
- Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | | | - Vicki Marsh
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Laura Merson
- Infectious Diseases Data Observatory, University of Oxford, Oxford, UK
| | | | | | | | - Vreni Schoenenberger
- International Federation of Pharmaceutical Manufacturers and Associations, Geneva
| | - Philippe J Guerin
- Infectious Diseases Data Observatory, University of Oxford, Oxford, UK
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Siemens DR, Saad F. Addressing concerns around the veracity of scientific research and publication. Can Urol Assoc J 2016; 10:151-152. [PMID: 27713788 DOI: 10.5489/cuaj.3891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Fred Saad
- CRCHUM/Université de Montréal, Montreal, QC, Canada
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30
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McDougal RA, Bulanova AS, Lytton WW. Reproducibility in Computational Neuroscience Models and Simulations. IEEE Trans Biomed Eng 2016; 63:2021-35. [PMID: 27046845 PMCID: PMC5016202 DOI: 10.1109/tbme.2016.2539602] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Like all scientific research, computational neuroscience research must be reproducible. Big data science, including simulation research, cannot depend exclusively on journal articles as the method to provide the sharing and transparency required for reproducibility. METHODS Ensuring model reproducibility requires the use of multiple standard software practices and tools, including version control, strong commenting and documentation, and code modularity. RESULTS Building on these standard practices, model-sharing sites and tools have been developed that fit into several categories: 1) standardized neural simulators; 2) shared computational resources; 3) declarative model descriptors, ontologies, and standardized annotations; and 4) model-sharing repositories and sharing standards. CONCLUSION A number of complementary innovations have been proposed to enhance sharing, transparency, and reproducibility. The individual user can be encouraged to make use of version control, commenting, documentation, and modularity in development of models. The community can help by requiring model sharing as a condition of publication and funding. SIGNIFICANCE Model management will become increasingly important as multiscale models become larger, more detailed, and correspondingly more difficult to manage by any single investigator or single laboratory. Additional big data management complexity will come as the models become more useful in interpreting experiments, thus increasing the need to ensure clear alignment between modeling data, both parameters and results, and experiment.
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31
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Björnmalm M, Faria M, Caruso F. Increasing the Impact of Materials in and beyond Bio-Nano Science. J Am Chem Soc 2016; 138:13449-13456. [PMID: 27672703 DOI: 10.1021/jacs.6b08673] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This is an exciting time for the field of bio-nano science: enormous progress has been made in recent years, especially in academic research, and materials developed and studied in this area are poised to make a substantial impact in real-world applications. Herein, we discuss ways to leverage the strengths of the field, current limitations, and valuable lessons learned from neighboring fields that can be adopted to accelerate scientific discovery and translational research in bio-nano science. We identify and discuss five interconnected topics: (i) the advantages of cumulative research; (ii) the necessity of aligning projects with research priorities; (iii) the value of transparent science; (iv) the opportunities presented by "dark data"; and (v) the importance of establishing bio-nano standards.
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Affiliation(s)
- Mattias Björnmalm
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
| | - Matthew Faria
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
| | - Frank Caruso
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, and Department of Chemical and Biomolecular Engineering, The University of Melbourne , Parkville, Victoria 3010, Australia
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Duan-Porter W, Goldstein KM, McDuffie JR, Hughes JM, Clowse MEB, Klap RS, Masilamani V, Allen LaPointe NM, Nagi A, Gierisch JM, Williams JW. Reporting of Sex Effects by Systematic Reviews on Interventions for Depression, Diabetes, and Chronic Pain. Ann Intern Med 2016; 165:184-93. [PMID: 27111355 PMCID: PMC6611166 DOI: 10.7326/m15-2877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Systematic reviews (SRs) have the potential to contribute uniquely to the evaluation of sex and gender differences (termed "sex effects"). This article describes the reporting of sex effects by SRs on interventions for depression, type 2 diabetes mellitus, and chronic pain conditions (chronic low back pain, knee osteoarthritis, and fibromyalgia). It includes SRs published since 1 October 2009 that evaluate medications, behavioral interventions, exercise, quality improvement, and some condition-specific treatments. The reporting of sex effects by primary randomized, controlled trials is also examined. Of 313 eligible SRs (86 for depression, 159 for type 2 diabetes mellitus, and 68 for chronic pain), few (n = 29) reported sex effects. Most SRs reporting sex effects used metaregression, whereas 9 SRs used subgroup analysis or individual-patient data meta-analysis. The proportion of SRs reporting the sex distribution of primary studies varied from a low of 31% (n = 8) for low back pain to a high of 68% (n = 23) for fibromyalgia. Primary randomized, controlled trials also infrequently reported sex effects, and most lacked an adequate sample size to examine them. Therefore, all SRs should report the proportion of women enrolled in primary studies and evaluate sex effects using appropriate methods whenever power is adequate.
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Navickas R, Gal D, Laucevičius A, Taparauskaitė A, Zdanytė M, Holvoet P. Identifying circulating microRNAs as biomarkers of cardiovascular disease: a systematic review. Cardiovasc Res 2016; 111:322-37. [PMID: 27357636 PMCID: PMC4996262 DOI: 10.1093/cvr/cvw174] [Citation(s) in RCA: 248] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/19/2016] [Indexed: 12/31/2022] Open
Abstract
The aim of the present study is to identify microRNAs (miRs) with high potential to be used as biomarkers in plasma and/or serum to clinically diagnose, or provide accurate prognosis for survival in, patients with atherosclerosis, coronary artery disease, and acute coronary syndrome (ACS). A systematic search of published original research yielded a total of 72 studies. After review of the risk of bias of the published studies, according to Cochrane Collaboration and the QUADUAS Group standards, 19 studies were selected. Overall 52 different miRs were reported. In particular, miR-133a/b (5 studies), miR-208a/b (6 studies), and miR-499 (7 studies) were well studied and found to be significant diagnostic and/or prognostic markers across different cardiovascular disease progression stages. miR-1 and miR-145b are potential biomarkers of ACS; miR-1 with higher sensitivity for all acute myocardial infarction (AMI), and miR-145 for STEMI and worse outcome of AMI. But when miRs were studied across different ACS study populations, patients had varying degrees of coronary stenosis, which was identified as an important confounder that limited the ability to quantitatively pool the study results. The identified miRs were found to regulate endothelial function and angiogenesis (miR-1, miR-133), vascular smooth muscle cell differentiation (miR-133, miR-145), communication between vascular smooth muscle and endothelial cell to stabilize plaques (miR-145), apoptosis (miR-1, miR-133, miR-499), cardiac myocyte differentiation (miR-1, miR-133, miR-145, miR-208, miR-499), and to repress cardiac hypertrophy (miR-133). Their role in these processes may be explained by regulation of shared RNA targets such as cyclin-dependent kinase inhibitor 1A (or p21), ETS proto-oncogene 1, fascin actin-bundling protein 1, hyperpolarization-activated cyclic nucleotide-gated potassium channel 4, insulin-like growth factor 1 receptor LIM and SH3 protein 1, purine nucleoside phosphorylase, and transgelin 2. These mechanistic data further support the clinical relevance of the identified miRs. miR-1, miR-133a/b, miR-145, miR-208a/b, and miR-499(a) in plasma and/or serum show some potential for diagnosis of cardiovascular disease. However, biased selection of miRs in most studies and unexplained contrasting results are major limitations of current miR research. Inconsistencies need to be addressed in order to definitively identify clinically useful miRs. Therefore, this paper presents important aspects to improve future miR research, including unbiased selection of miRs, standardization/normalization of reference miRs, adjustment for patient comorbidities and medication, and robust protocols of data-sharing plans that could prevent selective publication and selective reporting of miR research outcomes.
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Affiliation(s)
- Rokas Navickas
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | - Diane Gal
- Department of Cardiovascular Sciences, Atherosclerosis and Metabolism Unit, KU Leuven, Leuven, Belgium
| | - Aleksandras Laucevičius
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | | | | | - Paul Holvoet
- Department of Cardiovascular Sciences, Atherosclerosis and Metabolism Unit, KU Leuven, Leuven, Belgium
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Affiliation(s)
- Nicholas Wald
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
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Lu Y, Ioannidis JPA. Transparent Communication of Radiology Research: Reporting Guidelines and Beyond. Acad Radiol 2016; 23:529-30. [PMID: 27017133 DOI: 10.1016/j.acra.2016.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Ying Lu
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA; VA Cooperative Studies Program Coordinating Center, VA Palo Alto Health Care System, Palo Alto, California.
| | - John P A Ioannidis
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA; Department of Medicine, Stanford University School of Medicine, Stanford, California
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Kavsak PA. The International Committee of Medical Journal Editors proposal for sharing clinical trial data and the possible implications for the peer review process. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:115. [PMID: 27127768 DOI: 10.21037/atm.2016.02.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Peter A Kavsak
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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Abstract
Legal and ethical issues form an important component of modern research, related to the subject and researcher. This article seeks to briefly review the various international guidelines and regulations that exist on issues related to informed consent, confidentiality, providing incentives and various forms of research misconduct. Relevant original publications (The Declaration of Helsinki, Belmont Report, Council for International Organisations of Medical Sciences/World Health Organisation International Guidelines for Biomedical Research Involving Human Subjects, World Association of Medical Editors Recommendations on Publication Ethics Policies, International Committee of Medical Journal Editors, CoSE White Paper, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice) form the literature that are relevant to the ethical and legal aspects of conducting research that researchers should abide by when conducting translational and clinical research. Researchers should note the major international guidelines and regional differences in legislation. Hence, specific ethical advice should be sought at local Ethics Review Committees.
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Affiliation(s)
- Camille Yip
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Bukit Timah, Singapore
| | - Nian-Lin Reena Han
- Division of Clinical Support Services, KK Women's and Children's Hospital, Bukit Timah, Singapore
| | - Ban Leong Sng
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Bukit Timah, Singapore; Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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