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Macdonald S, Fatovich D, Finn J, Litton E. Critical Illness Outside the Intensive Care Unit: Research Challenges in Emergency and Prehospital Settings. Crit Care Clin 2024; 40:609-622. [PMID: 38796231 DOI: 10.1016/j.ccc.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
Patients with acute critical illness require prompt interventions, yet high-quality evidence supporting many investigations and treatments is lacking. Clinical research in this setting is challenging due to the need for immediate treatment and the inability of patients to provide informed consent. Attempts to obtain consent from surrogate decision-makers can be intrusive and lead to unacceptable delays to treatment. These problems may be overcome by pragmatic approaches to study design and the use of supervised waivers of consent, which is ethical and appropriate in situations where there is high risk of poor outcome and a paucity of proven effective treatment.
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Affiliation(s)
- Stephen Macdonald
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Level 6, Rear 54 Murray Street, Perth, WA6000, Australia; Royal Perth Hospital, Victoria Square, Perth, WA6000, Australia; Medical School, University of Western Australia, 35 Stirling Highway, Perth, WA6009, Australia.
| | - Daniel Fatovich
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Level 6, Rear 54 Murray Street, Perth, WA6000, Australia; Royal Perth Hospital, Victoria Square, Perth, WA6000, Australia; Medical School, University of Western Australia, 35 Stirling Highway, Perth, WA6009, Australia; East Metropolitan Health Service, 10 Murray Street, Perth, WA6000, Australia
| | - Judith Finn
- Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU), Curtin University, Kent Street, Bentley, WA6102, Australia
| | - Edward Litton
- Medical School, University of Western Australia, 35 Stirling Highway, Perth, WA6009, Australia; Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA6150, Australia
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2
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Razavi S, Sharma A, Lavin C, Pourmand A, Smalls N, Tran QK. COVID-19 Pandemic and Impact on Research Publications in Critical Care. Crit Care Explor 2024; 6:e1103. [PMID: 38846635 PMCID: PMC11155547 DOI: 10.1097/cce.0000000000001103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic precipitated a significant transformation of scientific journals. Our aim was to determine how critical care (CC) journals and their impact may have evolved during the COVID-19 pandemic. We hypothesized that the impact, as measured by citations and publications, from the field of CC would increase. DESIGN Observational study of journal publications, citations, and retractions status. SETTING All work was done electronically and retrospectively. SUBJECTS The top 18 CC journals broadly concerning CC, and the top 5 most productive CC journals on the SCImago list. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS For the top 18 CC journals and specifically Critical Care Medicine (CCM), time series analysis was used to estimate the trends of total citations, citations per publication, and publications per year by using the best-fit curve. We used PubMed and Retraction Watch to determine the number of COVID-19 publications and retractions. The average total citations and citations per publication for all journals was an upward quadratic trend with inflection points in 2020, whereas publications per year spiked in 2020 before returning to prepandemic values in 2021. For CCM total publications trend downward while total citations and citations per publication generally trend up from 2017 onward. CCM had the lowest percentage of COVID-related publications (15.7%) during the pandemic and no reported retractions. Two COVID-19 retractions were noted in our top five journals. CONCLUSIONS Citation activity across top CC journals underwent a dramatic increase during the COVID-19 pandemic without significant retraction data. These trends suggest that the impact of CC has grown significantly since the onset of COVID-19 while maintaining adherence to a high-quality peer-review process.
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Affiliation(s)
- Syrus Razavi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Arjun Sharma
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Cassidy Lavin
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ali Pourmand
- Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington DC
| | - Norma Smalls
- Division of Trauma and Critical Care, Howard University Hospital, Washington, DC
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
- Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD
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3
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Rosengaard LO, Andersen MZ, Rosenberg J, Fonnes S. Five aspects of research waste in biomedicine: A scoping review. J Evid Based Med 2024. [PMID: 38798014 DOI: 10.1111/jebm.12616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The number of published journal articles has grown exponentially during the last 30 years, which may have led to some wasteful research. However, the terminology associated with research waste remains unclear. To address this, we aimed to identify, define, and categorize the aspects of research waste in published biomedical reports. METHODS In this scoping review, we systematically searched for biomedical literature reports from 1993 to 2023 in two databases, focusing on those addressing and defining research waste. Through data charting, we analyzed and categorized the aspects of research waste. RESULTS Based on 4285 initial records in the searches, a total of 832 reports were included in the analysis. The included reports were primarily narrative reviews (26%) and original reports (21%). We categorized research waste into five aspects: methodological, invisible, negligible, underreported, and structural (MINUS) research waste. More than half of the reports (56%) covered methodological research waste concerning flaws in study design, study conduct, or analysis. Invisible research waste covered nonpublication, discontinuation, and lack of data-sharing. Negligible research waste primarily concerned unnecessary repetition, for example, stemming from the absence of preceding a trial with a systematic review of the literature. Underreported research waste mainly included poor reporting, resulting in a lack of transparency. Structural research waste comprised inadequate management, collaboration, prioritization, implementation, and dissemination. CONCLUSION MINUS encapsulates the five main aspects of research waste. Recognizing these aspects of research waste is important for addressing and preventing further research waste and thereby ensuring efficient resource allocation and scientific integrity.
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Affiliation(s)
- Louise Olsbro Rosengaard
- Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Mikkel Zola Andersen
- Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Jacob Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Siv Fonnes
- Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
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4
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McDermott KT, Perry M, Linden W, Croft R, Wolff R, Kleijnen J. The quality of COVID-19 systematic reviews during the coronavirus 2019 pandemic: an exploratory comparison. Syst Rev 2024; 13:126. [PMID: 38720337 PMCID: PMC11077834 DOI: 10.1186/s13643-024-02552-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The unprecedented volume and speed at which COVID-19-related systematic reviews (SRs) may have been produced has raised questions regarding the quality of this evidence. It is feasible that pandemic-related factors may have led to an impairment in quality (reduced internal validity, increased risk of bias [RoB]). This may have serious implications for decision-making related to public health and individual healthcare. OBJECTIVE The primary objective was to compare the quality of SRs published during the pandemic that were related to COVID-19 with SRs published during the pandemic that were unrelated to COVID-19 (all of which were fully appraised in the KSR Evidence database of SRs in healthcare). Our secondary objective was to compare the quality of SRs published during the pandemic (regardless of research topic), with SRs published pre-pandemic. METHODS We compared all SRs related to COVID-19 to all SRs unrelated to COVID-19 that (i) were published during the pandemic (between 1st March 2020 and September 14, 2022), (ii) were included in KSR Evidence, and (iii) had been appraised using the ROBIS tool. We then compared all SRs published during the pandemic (regardless of research topic) with a pre-pandemic sample of SRs. RESULTS For SRs published during the pandemic, we found there was no statistically significant difference in quality between those SRs tagged as being related to COVID-19 and those that were not [relative risk (RR) of low RoB for COVID-19 versus COVID-19-unrelated reviews: 0.94; 95% confidence interval (CI): 0.66 to 1.34]. Generally, COVID-19 SRs and COVID-19-unrelated SRs were both of low quality with only 10% of COVID-19 reviews and 11% of COVID-19-unrelated reviews rated as low RoB. However, SRs (regardless of topic) published during the pandemic were of lower quality than those published pre-pandemic (RR for low RoB for 'during pandemic' versus 'pre-pandemic': 0.30; 95% CI: 0.26 to 0.34) with 11% of pandemic and 36% of pre-pandemic SRs rated as low RoB. CONCLUSION These results suggest COVID-19 and COVID-19-unrelated SRs published during the pandemic are equally of low quality. SRs published during the pandemic were generally lower quality compared with SRs published pre-pandemic irrespective of COVID-19 focus. Moreover, SR quality in general is seriously lacking, and considerable efforts need to be made to substantially improve the quality and rigour of the SR process.
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Affiliation(s)
| | - Mark Perry
- Kleijnen Systematic Reviews Ltd, York, UK
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5
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Pearce-Smith N, Farrow E, Robinson J, Mahon B, McGillycuddy C, Savage K. Facilitating knowledge transfer to policy makers and front-line workers during a pandemic: Implementation, impact and lessons learned. Health Info Libr J 2024. [PMID: 38468365 DOI: 10.1111/hir.12523] [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: 08/30/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Stakeholders working on the COVID-19 pandemic response needed access to evidence, requiring a systematic approach to identify and disseminate relevant research. OBJECTIVES Outline the stages of development of a COVID-19 Literature Digest; demonstrate the impact the Digest had on decision-making and knowledge gain; identify the lessons learned. METHODS A standardised process was developed to identify and select papers. The main sources for content were PubMed, bioRxiv and medRxiv. A shared EndNote library was used to deduplicate and organise papers. Three user surveys obtained feedback from subscribers to determine if the Digest remained valuable, and explore the benefits to individuals. RESULTS 40-60 papers were summarised each week. 211 Digests were produced from March 2020 to March 2022, with around 10,000 papers included altogether. Survey results suggest benefits of the Digest were gaining new knowledge, saving time and contributing to evidence-based decision making. DISCUSSION Digest procedures constantly evolved and were adapted in response to survey feedback. Lessons identified: learn from failure, communication is key, measure your impact, work collaboratively, reflect and be flexible. CONCLUSION The Digest was successfully produced within the limits of available resource. The learning from this Digest will inform evidence monitoring, selection and dissemination for future health crises.
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Affiliation(s)
| | - Emma Farrow
- UK Health Security Agency (UKHSA), London, UK
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6
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del Re D, Palla L, Meridiani P, Soffi L, Loiudice MT, Antinozzi M, Cattaruzza MS. The spread in time and space of COVID-19 pandemic waves: the Italian experience from mortality data analyses. Front Public Health 2024; 12:1324033. [PMID: 38481837 PMCID: PMC10932994 DOI: 10.3389/fpubh.2024.1324033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/12/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction Italy was the first European country affected by COVID-19. Thanks to governmental containment measures (9 March 2020), the spread of COVID-19 was limited. However, in this context, accurate data assessment is crucial and mortality is a more reliable indicator of the virus spread compared to the count of positive cases. This study aimed to retrospectively evaluate the impact of the pandemic in different areas of Italy using the time series analysis of official deaths and excess COVID-19 deaths. Methods Mortality data (23 February-30 April 2022) by Istituto Nazionale di Statistica (ISTAT) were analyzed, including four waves of COVID-19. Previous mortality data (January 2015-November 2019) were used to estimate a Poisson regression model of the pre-pandemic mortality pattern and derive the excess COVID-19 deaths as the difference between the actual deaths number and the extrapolation of the previous mortality pattern to the pandemic period, separately for Northern, Central, and Southern Italy, to compare the impact of mortality across time periods and geographical areas. Results Estimated excess compared with official COVID-19 mortality shows that, during the first wave, there was an underestimation of deaths. COVID-19 mortality rate almost doubled the official rate in the North (1.60‰ vs. 0.86‰) and nearly tripled it in the South (0.22‰ vs. 0.08‰). In late 2020-early 2021, official and estimated mortality curves are closer, displaying just a small gap at the start of the second wave. During the fourth wave (end of 2021-early 2022), Northern and Central Italy show reasonable agreement; the South presents a large relative underestimation of deaths (+90% increase), with a large increase in its excess deaths national quota, 9% in the first wave to 42% in the fourth. Discussion The results provide a measure of the COVID-19 excess deaths and an unbiased estimate of Italian mortality rates. In the first wave, the gap between official COVID-19 and excess mortality was particularly high and lockdown measures may have reduced the spread of the infection. In the fourth wave, the gap for the South increases again, probably because the healthcare system may not have coped with the prolonged pressure of the pandemic, or for a decreased compliance with the official paper-based mortality surveillance system that could be overcome in the future by digitalizing the process.
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Affiliation(s)
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Paolo Meridiani
- Istituto Nazionale Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - Livia Soffi
- Istituto Nazionale Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - Michele Tancredi Loiudice
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Martina Antinozzi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Suh EH, Wyer PC. Revelation of mindlines in the setting of crisis. J Eval Clin Pract 2024; 30:60-67. [PMID: 37291751 DOI: 10.1111/jep.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
During the devastating early months of the unfolding COVID-19 pandemic in New York, healthcare systems and clinicians dynamically adapted to drastically changing everyday practice despite having little guidance from formal research evidence in the face of a novel virus. Through new, silo-breaking networks of communication, clinical teams transformed and synthesized provisional recommendations, rudimentary published research findings and numerous other sources of knowledge to address the immediate patient care needs they faced during the pandemic surge. These experiences illustrated underlying social processes that are always at play as clinicians integrate information from various sources, including research and published guidelines, with their own tacit knowledge to develop shared yet personal approaches to practice. In this article, we provide a narrative account of personal experience during the COVID-19 surge. We draw on the concept of mindlines as developed by Gabbay and Le May as a conceptual framework for interpreting that experience from the standpoint of how early information from research and guidelines was drawn on and transformed in the course of day-to-day struggle with the crisis in New York City emergency rooms. Finally, briefly referencing the challenges to conventional models of healthcare knowledge creation and translation through research and guideline production posed by COVID-19 crisis, we offer a provisional perspective on current and future developments.
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Affiliation(s)
- Edward Hyun Suh
- Department of Emergency Medicine, Columbia University Medical Center, New York, New York, USA
| | - Peter C Wyer
- Department of Emergency Medicine, Columbia University Medical Center, New York, New York, USA
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Janin YL. On the origins of SARS-CoV-2 main protease inhibitors. RSC Med Chem 2024; 15:81-118. [PMID: 38283212 PMCID: PMC10809347 DOI: 10.1039/d3md00493g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/13/2023] [Indexed: 01/30/2024] Open
Abstract
In order to address the world-wide health challenge caused by the COVID-19 pandemic, the 3CL protease/SARS-CoV-2 main protease (SARS-CoV-2-Mpro) coded by its nsp5 gene became one of the biochemical targets for the design of antiviral drugs. In less than 3 years of research, 4 inhibitors of SARS-CoV-2-Mpro have actually been authorized for COVID-19 treatment (nirmatrelvir, ensitrelvir, leritrelvir and simnotrelvir) and more such as EDP-235, FB-2001 and STI-1558/Olgotrelvir or five undisclosed compounds (CDI-988, ASC11, ALG-097558, QLS1128 and H-10517) are undergoing clinical trials. This review is an attempt to picture this quite unprecedented medicinal chemistry feat and provide insights on how these cysteine protease inhibitors were discovered. Since many series of covalent SARS-CoV-2-Mpro inhibitors owe some of their origins to previous work on other proteases, we first provided a description of various inhibitors of cysteine-bearing human caspase-1 or cathepsin K, as well as inhibitors of serine proteases such as human dipeptidyl peptidase-4 or the hepatitis C protein complex NS3/4A. This is then followed by a description of the results of the approaches adopted (repurposing, structure-based and high throughput screening) to discover coronavirus main protease inhibitors.
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Affiliation(s)
- Yves L Janin
- Structure et Instabilité des Génomes (StrInG), Muséum National d'Histoire Naturelle, INSERM, CNRS, Alliance Sorbonne Université 75005 Paris France
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9
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Fincham L, Hohlfeld A, Clarke M, Kredo T, McCaul M. Exploring trial publication and research waste in COVID-19 randomised trials of hydroxychloroquine, corticosteroids, and vitamin D: a meta-epidemiological cohort study. BMC Med Res Methodol 2024; 24:19. [PMID: 38262938 PMCID: PMC10804507 DOI: 10.1186/s12874-023-02110-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 11/23/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The global research response to the COVID-19 pandemic was impressive, but also led to an infodemic and considerable research waste. Registered, but unpublished trials added to this noise. We aimed to determine the proportion of registered randomised trials of common COVID-19 treatments that were published and to describe the characteristics of these trials to examine the association between trial characteristics, publication status and research waste. METHODS This meta-epidemiological cohort study used a sample of randomised trials of corticosteroids, hydroxychloroquine or vitamin D as treatments for COVID-19, registered between 1 November 2019 and 31 December 2021 and available via the WHO ICTRP portal. We searched for the trials' published results up to 20 October 2022. We extracted the trial characteristics, analysing with descriptive statistics. We performed univariate logistic regression to examine the association between trials' characteristics and publication status, followed by multiple logistic regression using significant characteristics to assess the association between trial characteristics and publication status. RESULTS We identified 357 eligible trials on ICTRP. Of these, 107 (30%) had published or made their results available publicly by 20 October 2022, while 250 (70%) had not been published or shared their results publicly. Multiple logistic regression analysis showed that a larger target sample size was a significant positive predictor of publication with target sample sizes above 300 almost tripling the odds of publication (aOR: 2.75, 95% CI: 1.35 to 5.62). CONCLUSIONS Less than one third of registered trials made their results public and our findings identified that many trialists had not updated their trial registry entry with the trial status, results or both. Failure to share trial results publicly is a disservice to patients, clinicians and policy makers and adds to research waste.
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Affiliation(s)
- Lisa Fincham
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.
| | - Ameer Hohlfeld
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Mike Clarke
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
- Northern Ireland Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Tamara Kredo
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine and Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Michael McCaul
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
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Barnes K, Hall Dykgraaf S, O'Brien K, Douglas K, Eggleton K, Bui N, Wong ST, Etz RS, Goodyear-Smith F. A novel methodological approach to participant engagement and policy relevance for community-based primary medical care research during the COVID-19 pandemic in Australia and New Zealand. Health Res Policy Syst 2024; 22:13. [PMID: 38254197 PMCID: PMC10802036 DOI: 10.1186/s12961-023-01100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care.
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Affiliation(s)
- Katelyn Barnes
- Academic Unit of General Practice, ACT Health Directorate, Canberra, ACT, Australia.
- Academic Unit of General Practice, School of Medicine and Psychology, the Australian National University, Canberra, ACT, Australia.
| | - Sally Hall Dykgraaf
- Rural Clinical School, School of Medicine and Psychology, the Australian National University, Canberra, ACT, Australia
| | - Kathleen O'Brien
- Academic Unit of General Practice, School of Medicine and Psychology, the Australian National University, Canberra, ACT, Australia
| | - Kirsty Douglas
- Academic Unit of General Practice, ACT Health Directorate, Canberra, ACT, Australia
- Academic Unit of General Practice, School of Medicine and Psychology, the Australian National University, Canberra, ACT, Australia
| | - Kyle Eggleton
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Nam Bui
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Sabrina T Wong
- School of Nursing and Centre for Health Services and Policy Research, University of British Columbia, 2211 Westbrook Mall, Vancouver, BC, V6T2B5, Canada
| | - Rebecca S Etz
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
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11
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Meier P. Accelerating progress in cardiology: embracing open science. Open Heart 2024; 11:e002587. [PMID: 38233043 PMCID: PMC10806485 DOI: 10.1136/openhrt-2023-002587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Affiliation(s)
- Pascal Meier
- Cardiology, Fribourg Hospitals, Fribourg, Switzerland
- Cardiology, Royal Brompton Hospital, London, UK
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12
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Rajit D, Johnson A, Callander E, Teede H, Enticott J. Learning health systems and evidence ecosystems: a perspective on the future of evidence-based medicine and evidence-based guideline development. Health Res Policy Syst 2024; 22:4. [PMID: 38178086 PMCID: PMC10768258 DOI: 10.1186/s12961-023-01095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024] Open
Abstract
Despite forming the cornerstone of modern clinical practice for decades, implementation of evidence-based medicine at scale remains a crucial challenge for health systems. As a result, there has been a growing need for conceptual models to better contextualise and pragmatize the use of evidence-based medicine, particularly in tandem with patient-centred care. In this commentary, we highlight the emergence of the learning health system as one such model and analyse its potential role in pragmatizing both evidence-based medicine and patient-centred care. We apply the learning health system lens to contextualise the key activity of evidence-based guideline development and implementation, and highlight how current inefficiencies and bottlenecks in the evidence synthesis phase of evidence-based guideline development threaten downstream adherence. Lastly, we introduce the evidence ecosystem as a complementary model to learning health systems, and propose how innovative developments from the evidence ecosystem may be integrated with learning health systems to better enable health impact at speed and scale.
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Affiliation(s)
- D Rajit
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
| | - A Johnson
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
| | - E Callander
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- Monash Health Endocrinology and Diabetes Departments, Melbourne, Australia
| | - J Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia.
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia.
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Khanna M, Allison P, Farmer J, Quiñonez C, Glogauer M, Siqueira WL, Rock LD, McNally M, Madathil S. Personal protective equipment during COVID-19: A natural history of dental and dental hygiene regulatory guidance in Canada. J Am Dent Assoc 2023; 154:1077-1086.e8. [PMID: 38008525 DOI: 10.1016/j.adaj.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/12/2023] [Accepted: 09/02/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Due to the evolving nature of COVID-19, there is evidence that COVID-19-specific infection prevention and control guideline (IPCG) documents formulated for oral health care settings are also changing rapidly. To better inform future policies, a comprehensive review of all IPCG documents across different phases of restrictions for oral health care practitioners is required. TYPES OF STUDIES REVIEWED A search was performed for documents shared from March 2020 through January 2022 on websites of oral health regulatory authorities in Canada's 10 provinces and 3 territories. The authors performed a narrative review of the identified IPCG documents for dentists (n = 78) and dental hygienists (n = 57). RESULTS Overall findings from more than 100 IPCG documents distributed during a period of 23 months revealed that the frequency of these updates differed among jurisdictions and between the 2 oral health care practitioners (ie, dentists and dental hygienists) within the same jurisdiction. The most notable observation was the different face-covering recommendations for dentists and dental hygienists within the same jurisdiction during the same timeframe. A common document was sometimes observed for dentists and dental hygienists, however, most jurisdictions had separate IPCG documents. CONCLUSIONS AND PRACTICAL IMPLICATIONS The different approaches could have been justified on the basis of prevalence of COVID-19 and availability of personal protective equipment; however, there was a risk of creating confusion about IPCG best practices. The findings of this review will support decision makers when planning future development and dissemination of regulations for all oral health care practitioners.
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Lipworth W, Kerridge I, Stewart C, Silva D, Upshur R. The Fragility of Scientific Rigour and Integrity in "Sped up Science": Research Misconduct, Bias, and Hype and in the COVID-19 Pandemic. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:607-616. [PMID: 38064166 DOI: 10.1007/s11673-023-10289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/20/2023] [Indexed: 03/16/2024]
Abstract
During the early years of the COVID-19 pandemic, preclinical and clinical research were sped up and scaled up in both the public and private sectors and in partnerships between them. This resulted in some extraordinary advances, but it also raised a range of issues regarding the ethics, rigour, and integrity of scientific research, academic publication, and public communication. Many of the failures of scientific rigour and integrity that occurred during the pandemic were exacerbated by the rush to generate, disseminate, and implement research findings, which not only created opportunities for unscrupulous actors but also compromised the methodological, peer review, and advisory processes that would usually identify sub-standard research and prevent compromised clinical or policy-level decisions. While it would be tempting to attribute these failures of science and its translation solely to the "unprecedented" circumstances of the COVID-19 pandemic, the reality is that they preceded the pandemic and will continue to arise once it is over. Existing strategies for promoting scientific rigour and integrity need to be made more rigorous, better integrated into research training and institutional cultures, and made more sophisticated. They might also need to be modified or supplemented with other strategies that are fit for purpose not only in public health emergencies but in any research that is sped-up and scaled up to address urgent unmet medical needs.
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Affiliation(s)
- W Lipworth
- Department of Philosophy, Macquarie University, Sydney, NSW, Australia.
| | - I Kerridge
- Department of Philosophy, Macquarie University, Sydney, NSW, Australia
- Royal North Shore Hospital and Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
| | - C Stewart
- Sydney Law School, University of Sydney, Sydney, NSW, Australia
| | - D Silva
- Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - R Upshur
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Adhikari NKJ, Hashmi M, Tirupakuzhi Vijayaraghavan BK, Haniffa R, Beane A, Webb SA, Angus DC, Gordon AC, Cook DJ, Guyatt GH, Berry LR, Lorenzi E, Mouncey PR, Au C, Pinto R, Ménard J, Sprague S, Masse MH, Huang DT, Heyland DK, Nichol AD, McArthur CJ, de Man A, Al-Beidh F, Annane D, Anstey M, Arabi YM, Battista MC, Berry S, Bhimani Z, Bonten MJM, Bradbury CA, Brant EB, Brunkhorst FM, Burrell A, Buxton M, Cecconi M, Cheng AC, Cohen D, Cove ME, Day AG, Derde LPG, Detry MA, Estcourt LJ, Fagbodun EO, Fitzgerald M, Goossens H, Green C, Higgins AM, Hills TE, Ichihara N, Jayakumar D, Kanji S, Khoso MN, Lawler PR, Lewis RJ, Litton E, Marshall JC, McAuley DF, McGlothlin A, McGuinness SP, McQuilten ZK, McVerry BJ, Murthy S, Parke RL, Parker JC, Reyes LF, Rowan KM, Saito H, Salahuddin N, Santos MS, Saunders CT, Seymour CW, Shankar-Hari M, Tolppa T, Trapani T, Turgeon AF, Turner AM, Udy AA, van de Veerdonk FL, Zarychanski R, Lamontagne F, Horvat C. Intravenous Vitamin C for Patients Hospitalized With COVID-19: Two Harmonized Randomized Clinical Trials. JAMA 2023; 330:1745-1759. [PMID: 37877585 PMCID: PMC10600726 DOI: 10.1001/jama.2023.21407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
Importance The efficacy of vitamin C for hospitalized patients with COVID-19 is uncertain. Objective To determine whether vitamin C improves outcomes for patients with COVID-19. Design, Setting, and Participants Two prospectively harmonized randomized clinical trials enrolled critically ill patients receiving organ support in intensive care units (90 sites) and patients who were not critically ill (40 sites) between July 23, 2020, and July 15, 2022, on 4 continents. Interventions Patients were randomized to receive vitamin C administered intravenously or control (placebo or no vitamin C) every 6 hours for 96 hours (maximum of 16 doses). Main Outcomes and Measures The primary outcome was a composite of organ support-free days defined as days alive and free of respiratory and cardiovascular organ support in the intensive care unit up to day 21 and survival to hospital discharge. Values ranged from -1 organ support-free days for patients experiencing in-hospital death to 22 organ support-free days for those who survived without needing organ support. The primary analysis used a bayesian cumulative logistic model. An odds ratio (OR) greater than 1 represented efficacy (improved survival, more organ support-free days, or both), an OR less than 1 represented harm, and an OR less than 1.2 represented futility. Results Enrollment was terminated after statistical triggers for harm and futility were met. The trials had primary outcome data for 1568 critically ill patients (1037 in the vitamin C group and 531 in the control group; median age, 60 years [IQR, 50-70 years]; 35.9% were female) and 1022 patients who were not critically ill (456 in the vitamin C group and 566 in the control group; median age, 62 years [IQR, 51-72 years]; 39.6% were female). Among critically ill patients, the median number of organ support-free days was 7 (IQR, -1 to 17 days) for the vitamin C group vs 10 (IQR, -1 to 17 days) for the control group (adjusted proportional OR, 0.88 [95% credible interval {CrI}, 0.73 to 1.06]) and the posterior probabilities were 8.6% (efficacy), 91.4% (harm), and 99.9% (futility). Among patients who were not critically ill, the median number of organ support-free days was 22 (IQR, 18 to 22 days) for the vitamin C group vs 22 (IQR, 21 to 22 days) for the control group (adjusted proportional OR, 0.80 [95% CrI, 0.60 to 1.01]) and the posterior probabilities were 2.9% (efficacy), 97.1% (harm), and greater than 99.9% (futility). Among critically ill patients, survival to hospital discharge was 61.9% (642/1037) for the vitamin C group vs 64.6% (343/531) for the control group (adjusted OR, 0.92 [95% CrI, 0.73 to 1.17]) and the posterior probability was 24.0% for efficacy. Among patients who were not critically ill, survival to hospital discharge was 85.1% (388/456) for the vitamin C group vs 86.6% (490/566) for the control group (adjusted OR, 0.86 [95% CrI, 0.61 to 1.17]) and the posterior probability was 17.8% for efficacy. Conclusions and Relevance In hospitalized patients with COVID-19, vitamin C had low probability of improving the primary composite outcome of organ support-free days and hospital survival. Trial Registration ClinicalTrials.gov Identifiers: NCT04401150 (LOVIT-COVID) and NCT02735707 (REMAP-CAP).
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Affiliation(s)
- Neill K J Adhikari
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University, Karachi, Pakistan
| | | | - Rashan Haniffa
- Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Abi Beane
- Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Steve A Webb
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- St John of God Health Care, Perth, Australia
| | - Derek C Angus
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony C Gordon
- Division of Anaesthetics, Pain Medicine, and Intensive Care, Imperial College London, London, England
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, England
| | - Deborah J Cook
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Critical Care, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Paul R Mouncey
- Intensive Care National Audit and Research Centre, London, England
| | - Carly Au
- Intensive Care National Audit and Research Centre, London, England
| | - Ruxandra Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Ménard
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sheila Sprague
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marie-Hélène Masse
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - David T Huang
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - Alistair D Nichol
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
- University College Dublin, Dublin, Ireland
- Alfred Health, Melbourne, Australia
| | - Colin J McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Angelique de Man
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Djillali Annane
- UVSQ University Paris Saclay, Institut-Hospitalo Universitaire Prometheus, Paris, France
- Médecine Intensive-Réanimation, Hôpital Raymond-Poincaré, Garches, France
| | - Matthew Anstey
- Sir Charles Gairdner Hospital, Nedlands, Australia
- University of Western Australia, Perth
| | - Yaseen M Arabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Marie-Claude Battista
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Zahra Bhimani
- St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Marc J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- European Clinical Research Alliance on Infectious Diseases, Utrecht, the Netherlands
| | | | - Emily B Brant
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Frank M Brunkhorst
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Aidan Burrell
- Alfred Health, Melbourne, Australia
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Meredith Buxton
- Global Coalition for Adaptive Research, Larkspur, California
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Allen C Cheng
- Monash Infectious Disease, Monash Health and School of Clinical Sciences, Monash University, Clayton, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dian Cohen
- Bishop's University, Sherbrooke, Quebec, Canada
- Massawippi Valley Foundation, Ayer's Cliff, Quebec, Canada
| | - Matthew E Cove
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Andrew G Day
- Kingston Health Sciences Centre and Queen's University, Kingston, Ontario, Canada
| | - Lennie P G Derde
- European Clinical Research Alliance on Infectious Diseases, Utrecht, the Netherlands
- Intensive Care Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Lise J Estcourt
- Department of Haematology, NHS Blood and Transplant, Bristol, England
- Radcliffe Department of Medicine, University of Oxford, Oxford, England
| | | | | | - Herman Goossens
- Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium
| | - Cameron Green
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alisa M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Nao Ichihara
- Department of Cardiovascular Surgery, School of Medicine, Jikei University, Tokyo, Japan
| | | | - Salmaan Kanji
- Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Patrick R Lawler
- University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Edward Litton
- Fiona Stanley Hospital, Department of Intensive Care Unit, University of Western Australia, Perth
| | - John C Marshall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Daniel F McAuley
- Queen's University of Belfast, Belfast, Northern Ireland
- Centre for Infection and Immunity, Royal Victoria Hospital, Belfast, Northern Ireland
| | | | - Shay P McGuinness
- Medical Research Institute of New Zealand, Wellington
- Auckland City Hospital, Cardiothoracic and Vascular Intensive Care Unit, Auckland, New Zealand
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
| | | | - Bryan J McVerry
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Rachael L Parke
- Medical Research Institute of New Zealand, Wellington
- Auckland City Hospital, Cardiothoracic and Vascular Intensive Care Unit, Auckland, New Zealand
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Jane C Parker
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
| | - Luis Felipe Reyes
- Department of Infectious Diseases, Universidad de La Sabana, Chia, Colombia
- Department of Critical Care Medicine, Clinica Universidad de La Sabana, Chia, Colombia
| | - Kathryn M Rowan
- Intensive Care National Audit and Research Centre, London, England
| | - Hiroki Saito
- Department of Emergency and Critical Care Medicine, St Marianna University Yokohama Seibu Hospital, Yokohama, Japan
| | - Nawal Salahuddin
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Marlene S Santos
- Department of Critical Care, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Christopher W Seymour
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Manu Shankar-Hari
- Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Timo Tolppa
- National Intensive Care Surveillance, Colombo, Sri Lanka
| | - Tony Trapani
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care, Université Laval, Quebec City, Quebec, Canada
- Population Health and Optimal Health Practices Research Unit, Departments of Traumatology, Emergency Medicine, and Critical Care Medicine, Université Laval Research Center, CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Anne M Turner
- Medical Research Institute of New Zealand, Wellington
| | - Andrew A Udy
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
- Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia
| | | | - Ryan Zarychanski
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - François Lamontagne
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Christopher Horvat
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Thomson WR, Puthucheary ZA, Wan YI. Critical care and pandemic preparedness and response. Br J Anaesth 2023; 131:847-860. [PMID: 37689541 PMCID: PMC10636520 DOI: 10.1016/j.bja.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/21/2023] [Accepted: 07/23/2023] [Indexed: 09/11/2023] Open
Abstract
Critical care was established partially in response to a polio epidemic in the 1950s. In the intervening 70 yr, several epidemics and pandemics have placed critical care and allied services under extreme pressure. Pandemics cause wholesale changes to accepted standards of practice, require reallocation and retargeting of resources and goals of care. In addition to clinical acumen, mounting an effective critical care response to a pandemic requires local, national, and international coordination in a diverse array of fields from research collaboration and governance to organisation of critical care networks and applied biomedical ethics in the eventuality of triage situations. This review provides an introduction to an array of topics that pertain to different states of pandemic acuity: interpandemic preparedness, alert, surge activity, recovery and relapse through the literature and experience of recent pandemics including COVID-19, H1N1, Ebola, and SARS.
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Affiliation(s)
- William R Thomson
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
| | - Zudin A Puthucheary
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Yize I Wan
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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van der Pol KH, Aljofan M, Blin O, Cornel JH, Rongen GA, Woestelandt AG, Spedding M. Drug Repurposing of Generic Drugs: Challenges and the Potential Role for Government. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:831-840. [PMID: 37398987 PMCID: PMC10627937 DOI: 10.1007/s40258-023-00816-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 07/04/2023]
Abstract
Drug repurposing is the process of identifying a new use for an existing drug or active substance in an indication outside the scope of the original indication. Drug repurposing has important advantages including reduced development time and costs, and potentially large societal healthcare cost savings. However, current generic drug repurposing research faces a number of challenges in obtaining research funds. Furthermore, regardless of the success of a repurposing trial, commercial parties often lack interest in pursuing marketing authorisation for financial reasons, and academic researchers lack the knowledge, time and funding. Therefore, the new indication of a repurposed drug often does not make it 'on label'. We propose a large increase in public funding for generic drug repurposing research, including funds for the marketing authorisation process when a trial is successful, and a reduction in the regulatory burden of the marketing authorisation process for repurposed generic drugs.
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Affiliation(s)
- Karel H van der Pol
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mohamad Aljofan
- Department of Biomedical Science, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- National Laboratory Astana, Nazarbayev University, Astana, 010000, Kazakhstan
| | - Olivier Blin
- Institut de Neurosciences des Systèmes, Aix Marseille Université, Inserm UMR 1106, Marseille, France
| | - Jan H Cornel
- Department of Cardiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Gerard A Rongen
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
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Antonio E, Pulik N, Lee J, Soni T, Hagen HE, Ryu CM, Norton A. Mapping regional funding for COVID-19 research in the Asia-Pacific region. BMJ Glob Health 2023; 8:e013551. [PMID: 37931938 PMCID: PMC10632820 DOI: 10.1136/bmjgh-2023-013551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/22/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION The Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) is a network of funders supporting research on infectious diseases of epidemic/pandemic potential. GloPID-R is establishing regional hubs to strengthen stakeholder engagement particularly among low-income and middle-income countries. The first pilot hub, led from Republic of Korea (South Korea), has been launched in the Asia-Pacific region, a region highly prone to outbreaks of emerging infectious diseases. We present findings of mapping research undertaken in support of the hub's development. METHODS We analysed five COVID-19 research databases in September 2022 to identify research funders and intermediary funding sources supporting research in infectious diseases in the Asia-Pacific region. This was complemented with an in-depth analysis of the UK Collaborative on Development Research (UKCDR) and GloPID-R COVID-19 Research Project Tracker to assess the alignment of funded projects in the region to the WHO COVID-19 research priorities. RESULTS We identified 453 funders and funding sources supporting COVID-19 research in the Asia-Pacific Region including public, private and philanthropic organisations and universities. However, these organisations were clustered in few countries in the region. The in-depth analysis of the UKCDR and GloPID-R COVID-19 Research project Tracker found limited research involving Asia-Pacific countries with the 117 funders supporting these projects investing at least US$604m in COVID-19 research in the region. Social Sciences was the dominant theme on which funded projects focused whereas the priority areas with the least number of projects were research on 'animal and environmental health' and 'ethics considerations for research'. CONCLUSION Our analyses show the diversity of funding sources for research on infectious diseases in the Asia-Pacific region. Engagement between multiple actors in the health research system is likely to promote enhanced coordination for greater research impact. GloPID-R's Asia-Pacific regional hub aims to support activities for the enhancement of preparedness for outbreaks of emerging infectious diseases in the region.
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Affiliation(s)
- Emilia Antonio
- GloPID-R Research and Policy Team, Policy and Practice Research Group, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Nicolas Pulik
- Stratégie et Partenariats, ANRS | Maladies infectieuses émergentes, Paris, France
- GloPID-R, Charite University Hospital Berlin Center 11 for Global Health, Berlin, Germany
| | - Jieun Lee
- Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Tanu Soni
- GloPID-R Research and Policy Team, Policy and Practice Research Group, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Hans-Eckhardt Hagen
- GloPID-R, Charite University Hospital Berlin Center 11 for Global Health, Berlin, Germany
| | - Choong-Min Ryu
- Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
- GloPID-R Asia-Pacific Regional Hub, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Alice Norton
- GloPID-R Research and Policy Team, Policy and Practice Research Group, Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Grüßer L, Eißing C, Kowark A, Keszei AP, Wallqvist J, Rossaint R, Ziemann S. Poor reporting quality of randomized controlled trials comparing treatments of COVID-19-A retrospective cross-sectional study on the first year of publications. PLoS One 2023; 18:e0292860. [PMID: 37844082 PMCID: PMC10578566 DOI: 10.1371/journal.pone.0292860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Transparent and complete reporting of randomized controlled trials (RCTs) is essential for critical scientific appraisal of the results. It has been argued whether publications during the COVID-19 pandemic have met reporting standards. In this study, we assessed reporting adherence of RCTs on treatment interventions in COVID-19 patients to the CONSORT checklist and discuss which lessons can be learned to improve reporting in the future. METHODS This was a retrospective, cross-sectional study performed at the University Hospital RWTH Aachen, Germany. We conducted a pragmatic systematic literature search in the PubMed database to identify RCTs on treatment interventions in COVID-19 patients in the first year of publications on the topic (March 2020-February 2021). We investigated the adherence of each publication to the CONSORT checklist and assessed the association between specific predictors and percentage adherence in an exploratory multivariable regression model. RESULTS We analyzed 127 RCTs and found that the median percentage adherence to the CONSORT checklist was 54.3% [IQR 38.9 to 65.7]. In the exploratory multivariable regression model, the impact factor (highest tertile of impact factor compared to lowest tertile ß = 21.77, 95% CI 13.89 to 29.66, p<0.001; middle tertile compared lowest tertile ß = 11.79, 95% CI 5.74 to 17.84, p<0.001)) and authors' referral to the CONSORT statement (ß = 9.29, 95% CI 2.98 to 15.60, p = 0.004) were associated with a higher percentage adherence to the CONSORT checklist. CONCLUSION The reporting quality of RCTs on treatment interventions in COVID-19 patients during the first year of publications was poor. Measures to improve reporting quality are urgently needed.
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Affiliation(s)
- Linda Grüßer
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Charlotte Eißing
- Department of Dermatology, Fachklinik Hornweide, Muenster, Germany
| | - Ana Kowark
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - András P. Keszei
- Center for Translational & Clinical Research Aachen (CTC-A), Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Julia Wallqvist
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Sebastian Ziemann
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
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Oh Y, Jung YJ, Sujata P, Kim M, Yon DK, Lee SW, Cho K, Koyanagi A, Dai Z, Smith L, Shin JI, Kim E. Spin in randomized controlled trials of pharmacology in COVID-19: A systematic review. Account Res 2023:1-19. [PMID: 37818630 DOI: 10.1080/08989621.2023.2269083] [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: 03/07/2023] [Accepted: 10/06/2023] [Indexed: 10/12/2023]
Abstract
Spin, defined as the misrepresentation of the results of a study, could negate the validity of scientific findings. To explore the manifestation of spin, and identify the factors affecting spin in COVID-19 RCTs, a systematic review was performed from PubMed/Medline, National Institutes of Health, EMBASE, Cochrane, and Web of Science. RCTs on pharmacotherapy for COVID-19 with nonsignificant primary outcomes published in 2020 were included. 21 abstracts (33.9%) and 28 main texts (45.2%) were found to contain spin in at least one section. In the conclusion section, other spin strategies beautifying their findings that were not included in the abstract were found in the main texts. More factors influencing the level of spin were found in abstracts than in the main texts, but most of the levels of spin in abstracts were comparable to those in the main texts. Although common factors that affected the manifestation of spin in the main texts and abstracts were the sample size and type of journal, further research to determine multicollinearity between significant factors and the manifestation of spin is required.
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Affiliation(s)
- Yunkyoung Oh
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
| | - Youn-Joo Jung
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
| | - Purja Sujata
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
| | - Minji Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
| | - Dong Keon Yon
- Centre for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Centre, Seoul, Republic of Korea
| | - Seung Won Lee
- Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Kyuyeon Cho
- Yonsei University College of Medicine, Seoul, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Zhaoli Dai
- College of Medicine and Public Health, Flinders University, South Australia; and School of Pharmacy, The University of Sydney, Sydney Australia
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Eunyoung Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
- The Graduate School of Pharmaceutical Industry Management, Chung-Ang University, Seoul, South Korea
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21
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Meadmore K, Church H, Crane K, Blatch-Jones A, Recio Saucedo A, Fackrell K. An in-depth exploration of researcher experiences of time and effort involved in health and social care research funding in the UK: The need for changes. PLoS One 2023; 18:e0291663. [PMID: 37733760 PMCID: PMC10513312 DOI: 10.1371/journal.pone.0291663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023] Open
Abstract
The need to reform the way in which research is undertaken is clear, with reducing research bureaucracy and waste at the forefront of this issue for the UK government, funding organisations, higher education institutions and wider research community. The aim of this study was to describe researchers' experiences of the time, effort and burden involved in funding processes-namely applying for research funding and fulfilling reporting requirements. This was an in-depth qualitative study using semi-structured interviews with researchers who had experience applying for funding and/or completing reporting requirements for a UK health and social care research funder between January 2018 and June 2021. Following thematic analysis, five key themes were identified describing researcher experiences of key issues around time, efforts and burden associated with funding processes. These themes encompassed (1) issues with the current funding model for health and social care research, (2) time and effort involved in funding processes, (3) the need for a streamlined end-to-end process, (4) implications for work-life balance, and (5) addressing the need for better support and communication. The findings from this study describe researcher experiences of tasks in the research pathway that currently take considerable time and effort. It was clear that whilst some of this time and effort is considered necessary, some is exacerbated by inefficient and ineffective processes, such as perceived under-funding of research or lack of clarity with regards to funder expectations. This in turn contributes to unnecessary researcher burden, research waste and negative research culture. Better investment in health and social care research and in the researchers themselves who design and deliver the research, alongside improvements in transparency, streamlining and research support could ensure a more positive research culture, and improve the quality of funded research.
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Affiliation(s)
- Katie Meadmore
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
| | - Hazel Church
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
| | - Ksenia Crane
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
| | - Amanda Blatch-Jones
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
| | - Alejandra Recio Saucedo
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
| | - Kathryn Fackrell
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, United Kingdom
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22
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Funada S, Yoshioka T, Luo Y, Iwama T, Mori C, Yamada N, Yoshida H, Katanoda K, Furukawa TA. Global Trends in Highly Cited Studies in COVID-19 Research. JAMA Netw Open 2023; 6:e2332802. [PMID: 37682572 PMCID: PMC10492181 DOI: 10.1001/jamanetworkopen.2023.32802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023] Open
Abstract
Importance Since the onset of the COVID-19 outbreak, an extremely high number of studies have been published worldwide, with variable quality. Research trends of highly cited papers may enable identification of influential research, providing insights for new research ideas; it is therefore important to investigate trends and focus on more influential publications in COVID-19-related studies. Objective To examine research trends of highly cited studies by conducting a bibliometric analysis of highly cited studies in the previous 2 months about COVID-19. Design, Setting, and Participants In this cross-sectional study, Essential Science Indicators (ESI) and Web of Science (WOS) Core Collection were used to find studies with a focus on COVID-19 that were identified as highly cited studies from Clarivate Analytics. Highly cited studies were extracted from the ESI database bimonthly between January 2020 and December 2022. Bibliographic details were extracted from WOS and combined with ESI data using unique accession numbers. The number of highly cited studies was counted based on the fractional counting method. Data were analyzed from January through July 2023. Main Outcomes and Measures The number of publications by research field, country, and institutional affiliation. Results The number of published COVID-19-related highly cited studies was 14 studies in January to February 2020, peaked at 1292 studies in November to December 2021, and showed a downward trend thereafter, reaching 649 studies in November to December 2022. China had the highest number of highly cited studies per 2-month period until July to August 2020 (138.3 studies vs 103.7 studies for the US, the second highest country), and the US had the greatest number of highly cited studies afterward (159.9 studies vs 157.6 studies for China in September to October 2020). Subsequently, the number of highly cited studies per 2-month period published by China declined (decreasing from 179.7 studies in November to December 2020 to 40.7 studies in September to October 2022), and the UK produced the second largest number of such studies in May to June 2021 (171.3 studies). Similarly, the top 5 institutional affiliations in May to June 2020 by highly cited studies per 2-month period were from China (Huazhong University: 14.7 studies; University of Hong Kong: 6.8 studies; Wuhan University: 4.8 studies; Zhejiang University: 4.5 studies; Fudan University: 4.5 studies), while in November to December 2022, the top 5 institutions were in the US and UK (Harvard University: 15.0 studies; University College London: 11.0 studies; University of Oxford: 10.2 studies; University of London: 9.9 studies; Imperial College London: 5.8 studies). Conclusions and Relevance This study found that the total number of highly cited studies related to COVID-19 peaked at the end of 2021 and showed a downward trend until the end of 2022, while the origin of these studies shifted from China to the US and UK.
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Affiliation(s)
- Satoshi Funada
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Yoshioka
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Population Health and Policy Research Unit, Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshi Iwama
- Office of Evidence and Analysis, Japan Society Technology and Agency, Tokyo, Japan
| | - Chikako Mori
- Office of Evidence and Analysis, Japan Society Technology and Agency, Tokyo, Japan
| | - Naofumi Yamada
- Office of Evidence and Analysis, Japan Society Technology and Agency, Tokyo, Japan
| | - Hideki Yoshida
- Office of Evidence and Analysis, Japan Society Technology and Agency, Tokyo, Japan
| | - Kota Katanoda
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Toshi A. Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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23
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Chan SCC, Choa G, Kelly J, Maru D, Rashid MA. Implementation of virtual OSCE in health professions education: A systematic review. MEDICAL EDUCATION 2023; 57:833-843. [PMID: 37080907 DOI: 10.1111/medu.15089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/13/2023] [Accepted: 03/28/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION The Objective Structured Clinical Examination (OSCE) has been widely used in health professions education since the 1970s. The global disruption caused by the COVID-19 pandemic restricted in-person assessments and medical educators globally sought alternative means to assess and certify students and trainees to meet the acute demand for health-care workers. One such solution was through virtual OSCE (vOSCE), which modified traditional in-person OSCE using videoconference platforms. This meta-ethnography sought to synthesise qualitative literature on candidates' and assessors' experiences of vOSCE to evaluate whether it may have a role in future assessment practices. METHODS In June 2022, we systematically searched PsycINFO, Medline and ERIC for peer-reviewed qualitative and mixed-methods articles that described candidates' and assessors' experiences of virtual OSCE in health professions education. Of 1069 articles identified, 17 were synthesised using meta-ethnography. RESULTS The final synthesis represented 1190 candidates and assessors from faculties of medicine, dentistry, nursing, pharmacy and osteopathy. We developed our findings into four key concepts. 'Strengthening confidence in a virtual environment' highlighted attempts to overcome and mitigate concerns associated with transitioning from in-person to virtual assessment. 'Understanding the scope of use as an assessment' reflected on the suitability of vOSCE in assessing various skills. 'Refining operational processes' emphasised the technical challenges of implementing vOSCE and impacts on accessibility and resources. 'Envisioning its future role' considered the applicability of vOSCE in the climate of rapid development in telehealth. CONCLUSION This meta-ethnography highlighted that although vOSCE was primarily considered a temporary and crisis response, candidates and assessors recognised positive, as well as negative, consequences of the transition towards them. Moving forward, medical education policymakers should carefully consider the extent to which elements of vOSCE could be incorporated into assessment systems, particularly in light of the rise of telehealth in clinical practice.
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Affiliation(s)
- See Chai Carol Chan
- Faculty of Medical Sciences, UCL Medical School, University College London, London, UK
| | - George Choa
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James Kelly
- Faculty of Medical Sciences, UCL Medical School, University College London, London, UK
| | - Devina Maru
- Faculty of Medical Sciences, UCL Medical School, University College London, London, UK
| | - Mohammed Ahmed Rashid
- Faculty of Medical Sciences, UCL Medical School, University College London, London, UK
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Arjuman A. A perspective on new dilemmas in scientific publishing in the time of a pandemic. Indian J Med Microbiol 2023; 45:100366. [PMID: 37019728 PMCID: PMC10069637 DOI: 10.1016/j.ijmmb.2023.100366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic exerted manifold pressures on the public health framework globally, but it also in a way unified different genres and allowed for strategizing and implementing regulatory decisions as best as possible, especially in India. There is an unmet need for such a unified and integrative approach in the area of scientific publishing which has also been touched by various dilemmas, either emergent or propagated during this pandemic. OBJECTIVES This article intends to re-visit some of the dilemmas in scientific publishing, which have taken centre stage owing to a healthcare emergency, with the objective of highlighting an unmet need for developing unified criteria for research conduction and publishing from a futuristic view point, as one is not without the other. CONTENT While a fast track delivery of research data has been a priority for research journals, the due pressures in the process management of the same while skimming the ethical boundaries of responsible mediation through a Journal platform has remained a challenge globally for various reasons. Furthermore, the inevitability of a healthcare emergency inadvertently led to some cumulative off-target effects including accumulation of research waste, diminishing validity of academic metrics, short data set publications, hasty zombie clinical trials publishing merely an overview of the actual data, etc, which are major issues not only for journal Editors or the research community as a whole, but also for regulatory authorities and policy makers. As a step towards future pandemic preparedness, strategizing and streamlining research and publication processes ensuing responsible reporting should be treated as a topic of paramount significance. Hence, through debating on these dilemmas as well as potential integrative approaches, unified guiding criteria in the area of scientific publishing may be developed in lieu of preparedness for such future pandemic scenarios.
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25
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van Aert RCM, Nuijten MB, Olsson-Collentine A, Stoevenbelt AH, van den Akker OR, Klein RA, Wicherts JM. Comparing the prevalence of statistical reporting inconsistencies in COVID-19 preprints and matched controls: a registered report. ROYAL SOCIETY OPEN SCIENCE 2023; 10:202326. [PMID: 37593717 PMCID: PMC10427813 DOI: 10.1098/rsos.202326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
The COVID-19 outbreak has led to an exponential increase of publications and preprints about the virus, its causes, consequences, and possible cures. COVID-19 research has been conducted under high time pressure and has been subject to financial and societal interests. Doing research under such pressure may influence the scrutiny with which researchers perform and write up their studies. Either researchers become more diligent, because of the high-stakes nature of the research, or the time pressure may lead to cutting corners and lower quality output. In this study, we conducted a natural experiment to compare the prevalence of incorrectly reported statistics in a stratified random sample of COVID-19 preprints and a matched sample of non-COVID-19 preprints. Our results show that the overall prevalence of incorrectly reported statistics is 9-10%, but frequentist as well as Bayesian hypothesis tests show no difference in the number of statistical inconsistencies between COVID-19 and non-COVID-19 preprints. In conclusion, the literature suggests that COVID-19 research may on average have more methodological problems than non-COVID-19 research, but our results show that there is no difference in the statistical reporting quality.
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Affiliation(s)
- Robbie C. M. van Aert
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Michèle B. Nuijten
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | | | - Andrea H. Stoevenbelt
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Olmo R. van den Akker
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Richard A. Klein
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Jelte M. Wicherts
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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26
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Chan A, Stathakis P, Goldsmith P, Smith S, Macutkiewicz C. The reorganisation of emergency general surgery services during the COVID-19 pandemic in the UK: outcomes of delayed presentation, socio-economic deprivation and Black, Asian and Minority Ethnic patients. Ann R Coll Surg Engl 2023; 105:S46-S53. [PMID: 35639022 PMCID: PMC10390243 DOI: 10.1308/rcsann.2022.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global public health emergency. Lockdown restrictions and the reconfiguration of healthcare systems to accommodate an increase in critical care capacity have had an impact on 'non-COVID' specialties. This study characterises the utilisation of emergency general surgery (EGS) services during the UK lockdown period at a university teaching hospital with a catchment population that represents one of the most deprived and ethnically diverse areas in the UK. METHODS EGS admissions during the UK lockdown period (March to May 2020) were compared with the same period in 2019. Patient demographics were recorded together with clinical presentation, hospital stay and treatment outcomes, and readmission data. RESULTS The study included 645 patients, comprising 223 in the COVID-19 period and 422 in the non-COVID-19 period. There was no difference in age, sex, comorbidity or socio-economic status. A lower proportion of patients of Black, Asian and Minority Ethnicity (BAME) were admitted during the pandemic (20.6% vs 35.4%, p < 0.05). The duration of symptoms prior to presentation was longer, and admission clinical parameters and serum inflammatory markers. More patients presented with an acute kidney injury (9.9% vs 4.7%, p = 0.012). There was no difference in perioperative outcomes or 30-day mortality, but more patients were readmitted following conservative management (10.6% vs 4.7%, p = 0.023). CONCLUSIONS The reorganisation of EGS to a senior-led model has been successful in terms of outcomes and access to treatment despite a more unwell population. There was a significantly lower proportion of BAME admissions suggesting additional barriers to healthcare access under pandemic lockdown conditions.
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Affiliation(s)
- A Chan
- Manchester University NHS Foundation Trust, UK
| | - P Stathakis
- Manchester University NHS Foundation Trust, UK
| | - P Goldsmith
- Manchester University NHS Foundation Trust, UK
| | - S Smith
- Manchester University NHS Foundation Trust, UK
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27
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Smadi M, Kaburis M, Schnapper Y, Reina G, Molero P, Molendijk ML. SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses. Br J Psychiatry 2023:1-14. [PMID: 37183681 DOI: 10.1192/bjp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected. AIMS To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome. METHOD Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect. RESULTS In total, 136 primary studies (total sample size n = 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16-2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44-5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34-2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00-2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60-3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40-0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56-2.27). CONCLUSIONS Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.
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Affiliation(s)
- Muhannad Smadi
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Melina Kaburis
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Youval Schnapper
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Microbiology, Pamplona, Spain
| | - Patricio Molero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Psychiatry and Medical Psychology, Pamplona, Spain
| | - Marc L Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands; and Leiden Institute for Brain and Cognition, Leiden University Medical Centre, Leiden, The Netherlands
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He J, Liu X, Lu X, Zhong M, Jia C, Lucero-Prisno DE, Ma ZF, Li H. The impact of COVID-19 on global health journals: an analysis of impact factor and publication trends. BMJ Glob Health 2023; 8:bmjgh-2022-011514. [PMID: 37012001 PMCID: PMC10083532 DOI: 10.1136/bmjgh-2022-011514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/09/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND COVID-19 has affected research productivity across all areas of knowledge. Current evidence suggests that COVID-19 has had a blockbuster effect on journal impact factors (JIFs) and publication trends, while little is known on global health journals. METHODS Twenty global health journals were included to analyse the impact of COVID-19 on their JIFs and publication trends. Indicator data, including numbers of publications, citations, articles with different types, etc, were extracted from journal websites and Web of Science Core Collection database. The JIFs from 2019 to 2021 were simulated for longitudinal and cross-sectional analyses. Interrupted time-series analysis and non-parametric tests were applied to assess whether COVID-19 had decreased non-COVID-19 publications from January 2018 to June 2022. RESULTS In 2020, 615 out of 3223 publications were COVID-19 related, accounting for 19.08%. The simulated JIFs of 17 out of 20 journals in 2021 were higher than those in 2019 and 2020. Notably, 18 out of 20 journals had a decrease in their simulated JIFs after excluding COVID-19-related publications. Moreover, 10 out of 20 journals decreased their monthly numbers of non-COVID-19 publications after the COVID-19 outbreak. For all the 20 journals as a whole, after the COVID-19 outbreak in February 2020, the total number of non-COVID-19 publications significantly decreased by 14.2 compared with the previous month (p=0.013), and since then, on average, the publications had decreased by 0.6 per month until June 2022 (p<0.001). CONCLUSIONS COVID-19 has impacted the structure of COVID-19-related publications, the JIFs of global health journals and their numbers of non-COVID-19 publications. Although journals may benefit from increased JIFs, global health journals should avoid relying on a single metric. More follow-up studies including more years of data with a combination of metrics should be conducted to generate more robust evidence.
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Affiliation(s)
- Jiaxin He
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Xinliang Liu
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Xinyang Lu
- Department of Mathematical Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Meiling Zhong
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Changli Jia
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Don Eliseo Lucero-Prisno
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Hao Li
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
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Jordan-Rios A, Nuzzi V, Bromage DI, McDonagh T, Sinagra G, Cannata A. Reshaping care in the aftermath of the pandemic. Implications for cardiology health systems. Eur J Intern Med 2023; 109:4-11. [PMID: 36462964 PMCID: PMC9709614 DOI: 10.1016/j.ejim.2022.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/12/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022]
Abstract
In the last two years, the COVID-19 pandemic has undeniably changed everyday life and significantly reshaped the healthcare systems. Besides the direct effect on daily care leading to significant excess mortality, several collateral damages have been observed during the pandemic. The impact of the pandemic led to staff shortages, disrupted education, worse healthcare professional well-being, and a lack of proper clinical training and research. In this review we highlight the results of these important changes and how can the healthcare systems can adapt to prevent unprecedented events in case of future catastrophes.
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Affiliation(s)
- Antonio Jordan-Rios
- Department of Cardiovascular Science, Faculty of Life Science and Medicine, King's College London, 125 Coldharbour lane, London SE5 9RS, UK
| | - Vincenzo Nuzzi
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - Daniel I Bromage
- Department of Cardiovascular Science, Faculty of Life Science and Medicine, King's College London, 125 Coldharbour lane, London SE5 9RS, UK
| | - Theresa McDonagh
- Department of Cardiovascular Science, Faculty of Life Science and Medicine, King's College London, 125 Coldharbour lane, London SE5 9RS, UK
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - Antonio Cannata
- Department of Cardiovascular Science, Faculty of Life Science and Medicine, King's College London, 125 Coldharbour lane, London SE5 9RS, UK; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.
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Zhao N, Pandey K, Lakshmanan S, Zhao R, Fan J, Zhang J, Bachmann MO, Fan H, Song F. Characteristics and result reporting of registered COVID-19 clinical trials of Chinese and Indian traditional medicine: A comparative analysis. Front Med (Lausanne) 2023; 10:1118269. [PMID: 36873866 PMCID: PMC9981796 DOI: 10.3389/fmed.2023.1118269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/03/2023] [Indexed: 02/19/2023] Open
Abstract
Objective To assess the main characteristics and result reporting of registered COVID-19 interventional trials of traditional Chinese medicine and traditional Indian medicine. Materials and methods We assessed design quality and result reporting of COVID-19 trials of traditional Chinese medicine (TCM) and traditional Indian medicine (TIM) registered before 10 February 2021, respectively, on Chinese Clinical Trial Registry (ChiCTR) and Clinical Trial Registry-India (CTRI). Comparison groups included registered COVID-19 trials of conventional medicine conducted in China (WMC), India (WMI), and in other countries (WMO). Cox regression analysis was used to assess the association between time from trial onset to result reporting and trial characteristics. Results The proportion of COVID-19 trials investigating traditional medicine was 33.7% (130/386) among trials registered on ChiCTR, and 58.6% (266/454) on CTRI. Planned sample sizes were mostly small in all COVID-19 trials (median 100, IQR: 50-200). The proportion of trials that were randomized was 75.4 and 64.8%, respectively, for the TCM and TIM trials. Blinding measures were used in 6.2% of the TCM trials, and 23.6% of the TIM trials. Cox regression analysis revealed that planned COVID-19 clinical trials of traditional medicine were less likely to have results reported than trials of conventional medicine (hazard ratio 0.713, 95% confidence interval: 0.541-0.939; p = 0.0162). Conclusion There were considerable between-country and within-country differences in design quality, target sample size, trial participants, and reporting of trial results. Registered COVID-19 clinical trials of traditional medicine were less likely to report results than trials of conventional medicine.
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Affiliation(s)
- Nan Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Kritika Pandey
- Integrative Ayurveda Network, Aarogyam (UK) CIC, Leicester, United Kingdom
| | | | - Ran Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jingchun Fan
- School of Public Health, Gansu University of Traditional Chinese Medicine, Lanzhou, China
| | - Junhua Zhang
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Max O Bachmann
- Faculty of Medicine and Health Science, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Hong Fan
- School of Nursing, Nanjing Medical University, Nanjing, China.,School of Public Health, Nanjing Medical University, Nanjing, China
| | - Fujian Song
- Faculty of Medicine and Health Science, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Pranić SM, Vasanthan LT, Thompson JY, Mishra V, Kumar P, Ananda RA, Malih N, Chan KK. Protocol of a scoping review of systematic reviews and meta-analyses about COVID-19 vaccines and associated adverse events from vaccination. PLoS One 2023; 18:e0285442. [PMID: 37163502 PMCID: PMC10171674 DOI: 10.1371/journal.pone.0285442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/23/2023] [Indexed: 05/12/2023] Open
Abstract
The continuous dissemination of coronavirus disease of 2019 (COVID-19) literature can inform decision-makers and the public. Since the widespread use of COVID-19 vaccines, more systematic reviews have summarized the effectiveness and reported adverse events associated with vaccination. Previous systematic and scoping reviews on COVID-19 summarized various aspects surrounding COVID-19, however, a scoping review is needed to summarize the characteristics of COVID-19 vaccines and associated adverse events reported in systematic reviews and meta-analyses to provide comprehensive evidence for informed medical decision-making. We will conduct a scoping review concerning COVID-19 vaccines and adverse events from vaccines. We will search from December 2019 to present in Epistemonikos, Campbell Library, CINAHL (Ovid), MEDLINE (Ovid), Scopus, CENTRAL (Ovid), Web of Science, WHO COVID-19 database, Joanna Briggs Institute of Excellence, and COVID-19 Evidence Reviews resource. We will include systematic reviews, meta-analyses, or both of randomized controlled trials and observational studies and exclude individual randomized controlled trials and observational studies. Abstracts and full-texts will be screened prior to selection. Investigators will independently use a calibrated quantitative and qualitative data extraction sheet and rate the quality of articles with AMSTAR, resolving disagreements to aim for good agreement (≥80%). An updated scoping review of the characteristics and safety of COVID-19 vaccines would highlight the accuracy of the evidence to inform decision-making concerning COVID-19 vaccination.
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Affiliation(s)
- Shelly Melissa Pranić
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- Cochrane Croatia, Split, Croatia
| | - Lenny T Vasanthan
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India
| | - Jacqueline Y Thompson
- Institute of Applied Health Research, University of Birmingham, University of Birmingham, Birmingham, United Kingdom
| | - Vinayak Mishra
- Department of Children's Health, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Narges Malih
- Global Health Research Group, University of the Balearic Islands (UIB), Palma, Spain
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ka-King Chan
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
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Ioannidis JPA. Prolific non-research authors in high impact scientific journals: meta-research study. Scientometrics 2023; 128:3171-3184. [PMID: 37101975 PMCID: PMC10089822 DOI: 10.1007/s11192-023-04687-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/05/2023] [Indexed: 04/28/2023]
Abstract
Journalistic papers published in high impact scientific journals can be very influential, especially in hot fields. This meta-research analysis aimed to evaluate the publication profiles, impact, and disclosures of conflicts of interest of non-research authors who had published > 200 Scopus-indexed papers in Nature, Science, PNAS, Cell, BMJ, Lancet, JAMA or New England Journal of Medicine. 154 prolific authors were identified, 148 of whom had published 67,825 papers in their main affiliated journal in a non-researcher capacity. Nature, Science, and BMJ have the lion's share of such authors. Scopus characterized 35% of the journalistic publications as full articles and another 11% as short surveys. 264 papers had received more than 100 citations. 40/41 most-cited papers in 2020-2022 were on hot COVID-19 topics. Of 25 massively prolific authors with > 700 publications in one of these journals, many were highly-cited (median citations 2273), almost all had published little or nothing in the Scopus-indexed literature other than in their main affiliated journal, and their influential writing covered diverse hot topics over the years. Of the 25, only 3 had a PhD degree in any subject matter, and 7 had a Master's degree in journalism. Only the BMJ offered conflicts of interest disclosures for prolific science writers in its website, but even then only 2 of the 25 massively prolific authors disclosed potential conflicts with some specificity. The practice of assigning so much power to non-researchers in shaping scientific discourse should be further debated and disclosures of potential conflicts of interest should be emphasized.
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Affiliation(s)
- John P. A. Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA 94305 USA
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Smith JA, DeVito N, Lee H, Tiplady C, Abhari RE, Kartsonaki C. Estimating the effect of COVID-19 on trial design characteristics: a registered report. ROYAL SOCIETY OPEN SCIENCE 2023; 10:201543. [PMID: 36686547 PMCID: PMC9832295 DOI: 10.1098/rsos.201543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
There have been reports of poor-quality research during the COVID-19 pandemic. This registered report assessed design characteristics of registered clinical trials for COVID-19 compared to non-COVID-19 trials to empirically explore the design of clinical research during a pandemic and how it compares to research conducted in non-pandemic times. We did a retrospective cohort study with a 1 : 1 ratio of interventional COVID-19 registrations to non-COVID-19 registrations, with four trial design outcomes: use of control arm, randomization, blinding and prospective registration. Logistic regression was used to estimate the odds ratio of investigating COVID-19 versus not COVID-19 and estimate direct and total effects of investigating COVID-19 for each outcome. The primary analysis showed a positive direct and total effect of COVID-19 on the use of control arms and randomization. It showed a negative direct effect of COVID-19 on blinding but no evidence of a total effect. There was no evidence of an effect on prospective registration. Taken together with secondary and sensitivity analyses, our findings are inconclusive but point towards a higher prevalence of key design characteristics in COVID-19 trials versus controls. The findings do not support much existing COVID-19 research quality literature, which generally suggests that COVID-19 led to a reduction in quality. Limitations included some data quality issues, minor deviations from the pre-registered plan and the fact that trial registrations were analysed which may not accurately reflect study design and conduct. Following in-principle acceptance, the approved stage 1 version of this manuscript was pre-registered on the Open Science Framework at https://doi.org/10.17605/OSF.IO/5YAEB. This pre-registration was performed prior to data analysis.
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Affiliation(s)
- James A. Smith
- Botnar Research Centre and Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX1 2JD, UK
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Nicholas DeVito
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Hopin Lee
- Botnar Research Centre and Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Catherine Tiplady
- Botnar Research Centre and Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Roxanna E. Abhari
- Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
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Hughes N, Rijnbeek PR, van Bochove K, Duarte-Salles T, Steinbeisser C, Vizcaya D, Prieto-Alhambra D, Ryan P. Evaluating a novel approach to stimulate open science collaborations: a case series of "study-a-thon" events within the OHDSI and European IMI communities. JAMIA Open 2022; 5:ooac100. [PMID: 36406796 PMCID: PMC9670330 DOI: 10.1093/jamiaopen/ooac100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVE We introduce and review the concept of a study-a-thon as a catalyst for open science in medicine, utilizing harmonized real world, observation health data, tools, skills, and methods to conduct network studies, generating insights for those wishing to use study-a-thons for future research. MATERIALS AND METHODS A series of historical study-a-thons since 2017 to present were reviewed for thematic insights as to the opportunity to accelerate the research method to conduct studies across therapeutic areas. Review of publications and experience of the authors generated insights to illustrate the conduct of study-a-thons, key learning, and direction for those wishing to conduct future such study-a-thons. RESULTS A review of six study-a-thons have provided insights into their scientific impact, and 13 areas of insights for those wishing to conduct future study-a-thons. Defining aspects of the study-a-thon method for rapid, collaborative research through network studies reinforce the need to clear scientific rationale, tools, skills, and methods being collaboratively to conduct a focused study. Well-characterized preparatory, execution and postevent phases, coalescing skills, experience, data, clinical input (ensuring representative clinical context to the research query), and well-defined, logical steps in conducting research via the study-a-thon method are critical. CONCLUSIONS A study-a-thon is a focused multiday research event generating reliable evidence on a specific medical topic across different countries and health systems. In a study-a-thon, a multidisciplinary team collaborate to create an accelerated contribution to scientific evidence and clinical practice. It critically accelerates the research process, without inhibiting the quality of the research output and evidence generation, through a reproducible process.
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Affiliation(s)
- N Hughes
- Epidemiology, Janssen R&D, Beerse, Belgium
| | - P R Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - T Duarte-Salles
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - D Vizcaya
- Bayer Pharmaceuticals, Sant Joan Despi, Spain
| | | | - P Ryan
- Epidemiology, Janssen R&D, Titusville, New Jersey, USA
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Beresford L, Walker R, Stewart L. Extent and nature of duplication in PROSPERO using COVID-19-related registrations: a retrospective investigation and survey. BMJ Open 2022; 12:e061862. [PMID: 36456005 PMCID: PMC9716408 DOI: 10.1136/bmjopen-2022-061862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES During COVID-19, the International Prospective Register of Systematic Reviews (PROSPERO) experienced a surge in registrations for COVID-19-related systematic reviews, and duplication of research questions became apparent. Duplication can waste funding, time and research effort and make policy making more difficult.This project explored the extent of and reasons for duplication of COVID-19-related systematic review registrations in PROSPERO during the pandemic. DESIGN Retrospective analysis of COVID-19-related registrations in PROSPERO, and a qualitative survey. SETTING PROSPERO was searched for registrations related to four COVID-19 research areas: epidemiology, rehabilitation, transmission and treatments. METHODS Records identified were compared using Population, Intervention/Exposure, Comparator, Outcome, Study Design (PICOS) elements of PROSPERO registration forms. Registrations with similar or identical PICOS were evaluated further as 'duplicates'.Authors of 'duplicate' registrations were invited to complete a survey asking whether they searched PROSPERO prior to registration, identified similar reviews and, if so, why they continued with their review. RESULTS 1054 COVID-19 reviews were registered between March 2020 and January 2021, of which 138 were submitted when at least one similar protocol was already registered in PROSPERO. Duplication was greatest in reviews of COVID-19 treatments; for example, there were 14 similar reviews evaluating the efficacy of hydroxychloroquine.From 138 authors invited to take part in the survey, we received 41 responses. Most respondents said that they identified similar reviews when they searched PROSPERO prior to registration. Main reasons given for 'duplication' were differences in PICOS or planned analyses (n=13), poor quality of previous registrations (n=2) and the need to update evidence (n=3). CONCLUSIONS This research highlights that registration of similar and duplicate systematic reviews related to COVID-19 in PROSPERO occurred frequently. Awareness of research waste is required, and initial checking for similar reviews should be embedded within good review practice.
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Affiliation(s)
- Lucy Beresford
- Centre for Review and Dissemination, University of York, York, UK
| | - Ruth Walker
- Centre for Review and Dissemination, University of York, York, UK
| | - Lesley Stewart
- Centre for Review and Dissemination, University of York, York, UK
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Robins-Browne K, Lewis M, Burchill LJ, Gilbert C, Johnson C, O'Donnell M, Kotevski A, Poonian J, Palmer VJ. Interventions to support the mental health and well-being of front-line healthcare workers in hospitals during pandemics: an evidence review and synthesis. BMJ Open 2022; 12:e061317. [PMID: 36344001 PMCID: PMC9644079 DOI: 10.1136/bmjopen-2022-061317] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Pandemics negatively impact healthcare workers' (HCW's) mental health and well-being causing additional feelings of anxiety, depression, moral distress and post-traumatic stress. A comprehensive review and evidence synthesis of HCW's mental health and well-being interventions through pandemics reporting mental health outcomes was conducted addressing two questions: (1) What mental health support interventions have been reported in recent pandemics, and have they been effective in improving the mental health and well-being of HCWs? (2) Have any mobile apps been designed and implemented to support HCWs' mental health and well-being during pandemics? DESIGN A narrative evidence synthesis was conducted using Cochrane criteria for synthesising and presenting findings when systematic review and pooling data for statistical analysis are not suitable due to the heterogeneity of the studies. DATA SOURCES Evidence summary resources, bibliographic databases, grey literature sources, clinical trial registries and protocol registries were searched. ELIGIBILITY CRITERIA Subject heading terms and keywords covering three key concepts were searched: SARS-CoV-2 coronavirus (or similar infectious diseases) epidemics, health workforce and mental health support interventions. Searches were limited to English-language items published from 1 January 2000 to 14 June 2022. No publication-type limit was used. DATA EXTRACTION AND SYNTHESIS Two authors determined eligibility and extracted data from identified manuscripts. Data was synthesised into tables and refined by coauthors. RESULTS 2694 studies were identified and 27 papers were included. Interventions were directed at individuals and/or organisations and most were COVID-19 focused. Interventions had some positive impacts on HCW's mental health and well-being, but variable study quality, low sample sizes and lack of control conditions were limitations. Two mobile apps were identified with mixed outcomes. CONCLUSION HCW interventions were rapidly designed and implemented with few comprehensively described or evaluated. Tailored interventions that respond to HCWs' needs using experience co-design for mental health and well-being are required with process and outcome evaluation.
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Affiliation(s)
- Kate Robins-Browne
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
| | - Matthew Lewis
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
| | - Luke James Burchill
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Cecily Gilbert
- The Centre for Digital Transformation of Health Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Vic, Australia
| | - Caroline Johnson
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
| | - Meaghan O'Donnell
- The Department of Psychiatry, Melbourne Medical School, Facutly of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Vic, Australia
| | - Aneta Kotevski
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Jasmine Poonian
- Emergency Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Victoria J Palmer
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- The ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
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Hirt J, Janiaud P, Hemkens LG. Clinical trial research agenda on COVID-19 - the first two years in Germany and beyond. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 174:32-42. [PMID: 36180342 PMCID: PMC9514972 DOI: 10.1016/j.zefq.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND We have followed the COVID-19 clinical trial research agenda from the beginning using the COVID-evidence.org platform. Now, two years after the COVID-19 pandemic started, our aim was to re-examine this research agenda with the latest data to provide a global perspective on the research landscape with a focus on Germany. METHODS We reviewed and updated previously published data on the COVID-19 clinical research agenda as of 28February 2022 focusing on randomized trials. We used the COVID-evidence.org platform including registry entries from ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform as well as publications from the Living OVerview of Evidence platform for COVID-19 (L·OVE). RESULTS Two years on from the pandemic outbreak, there were 4,673 registered trials. The majority of these trials have remained small with a median of 120 planned participants (IQR 60-320). In the first hundred days of the pandemic most of them (50%) had been registered in China. More than two years later, the five countries with the most registered trials (alone or within a framework of international collaborations) were the USA (825 trials; 18%), Iran (619 trials; 13%), India (566 trials; 12%), China (353 trials; 8%), and Spain (309 trials; 7%). Only 119 trials were reported to have a study site in Germany (2.5% of the registered trials). Of the 4,673 trials registered, 15% (694 trials) had published their results by February 2022. The clinical research agenda has been marked by both successes, such as the large RECOVERY trial providing evidence on 10 treatments for COVID-19 including over 45,000 patients as of February 2022, and failures: worldwide only 57 randomized trials have been registered over two years that aimed to assess non-pharmaceutical interventions (e.g., face mask policies and lockdown measures) to prevent COVID-19, and only 11 of them had published results informing decisions that have an impact on the life of billions of people worldwide. CONCLUSIONS The COVID-19 clinical research agenda has highlighted the substantial effort of the research community but also the challenges of the clinical research ecosystem. Most importantly, it has shed light on the ability to circumvent traditional barriers and to make trials more useful even under extraordinary conditions. The time to learn our lessons and apply them is now, and the time to demonstrate how we have improved the system is before the next pandemic.
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Affiliation(s)
- Julian Hirt
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland,International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Perrine Janiaud
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Lars G. Hemkens
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland,Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA,Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany,Corresponding author. Lars G. Hemkens, MD, MPH. Department of Clinical Research, University Hospital Basel, Spitalstrasse 12, 4031 Basel, Switzerland
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Janin YL. On drug discovery against infectious diseases and academic medicinal chemistry contributions. Beilstein J Org Chem 2022; 18:1355-1378. [PMID: 36247982 PMCID: PMC9531561 DOI: 10.3762/bjoc.18.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
This perspective is an attempt to document the problems that medicinal chemists are facing in drug discovery. It is also trying to identify relevant/possible, research areas in which academics can have an impact and should thus be the subject of grant calls. Accordingly, it describes how hit discovery happens, how compounds to be screened are selected from available chemicals and the possible reasons for the recurrent paucity of useful/exploitable results reported. This is followed by the successful hit to lead stories leading to recent and original antibacterials which are, or about to be, used in human medicine. Then, illustrated considerations and suggestions are made on the possible inputs of academic medicinal chemists. This starts with the observation that discovering a “good” hit in the course of a screening campaign still rely on a lot of luck – which is within the reach of academics –, that the hit to lead process requires a lot of chemistry and that if public–private partnerships can be important throughout these stages, they are absolute requirements for clinical trials. Concerning suggestions to improve the current hit success rate, one academic input in organic chemistry would be to identify new and pertinent chemical space, design synthetic accesses to reach these and prepare the corresponding chemical libraries. Concerning hit to lead programs on a given target, if no new hits are available, previously reported leads along with new structural data can be pertinent starting points to design, prepare and assay original analogues. In conclusion, this text is an actual plea illustrating that, in many countries, academic research in medicinal chemistry should be more funded, especially in the therapeutic area neglected by the industry. At the least, such funds would provide the intensive to secure series of hopefully relevant chemical entities which appears to often lack when considering the results of academic as well as industrial screening campaigns.
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Affiliation(s)
- Yves L Janin
- Structure et Instabilité des Génomes (StrInG), Muséum National d'Histoire Naturelle, INSERM, CNRS, Alliance Sorbonne Université, 75005 Paris, France
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Hanney SR, Straus SE, Holmes BJ. Saving millions of lives but some resources squandered: emerging lessons from health research system pandemic achievements and challenges. Health Res Policy Syst 2022; 20:99. [PMID: 36088365 PMCID: PMC9464102 DOI: 10.1186/s12961-022-00883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
During the SARS-CoV-2 pandemic, astonishingly rapid research averted millions of deaths worldwide through new vaccines and repurposed and new drugs. Evidence use informed life-saving national policies including non-pharmaceutical interventions. Simultaneously, there was unprecedented waste, with many underpowered trials on the same drugs. We identified lessons from COVID-19 research responses by applying WHO's framework for research systems. It has four functions-governance, securing finance, capacity-building, and production and use of research-and nine components. Two linked questions focused the analysis. First, to what extent have achievements in knowledge production and evidence use built on existing structures and capacity in national health research systems? Second, did the features of such systems mitigate waste? We collated evidence on seven countries, Australia, Brazil, Canada, Germany, New Zealand, the United Kingdom and the United States, to identify examples of achievements and challenges.We used the data to develop lessons for each framework component. Research coordination, prioritization and expedited ethics approval contributed to rapid identification of new therapies, including dexamethasone in the United Kingdom and Brazil. Accelerated vaccines depended on extensive funding, especially through the Operation Warp Speed initiative in the United States, and new platforms created through long-term biomedical research capacity in the United Kingdom and, for messenger ribonucleic acid (mRNA) vaccines, in Canada, Germany and the United States. Research capacity embedded in the United Kingdom's healthcare system resulted in trial acceleration and waste avoidance. Faster publication of research saved lives, but raised challenges. Public/private collaborations made major contributions to vastly accelerating new products, available worldwide, though unequally. Effective developments of living (i.e. regularly updated) reviews and guidelines, especially in Australia and Canada, extended existing expertise in meeting users' needs. Despite complexities, effective national policy responses (less evident in Brazil, the United Kingdom and the United States) also saved lives by drawing on health research system features, including collaboration among politicians, civil servants and researchers; good communications; and willingness to use evidence. Comprehensive health research strategies contributed to success in research production in the United Kingdom and in evidence use by political leadership in New Zealand. In addition to waste, challenges included equity issues, public involvement and non-COVID research. We developed recommendations, but advocate studies of further countries.
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Affiliation(s)
- Stephen R Hanney
- Health Economics Research Group, Department of Health Sciences, Brunel University London, London, United Kingdom.
| | - Sharon E Straus
- St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Bev J Holmes
- Michael Smith Health Research BC, Vancouver, BC, Canada
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Gordon M, Bishop M, Chen Y, Dreber A, Goldfedder B, Holzmeister F, Johannesson M, Liu Y, Tran L, Twardy C, Wang J, Pfeiffer T. Forecasting the publication and citation outcomes of COVID-19 preprints. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220440. [PMID: 36177198 PMCID: PMC9515639 DOI: 10.1098/rsos.220440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Many publications on COVID-19 were released on preprint servers such as medRxiv and bioRxiv. It is unknown how reliable these preprints are, and which ones will eventually be published in scientific journals. In this study, we use crowdsourced human forecasts to predict publication outcomes and future citation counts for a sample of 400 preprints with high Altmetric score. Most of these preprints were published within 1 year of upload on a preprint server (70%), with a considerable fraction (45%) appearing in a high-impact journal with a journal impact factor of at least 10. On average, the preprints received 162 citations within the first year. We found that forecasters can predict if preprints will be published after 1 year and if the publishing journal has high impact. Forecasts are also informative with respect to Google Scholar citations within 1 year of upload on a preprint server. For both types of assessment, we found statistically significant positive correlations between forecasts and observed outcomes. While the forecasts can help to provide a preliminary assessment of preprints at a faster pace than traditional peer-review, it remains to be investigated if such an assessment is suited to identify methodological problems in preprints.
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Affiliation(s)
- Michael Gordon
- New Zealand Institute for Advanced Study, Massey University, Auckland, New Zealand
| | | | - Yiling Chen
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Anna Dreber
- Department of Economics, Stockholm School of Economics, Stockholm, Sweden
- Department of Economics, University of Innsbruck, Innsbruck, Austria
| | | | - Felix Holzmeister
- Department of Economics, University of Innsbruck, Innsbruck, Austria
| | - Magnus Johannesson
- Department of Economics, Stockholm School of Economics, Stockholm, Sweden
| | - Yang Liu
- Department of Computer Science and Engineering, University of California, Santa Cruz, CA, USA
| | - Louisa Tran
- Jacobs Engineering Group Inc., Herndon, VA, USA
| | - Charles Twardy
- Jacobs Engineering Group Inc., Herndon, VA, USA
- C41 & Cyber Center, George Mason University, Fairfax, VA, USA
| | - Juntao Wang
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Thomas Pfeiffer
- New Zealand Institute for Advanced Study, Massey University, Auckland, New Zealand
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Casino G. [Communication in times of pandemic: information, disinformation, and provisional lessons from the coronavirus crisis]. GACETA SANITARIA 2022; 36 Suppl 1:S97-S104. [PMID: 35781157 PMCID: PMC9244671 DOI: 10.1016/j.gaceta.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
Objetivo Caracterizar la infodemia asociada a la pandemia de COVID-19 y analizar, en el caso de España, el consumo de información, la confianza en las fuentes, el papel de los medios y la comunicación gubernamental, así como discutir algunas lecciones de comunicación provisionales a partir de los estudios sobre esta y otras pandemias. Método Búsqueda bibliográfica en PubMed y Scopus, y revisión de los documentos seleccionados con los criterios de relevancia para los objetivos y el ámbito español. Resultados La pandemia de COVID-19 se ha solapado con una infodemia que ha provocado la mayor avalancha de desinformación conocida y dificultades para encontrar información fiable a casi la mitad de la población. En España, el consumo de información se ha concentrado en los medios tradicionales y WhatsApp. Los medios han ayudado a entender la pandemia y han sido relativamente bien valorados, aunque inspiran menos confianza que en otros países occidentales. El análisis de la comunicación del Gobierno español muestra algunos errores, como la difusión de mensajes demasiado tranquilizadores al inicio de la pandemia, la falta de transparencia, el exceso de información y el modelo de portavocía adoptado. Conclusiones El conocimiento de la infodemia asociada a la COVID-19 es fragmentario e insuficiente. Aunque la crisis sanitaria no está cerrada para ser debidamente evaluada, es posible extraer algunas lecciones comunicativas provisionales. La complejidad del fenómeno de la desinformación exige considerar la infodemiología como una disciplina científica para conocer la propagación de la desinformación igual que la de la enfermedad.
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Affiliation(s)
- Gonzalo Casino
- Centro Cochrane Iberoamericano, Instituto de Investigación Biomédica Sant Pau, Barcelona, España; Departamento de Comunicación, Universidad Pompeu Fabra, Barcelona, España.
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ter Schure J, Grünwald P. ALL-IN meta-analysis: breathing life into living systematic reviews. F1000Res 2022; 11:549. [PMID: 36313543 PMCID: PMC9587381 DOI: 10.12688/f1000research.74223.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/20/2022] Open
Abstract
Science is justly admired as a cumulative process (“standing on the shoulders of giants”), yet scientific knowledge is typically built on a patchwork of research contributions without much coordination. This lack of efficiency has specifically been addressed in clinical research by recommendations for living systematic reviews and against research waste. We propose to further those recommendations with ALL-IN meta-analysis: Anytime Live and Leading INterim meta-analysis. ALL-IN provides statistical methodology for a meta-analysis that can be updated at any time—reanalyzing after each new observation while retaining type-I error guarantees, live—no need to prespecify the looks, and leading—in the decisions on whether individual studies should be initiated, stopped or expanded, the meta-analysis can be the leading source of information. We illustrate the method for time-to-event data, showing how synthesizing data at interim stages of studies can increase efficiency when studies are slow in themselves to provide the necessary number of events for completion. The meta-analysis can be performed on interim data, but does not have to. The analysis design requires no information about the number of patients in trials or the number of trials eventually included. So it can breathe life into living systematic reviews, through better and simpler statistics, efficiency, collaboration and communication
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Affiliation(s)
| | - Peter Grünwald
- Machine Learning, CWI, Amsterdam, The Netherlands
- Mathematics, Leiden University, Leiden, The Netherlands
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Sofi-Mahmudi A, Raittio E. Transparency of COVID-19-Related Research in Dental Journals. FRONTIERS IN ORAL HEALTH 2022; 3:871033. [PMID: 35464778 PMCID: PMC9019132 DOI: 10.3389/froh.2022.871033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveWe aimed to assess the adherence to transparency practices (data availability, code availability, statements of protocol registration and conflicts of interest and funding disclosures) and FAIRness (Findable, Accessible, Interoperable, and Reusable) of shared data from open access COVID-19-related articles published in dental journals available from the Europe PubMed Central (PMC) database.MethodsWe searched and exported all COVID-19-related open-access articles from PubMed-indexed dental journals available in the Europe PMC database in 2020 and 2021. We detected transparency indicators with a validated and automated tool developed to extract the indicators from the downloaded articles. Basic journal- and article-related information was retrieved from the PMC database. Then, from those which had shared data, we assessed their accordance with FAIR data principles using the F-UJI online tool (f-uji.net).ResultsOf 650 available articles published in 59 dental journals, 74% provided conflicts of interest disclosure and 40% funding disclosure and 4% were preregistered. One study shared raw data (0.15%) and no study shared code. Transparent practices were more common in articles published in journals with higher impact factors, and in 2020 than in 2021. Adherence to the FAIR principles in the only paper that shared data was moderate.ConclusionWhile the majority of the papers had a COI disclosure, the prevalence of the other transparency practices was far from the acceptable level. A much stronger commitment to open science practices, particularly to preregistration, data and code sharing, is needed from all stakeholders.
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Affiliation(s)
- Ahmad Sofi-Mahmudi
- Seqiz Health Network, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran, Iran
- *Correspondence: Ahmad Sofi-Mahmudi ;
| | - Eero Raittio
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
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McCarthy MS, McCarthy MW. Ethical challenges of prospective clinical trials during the COVID-19 pandemic. Expert Rev Anti Infect Ther 2022; 20:549-554. [PMID: 34797183 PMCID: PMC8631693 DOI: 10.1080/14787210.2022.2009343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/18/2021] [Indexed: 10/29/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has created an unprecedented opportunity to reimagine clinical research. While much has been written about the challenges associated with generating real-world evidence during the COVID-19 pandemic, comparatively little attention has been paid to the ethical challenges facing patients, clinicians, researchers, and regulatory bodies. AREAS COVERED In this manuscript, we examine these challenges through the lens of informed consent and explore how the consenting process changes as our understanding of the disease is altered. EXPERT OPINION We also suggest ways to limit these ethical hurdles through the use of embedded pragmatic clinical trials, which generate real-world data without the limitations associated with observational trials or the resources and lack of generalizability that are obstacles to conducting conventional randomized clinical trials. We argue that clinical research must become more nimble, and must include embedded researchers to ensure that relevant questions and ethical issues are properly addressed.
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Affiliation(s)
| | - Matthew W. McCarthy
- Weill Cornell Medical College, Division of General Internal Medicine, New York-Presbyterian Hospital, New York, NY, USA
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Cheng X, Chen Q, Tang L, Wu Y, Wang H, Wang G. Rapid Response in an Uncertain Environment: Study of COVID-19 Scientific Research Under the Parallel Model. Healthc Policy 2022; 15:339-349. [PMID: 35250320 PMCID: PMC8896189 DOI: 10.2147/rmhp.s351261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/12/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The rapid response of COVID-19 scientific research played a significant role in pandemic prevention and control but failed to block the spread of the pandemic rapidly. Besides the complexity of the virus, the effectiveness of control and prevention measures, and other factors, the adaptation of the mode of conducting scientific research is also crucial for the prevention and control of COVID-19. In this study, a parallel model was used to explore the effects of the rapid scientific response on COVID-19 to assess why pandemics continue to spread under rapid response. Analysis This study presents the response of scientific research based on country/region and publication dimensions after analyzing COVID-19 studies in the Web of Science and PubMed databases. Co-occurrence analysis of items was used to determine the generation rate of COVID-19 research under different topics to identify the reflected innovation model. Results More manifestations on rapid response of COVID-19 research, especially compared with the linear model of SARS research, showed that the COVID-19 research followed a parallel or concurrent innovation model. Conclusion Early multi-stakeholder partnership, convenient information sharing, and improved research competence promote the parallel model in COVID-19. Meanwhile, the uncertainty of the COVID-19 virus and the adverse effect of rapid response may limit the time efficiency of the parallel model. In conclusion, the rapid prevention and control of the pandemic cannot fully rely on scientific research but requires more combined effort under an uncertain global setting.
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Affiliation(s)
- Xi Cheng
- Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China
| | - Qiyuan Chen
- Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China
| | - Li Tang
- Department of Public Administration, Fudan University, Shanghai, 200433, People’s Republic of China
| | - Yue Wu
- Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China
| | - Haoran Wang
- Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China
| | - Guoyan Wang
- Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China
- Correspondence: Guoyan Wang, Department of Digital Communication, Soochow University, Soochow, Jiangsu, 215123, People’s Republic of China, Tel +86-19951313650, Email
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Alves CPDL, Barreto Segundo JDD, da Costa GG, Pereira-Cenci T, Lima KC, Demarco FF, Crochemore-Silva I. How a few poorly designed COVID-19 studies may have contributed to misinformation in Brazil: the case for evidence-based communication of science. BMJ OPEN SCIENCE 2022; 5:e100202. [PMID: 35047704 PMCID: PMC8647590 DOI: 10.1136/bmjos-2021-100202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Haber NA, Clarke-Deelder E, Feller A, Smith ER, Salomon JA, MacCormack-Gelles B, Stone EM, Bolster-Foucault C, Daw JR, Hatfield LA, Fry CE, Boyer CB, Ben-Michael E, Joyce CM, Linas BS, Schmid I, Au EH, Wieten SE, Jarrett B, Axfors C, Nguyen VT, Griffin BA, Bilinski A, Stuart EA. Problems with evidence assessment in COVID-19 health policy impact evaluation: a systematic review of study design and evidence strength. BMJ Open 2022; 12:e053820. [PMID: 35017250 PMCID: PMC8753111 DOI: 10.1136/bmjopen-2021-053820] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/03/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation studies given the circumstances for evaluation and concerns about the publication environment. METHODS We included studies that were primarily designed to estimate the quantitative impact of one or more implemented COVID-19 policies on direct SARS-CoV-2 and COVID-19 outcomes. After searching PubMed for peer-reviewed articles published on 26 November 2020 or earlier and screening, all studies were reviewed by three reviewers first independently and then to consensus. The review tool was based on previously developed and released review guidance for COVID-19 policy impact evaluation. RESULTS After 102 articles were identified as potentially meeting inclusion criteria, we identified 36 published articles that evaluated the quantitative impact of COVID-19 policies on direct COVID-19 outcomes. Nine studies were set aside because the study design was considered inappropriate for COVID-19 policy impact evaluation (n=8 pre/post; n=1 cross-sectional), and 27 articles were given a full consensus assessment. 20/27 met criteria for graphical display of data, 5/27 for functional form, 19/27 for timing between policy implementation and impact, and only 3/27 for concurrent changes to the outcomes. Only 4/27 were rated as overall appropriate. Including the 9 studies set aside, reviewers found that only four of the 36 identified published and peer-reviewed health policy impact evaluation studies passed a set of key design checks for identifying the causal impact of policies on COVID-19 outcomes. DISCUSSION The reviewed literature directly evaluating the impact of COVID-19 policies largely failed to meet key design criteria for inference of sufficient rigour to be actionable by policy-makers. More reliable evidence review is needed to both identify and produce policy-actionable evidence, alongside the recognition that actionable evidence is often unlikely to be feasible.
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Affiliation(s)
- Noah A Haber
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Emma Clarke-Deelder
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Avi Feller
- Department of Statistics, Goldman School of Public Policy, University of California Berkeley, Berkeley, California, USA
| | - Emily R Smith
- Department of Global Health, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
| | - Joshua A Salomon
- Department of Health Policy, Stanford University, Stanford, CA, USA
| | - Benjamin MacCormack-Gelles
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth M Stone
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Clara Bolster-Foucault
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Jamie R Daw
- Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Laura Anne Hatfield
- Department of Biostatistics, Harvard Medical School, Boston, Massachusetts, USA
| | - Carrie E Fry
- Department of Health Policy, Vanderbilt University, Nashville, Tennessee, USA
| | - Christopher B Boyer
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Eli Ben-Michael
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Caroline M Joyce
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Beth S Linas
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Applied Public Health and Research, RTI International, Washington, DC, USA
| | - Ian Schmid
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eric H Au
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah E Wieten
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Brooke Jarrett
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cathrine Axfors
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Van Thu Nguyen
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | | | - Alyssa Bilinski
- Interfaculty Initiative in Health Policy, Harvard University Graduate School of Arts and Sciences, Cambridge, Massachusetts, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Connor AE, Dibble KE, Visvanathan K. Utilizing Social Media Advertisements and Participant Social Networks to Recruit African American Breast Cancer Survivors: Design and Rationale. Front Public Health 2022; 10:931102. [PMID: 35899153 PMCID: PMC9309894 DOI: 10.3389/fpubh.2022.931102] [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: 04/29/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Our objective is to pilot an advertisement-driven sampling procedure among African American (AA) breast cancer survivors living in Maryland. These pilot study methods will inform a future population-based study of AA breast cancer survivors at high risk of poor outcomes due to biological differences and social inequities. Methods This cross-sectional study utilizes an innovative, social media-based advertisement campaign with an associated social media study page to recruit 100 AA breast cancer survivors. Participants are biologically female, aged 18 and older, identify as AA/Black, have a diagnosis of breast cancer, and reside in Maryland. A preset "Audience" was created via Meta (formerly Facebook) to automatically target potential interest in the online study via geolocation and public social media interests (estimated range = 101,000 women). Eligible participants complete an online survey including demographic and clinical characteristics, cancer screening, healthcare access, and utilization, COVID-19 impact, quality of doctor-patient communication, and preferences for future study participation. Results Recruitment began on 5 January 2022 and remains ongoing. As of 7 June 2002: 124 completed the screener, 110/124 (88.7%) consented passively, 24/110 (21.8%) started but did not complete survey, 86/110 (78.1%) completed the survey. Conclusions Results from this study will inform a statewide multilevel prospective population-based study to improve health behaviors, disease management, and self-efficacy of chronic disease management among AA breast cancer survivors.
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Affiliation(s)
- Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, United States
| | - Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, United States
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Simon GE, Platt R, Watanabe JH, Bindman AB, John London A, Horberg M, Hernandez A, Califf RM. When Can We Rely on Real-World Evidence to Evaluate New Medical Treatments? Clin Pharmacol Ther 2022; 111:30-34. [PMID: 33895994 PMCID: PMC8251042 DOI: 10.1002/cpt.2253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence (RWE) in the evaluation of new treatments or products. The RWE label has been used to refer to a variety of departures from the methods of traditional randomized controlled trials. Recognizing this complexity and potential confusion, the National Academies of Science, Engineering, and Medicine convened a series of workshops to clarify and address questions regarding the use of RWE to evaluate new medical treatments. Those workshops identified three specific dimensions in which RWE studies might differ from traditional clinical trials: use of real-world data (data extracted from health system records or data captured by mobile devices), delivery of real-world treatment (open-label treatments delivered in community settings by community practitioners), and real-world treatment assignment (including nonrandomized comparisons and variations on random assignment such as before-after or stepped-wedge designs). For any RWE study, decisions regarding each of these dimensions depends on the specific research question, characteristics of the potential study settings, and characteristics of the settings where study results would be applied.
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Affiliation(s)
| | - Richard Platt
- Harvard Pilgrim Health Care InstituteHarvard Medical School
| | | | | | - Alex John London
- Philosophy Department & Center for Ethics and PolicyCarnegie Mellon University
| | - Michael Horberg
- Kaiser Permanente Mid‐Atlantic Permanente Research InstituteMid‐Atlantic Permanente Medical Group
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