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Shallwani SM, Thomas R, Poitras S, Toupin-April K, Sheill G, King J. Canadian oncology physiotherapists' perspectives of physical activity in people with advanced cancer: a mixed-methods study. Physiother Theory Pract 2024; 40:1281-1299. [PMID: 36305676 DOI: 10.1080/09593985.2022.2138663] [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: 04/22/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Individuals with advanced cancer can benefit from physical activity (PA), but face barriers to PA participation. Physiotherapists can be well-positioned to support this patient population. OBJECTIVE Our objective was to describe the perspectives, practices, knowledge, and skills of oncology physiotherapists related to PA in people with advanced cancer. METHODS In this mixed-methods study, we recruited Canadian physiotherapists with current or recent clinical experience with advanced cancer. Phase I consisted of an online survey about views toward PA in advanced cancer and activity-related recommendations and concerns for two case scenarios. Phase II involved individual, semi-structured interviews about perspectives related to working with advanced cancer. RESULTS Sixty-two physiotherapists participated in the survey, of which 13 participated in interviews. Most respondents (> 85%) agreed or strongly agreed PA is important and safe for individuals with advanced cancer. Case responses highlighted cancer-related considerations (e.g. bone metastases) tailored activity recommendations, and patient-centered, interprofessional care. Interview themes included: 1) situating PA within individually meaningful goals; 2) tailored strategies to promote PA; 3) overarching roles in functional optimization and symptom management; and 4) generalized lack of awareness regarding physiotherapy. CONCLUSION Our findings indicate Canadian oncology physiotherapists describe knowledge of the safety and importance of PA, as well as key considerations in advanced cancer. Moreover, they highlight the importance of a patient-centered approach to support this population, particularly in facilitating safe and meaningful PA, as well as optimizing function and alleviating symptom burden. Further efforts are needed to investigate the development and integration of physiotherapy within cancer care.
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Affiliation(s)
- Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- McGill Lymphedema Research Program, McGill University Health Centre, Montreal, QC, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Institut du savoir Montfort, Ottawa, ON, Canada
| | - Grainne Sheill
- Department of Physiotherapy, Trinity College Dublin, University of Dublin, College Green, Ireland
- Department of Physiotherapy, Dublin Trinity Centre for Health Sciences, Dublin, Ireland
| | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
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Daniel IC, Siqueira MSM, Romaneli GU, Rocha Orsi JS, Werneck RI. Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review. Nutrients 2024; 16:1233. [PMID: 38674923 PMCID: PMC11053862 DOI: 10.3390/nu16081233] [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: 02/20/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.
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Affiliation(s)
| | | | | | | | - Renata Iani Werneck
- Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80242 980, Brazil; (I.C.D.); (G.U.R.); (J.S.R.O.)
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Shallwani SM, Thomas R, King J, Toupin-April K, Poitras S. Perspectives and experiences of leisure-time physical activity in adults with stage 4 cancer: a qualitative interpretive-description study. Disabil Rehabil 2024; 46:1515-1526. [PMID: 37067063 DOI: 10.1080/09638288.2023.2200037] [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: 06/06/2022] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Leisure-time physical activity (LTPA) can be beneficial for individuals with advanced cancer, but little is known on how to tailor rehabilitation strategies targeting LTPA in cancer care. Our objective was to explore perspectives and experiences of LTPA in people with stage 4 cancer. MATERIALS AND METHODS Guided by interpretive-description methodology, our qualitative study consisted of individual, semi-structured interviews with 20 Canadian adults diagnosed with stage 4 cancer. Interviews were transcribed verbatim and analyzed inductively. RESULTS The participants' median age was 51.5 (range, 35-73) years. Cancer types included breast (n = 12), lung (n = 4), and other (n = 4). Participants highlighted their experiences of LTPA as diverse and complex, impacted by individual and cancer-related factors. They emphasized being intentional with LTPA through activity planning and modification. LTPA participation was linked to physical well-being, social connections, and meanings of accomplishment and loss. Many participants desired personalized support related to LTPA, that is integrated, interprofessional, and accessible in cancer care. CONCLUSION The experiences of LTPA for people with stage 4 cancer are personal and connected to health and psychosocial meanings. Further efforts in rehabilitation are needed to address the challenges faced by people with advanced cancer and optimize safe, meaningful participation in LTPA.IMPLICATIONS FOR REHABILITATIONExperiences of leisure-time physical activity in individuals with stage 4 cancer are personal and linked to health benefits and psychosocial meanings.Activity participation frequently involves consideration of cancer-related symptoms, management of risks, and intentional planning and modification of activities.Trained rehabilitation professionals integrated in cancer care may be well suited to support people with stage 4 cancer through personalized activity recommendations.This research can help inform future clinical, research, and educational efforts in rehabilitation aimed at targeting physical activity in individuals with advanced cancer.
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Affiliation(s)
- Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Lymphedema Research Program, McGill University Health Centre, Montreal, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Institut du savoir Montfort, Ottawa, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
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Valdivia-Martínez M, Fernández-Gualda MÁ, Gallegos-García E, Postigo-Martin P, Fernández-González M, Ortiz-Comino L. Physiotherapy Interventions in Lung Cancer Patients: A Systematic Review. Cancers (Basel) 2024; 16:924. [PMID: 38473286 DOI: 10.3390/cancers16050924] [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: 02/09/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Lung cancer is a very common disease and leads to a series of sequelae such as reduced lung capacity or reduced functional capacity in patients, which are associated not only with the disease itself, but also with medical treatment. Thus, physiotherapeutic interventions are needed to improve quality of life and reduce these symptoms. OBJECTIVES To find out the effects of physiotherapy on functional capacity, lung capacity, dyspnea, pain, and quality of life in lung cancer patients. METHODS A systematic review was carried out in five databases. Randomized clinical trials published between 2019-2023 were selected, in which the physiotherapeutic treatment was physical exercise and/or respiratory physiotherapy. RESULTS Nine articles were included, in which the total sample consisted of 635 lung cancer patients. When combined, respiratory physiotherapy and physical exercise improved functional capacity and lung capacity (p < 0.05). Dyspnea also improved, but less significance was shown in the included studies. CONCLUSIONS Multimodal physiotherapy interventions may offer benefits for some lung cancer patients, but the extent and nature of these benefits may vary depending on the intervention applied. Therefore, it would be of great interest to carry out further scientific research to support this conclusion.
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Affiliation(s)
| | - Miguel Ángel Fernández-Gualda
- A02-Cuídate, Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Sports and Health Research Center (IMUDs), Parque Tecnológico de la Salud, 18007 Granada, Spain
- BIO277 Group, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
| | | | - Paula Postigo-Martin
- A02-Cuídate, Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Sports and Health Research Center (IMUDs), Parque Tecnológico de la Salud, 18007 Granada, Spain
- BIO277 Group, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- Faculty of Health Sciences Faculty (Melilla), University of Granada, 52005 Melilla, Spain
| | | | - Lucía Ortiz-Comino
- A02-Cuídate, Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Sports and Health Research Center (IMUDs), Parque Tecnológico de la Salud, 18007 Granada, Spain
- BIO277 Group, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- Faculty of Health Sciences Faculty (Melilla), University of Granada, 52005 Melilla, Spain
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Santero M, de Mas J, Rifà B, Clavero I, Rexach I, Bonfill Cosp X. Assessing the methodological strengths and limitations of the Spanish Society of Medical Oncology (SEOM) guidelines: a critical appraisal using AGREE II and AGREE-REX tool. Clin Transl Oncol 2024; 26:85-97. [PMID: 37368198 PMCID: PMC10761528 DOI: 10.1007/s12094-023-03219-0] [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: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The Spanish Society of Medical Oncology (SEOM) has provided open-access guidelines for cancer since 2014. However, no independent assessment of their quality has been conducted to date. This study aimed to critically evaluate the quality of SEOM guidelines on cancer treatment. METHODS Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE-REX tool was used to evaluate the qualities of the guidelines. RESULTS We assessed 33 guidelines, with 84.8% rated as "high quality". The highest median standardized scores (96.3) were observed in the domain "clarity of presentation", whereas "applicability" was distinctively low (31.4), with only one guideline scoring above 60%. SEOM guidelines did not include the views and preferences of the target population, nor did specify updating methods. CONCLUSIONS Although developed with acceptable methodological rigor, SEOM guidelines could be improved in the future, particularly in terms of clinical applicability and patient perspectives.
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Affiliation(s)
| | - Júlia de Mas
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Berta Rifà
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Inés Clavero
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Irene Rexach
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Xavier Bonfill Cosp
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Billings J, Zhan Yuen Wong N, Nicholls H, Burton P, Zosmer M, Albert I, Grey N, El-Leithy S, Murphy D, Tehrani N, Wheatley J, Bloomfield MAP, Greene T. Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance. Eur J Psychotraumatol 2023; 14:2281751. [PMID: 38032045 PMCID: PMC10990448 DOI: 10.1080/20008066.2023.2281751] [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: 05/02/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, UK
| | | | - Helen Nicholls
- Division of Psychiatry, University College London, London, UK
| | - Peter Burton
- Division of Psychiatry, University College London, London, UK
| | - Maya Zosmer
- Division of Psychiatry, University College London, London, UK
| | - Idit Albert
- King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nick Grey
- University of Sussex, Falmer, UK
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
| | | | - Dominic Murphy
- King’s College London, London, UK
- Combat Stress, London, UK
| | | | - Jon Wheatley
- Homerton Healthcare NHS Foundation Trust, London, UK
| | - Michael A. P. Bloomfield
- Division of Psychiatry, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
| | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, London, UK
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Wilson TN, Roquelaure Y, Evanoff B, Aublet-Cuvelier A, Porro B. Physical activity in people diagnosed with cancer: a rapid review of recommendations and critical appraisal of international guidelines. Support Care Cancer 2023; 31:679. [PMID: 37934319 DOI: 10.1007/s00520-023-08123-5] [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: 06/06/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE There are numerous guidelines that recommend physical activity (PA) in people diagnosed with cancer, but the quality of these guidelines is unknown. The aim of this study was to identify existing PA guidelines for cancer survivors, describe the recommendations, and assess their methodology quality. METHODS A rapid review of the literature was conducted in PubMed and EMBASE, supplemented by a search of the grey literature. The methodological quality of the guidelines was assessed using the AGREE II checklist. A descriptive synthesis of the recommendations from guidelines judged to be of good quality has been performed. RESULTS A total of nine guidelines published between 2006 and 2019 were included. Of nine guidelines, five achieved a high enough AGREE II score and were judged to be of good quality for use in clinical practice. We found that the recommendations from the five guidelines converged on the prescription of supervised PA (aerobic and resistance exercise) of at least 75 min per week of high intensity or 150 min per week of moderate intensity, spread over two to five sessions per week, equating to a PA dose between 8.70 and 17.5 MET.h/week. The recommendations were applicable to address the most common side effects of cancer and its treatment, namely fatigue, lymphedema, anxiety, depressive symptoms, health-related quality of life (QoL), survival, and physical function. However, no guideline recommends PA to improve other cancer-related outcomes, such as cognitive impairment, falls, sexual function, and peripheral neuropathy frequently experienced by cancer survivors. No guideline also referred to work outcomes (i.e., work ability, return to work, etc.). CONCLUSION Most PA guidelines for cancer survivors are of good quality. However, specific PA guidelines are needed for a given cancer site (e.g., location, stage), at a particular phase of the cancer trajectory, and for specific outcomes including return to work (RTW) in order to tailor PA to each cancer survivor.
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Affiliation(s)
- Têtê Norbert Wilson
- Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France.
- Grain de Sel Togo, Inc., Athens, USA.
| | - Yves Roquelaure
- Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France
| | - Bradley Evanoff
- Washington University in St. Louis, School of Medicine, St. Louis, USA
| | - Agnès Aublet-Cuvelier
- INRS (Institut National de Recherche et de Sécurité), Direction des Etudes et de la Recherche, 1 rue du Morvan, CS60027, 54519, Vandœuvre-lès-Nancy, France
| | - Bertrand Porro
- Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France
- Department of Human and Social Sciences, Institut de Cancérologie de l'Ouest (ICO), 49055, Angers, France
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Yu CW, Nanji K, Hatamnejad A, Gemae M, Joarder I, Achunair A, Devji T, Phillips M, Zeraatkar D, Steel DH, Guymer RH, Sivaprasad S, Wykoff CC, Chaudhary V. Patient-Reported Outcome Measure Use in Guidelines Published by the American Academy of Ophthalmology: A Review. Ophthalmology 2023; 130:1201-1211. [PMID: 37429499 DOI: 10.1016/j.ophtha.2023.07.001] [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: 04/23/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023] Open
Abstract
TOPIC We reviewed the use of patient-reported outcome measures (PROMs) in the treatment of ophthalmologic conditions as recommended by the Clinical Practice Guidelines (CPGs) published by the American Academy of Ophthalmology (AAO). CLINICAL RELEVANCE Patient-reported outcome measures are standardized instruments that provide information regarding a patient's health status or health-related quality of life. Patient-reported outcome measures are increasingly used to inform study end points in ophthalmology studies. However, the extent to which PROMs are ultimately informing patient management recommendations in ophthalmology as part of CPGs remains an area of evidence gap. METHODS We included all CPGs published by the AAO from inception to June 2022. We also included all primary studies and systematic reviews cited in the treatment sections of the CPGs evaluating treatment of an ophthalmic condition. The primary outcome was the frequency of PROMs discussed in CPGs and in cited studies evaluating treatment. Secondary outcomes included frequency of minimal important difference (MID) use to contextualize PROM results and percentage of strong and discretionary recommendations supported by PROMs. We published a study protocol a priori on PROSPERO (CRD42022307427). Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We assessed risk of bias using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. RESULTS We identified 24 eligible CPGs, providing 2458 cited studies (2191 primary, 267 secondary) evaluating treatment of eye conditions. Ten CPGs (41.7%) reported consideration of PROMs. Of these, 31 of 94 (33%) recommendations were informed by studies evaluating a PROM as an outcome. Across all studies cited in the development of CPGs, 221 (9.0%) used PROMs as a primary or secondary outcome, of which 4 PROM results (1.8%) were interpreted using an empirically determined MID. Overall, the risk of bias was low for all CPGs. CONCLUSIONS Overall, outcomes of PROMs are seldom used in ophthalmology CPGs published by the AAO and in cited primary and secondary research on treatments. When PROMs were considered, their interpretation was seldom based on an MID. To improve patient care, guideline developers may consider incorporating PROMs and applicable MIDs to inform key outcomes when formulating treatment recommendations. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Caberry W Yu
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Keean Nanji
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Amin Hatamnejad
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mohamed Gemae
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Ishraq Joarder
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Tahira Devji
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - David H Steel
- Bioscience Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom; Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, United Kingdom
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
| | - Charles C Wykoff
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Varun Chaudhary
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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Wang Q, Zhu R, Ning Y, Feng Y, Feng Y, Han S. Evaluation of the quality of guidelines for sublingual immunotherapy of allergic rhinitis. Eur Arch Otorhinolaryngol 2023; 280:4319-4325. [PMID: 37410146 DOI: 10.1007/s00405-023-08083-w] [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: 06/16/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Guidelines are intended to facilitate evidence-based clinical decision-making and knowledge translation; however, the quality and rigor of the guidelines are different. This study was conducted to assess the quality of sublingual immunotherapy guidelines for allergic rhinitis, in order to provide a reference for evidence-based clinical treatment and management of sublingual immunotherapy. METHODS Using both Chinese and English search methods, articles were obtained from PubMed, Cochrane, Web of Science, CNKI, CBM, WanFang Data, VIP, and other databases from the construction of the database to September 2020. The AGREE II instrument was used by two researchers to independently evaluate the quality of the extracted articles, and the consistency of the researchers was evaluated using the inter-group correlation coefficient. RESULTS Ten articles were included in this study, of which two articles ranked A level, six articles ranked B level, and two articles ranked C level. The six sections of AGREE II included scope and aim, clarity, participant, applicability, rigor, and editorial independence, with standardized scores of 78.06%, 45.83%, 42.81%, 77.50%, 50.42%, and 46.25%, respectively. CONCLUSION The quality of the current guidelines for sublingual immunotherapy is average. The formulation methodology and reporting standards of these guidelines must be developed. By standardizing the treatment of sublingual immunotherapy properly, it is recommended that guideline makers refer to the AGREE II to formulate high-quality guidelines and promote their wide application.
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Affiliation(s)
- Qian Wang
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Ruifang Zhu
- School of Nursing, Shanxi Medical University, Taiyuan, China
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yan Ning
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Yaoqing Feng
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Yan Feng
- School of Nursing, Shanxi Medical University, Taiyuan, China
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shifan Han
- School of Nursing, Shanxi Medical University, Taiyuan, China.
- First Hospital of Shanxi Medical University, Taiyuan, China.
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Gavriilidis P, Askari A, Gavriilidis E, Di Saverio S, Davies RJ, de’Angelis N. Evaluation of the current guidelines for the management of haemorrhoidal disease using the Appraisal of Guidelines Research and Evaluation II instrument. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:265. [PMID: 37082684 PMCID: PMC10113081 DOI: 10.21037/atm-22-4255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/09/2022] [Indexed: 02/18/2023]
Abstract
Background Haemorrhoids are a very common disease and many professional societies have produced guidelines for their treatment. The aim of this study is to appraise the quality of the existing guidelines in the management of haemorrhoids. Methods A systematic search of the literature was conducted in the EMBASE, Google Scholar, Cochrane library, and PubMed databases. The quality of guidelines was independently appraised using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument by five of the authors. Results Six guidelines of varying quality were identified and included in this study. The highest scoring guidelines were the SICCR (Società Italiana di Chirurgia Colorectale, which is Italian Society of Colorectal Surgery), ESCP (European Society of Coloproctology) and ASCRS (American Society of Colon and Rectal Surgeons) guidelines, scoring 86% each overall. There was considerable variability across not just the studies but across the different domains. The highest scoring domains were domain VI: editorial independence (median =95% across all studies) and domain I: Scope & Purpose (85%). The lowest scores were observed in domain V: Applicability (48%) and domain II: Stakeholder Involvement (41%). Only three of the six gained unanimous support for their use, whilst two of the guidelines were unanimously declared not suitable for clinical use. Conclusions With the notable exception of three guidelines (SICCR, ESCP and ASCRS), the general quality of haemorrhoid guidelines is poor. Stakeholder (especially patient) involvement and instructions on how to implement recommendations is lacking from the majority of guidelines. This is an area that requires urgent attention if we are to improve guidelines in haemorrhoid management.
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Affiliation(s)
- Paschalis Gavriilidis
- Department of Surgery, University Hospitals of Coventry and Warwickshire NHS, Coventry, UK
| | - Alan Askari
- Cambridge Oesophagogastric Centre, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Efstratios Gavriilidis
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Salomone Di Saverio
- Department of Surgery, San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy
| | - R. Justin Davies
- Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - Nicola de’Angelis
- Department of Digestive Surgery, University Hospital Henri Mondor (AP-HP), Créteil, France
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Zhou X, Yang Y, Li C, Gu S, Hou W, Lai X, Zhai L, Zhu Y. What information can we gain from the quality appraisal of guidelines with physical activity recommendations for cancer patients?A systematic review using the AGREE II and AGREE-REX tools. Support Care Cancer 2023; 31:97. [PMID: 36598576 PMCID: PMC9811039 DOI: 10.1007/s00520-022-07567-5] [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: 04/05/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE There has been growing amount of evidence supporting the benefits of physical activity (PA) on oncological patients' cancer-related health outcomes. Although guidelines on cancer rehabilitation are widely available, the varying quality and practical applicability limited the clinical application of PA recommendations. To assist the future development of guidelines, in this systematic review, we evaluated the quality and applicability of current cancer rehabilitation guidelines with PA recommendations and synthesized PA recommendations for the oncological population. METHODS A systematic search was conducted in PubMed, CINAHL, PEDro, EMBASE, and guideline repositories to identify guidelines with PA recommendations for cancer patients from 1 May 2016 to 1 June 2022. The quality of included guidelines was appraised using the tools "Appraisal of Guidelines for Research and Evaluation II" (AGREE II) and AGREE-REX (Recommendation Excellence). PA recommendations were synthesized from the guidelines. RESULTS Sixteen guidelines were extracted. The AGREE II domain "clarity of presentation" obtained the highest score, while "applicability" received the lowest, ranging from 33.33% to 98.58%. The AGREE-REX domains "values and preferences" and "implementability" generally scored lower and ranged from 45.83% to 74.17% and 55% to 88.33%, respectively. Eight high-quality guidelines were identified, and the included PA recommendations were extracted. CONCLUSION There were some disparities in the quality of the included guidelines. Methodological weaknesses were commonly observed in domains "applicability," "values and preferences," and "implementability"; particular attention should be given to these domains when developing future guidelines. Furthermore, this analysis indicated that more rigorous, high-quality studies are needed to generate evidence for supporting PA recommendations and provide guidance on research gaps in the field of cancer rehabilitation.
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Affiliation(s)
- Xue Zhou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Yujie Yang
- University of Health and Rehabilitation Sciences, Qingdao, 266000 Shandong China
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Shanshan Gu
- Department of Physical Therapy, University of Toronto, Toronto, Ontario Canada
| | - Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Xigui Lai
- Department of Kinesiology, Shanghai University of Sport, Shanghai, 200438 China
| | - Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
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12
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Tully L, Arthurs N, Wyse C, Browne S, Case L, McCrea L, O’Connell JM, O’Gorman CS, Smith SM, Walsh A, Ward F, O’Malley G. Guidelines for treating child and adolescent obesity: A systematic review. Front Nutr 2022; 9:902865. [PMID: 36313105 PMCID: PMC9597370 DOI: 10.3389/fnut.2022.902865] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is a chronic disease that compromises the physical and mental health of an increasing proportion of children globally. In high-income countries, prevalence of paediatric obesity is increasing faster in those from marginalised populations such as low-income households, suggesting the disease as one that is largely systemic. Appropriate treatment should be prioritised in these settings to prevent the development of complications and co-morbidities and manage those that already exist. An array of clinical practice guidelines are available for managing overweight and obesity in children and adolescents, but no systematic review has yet compared their quality or synthesised their recommendations. We aimed to narratively review clinical practice guidelines published in English for treating child and adolescent obesity, to identify the highest quality guidelines, and assess similarities, conflicts, and gaps in recommendations. We systematically searched academic databases and grey literature for guidelines published. We used the AGREE II tool to assess the quality, and identified nine high quality guidelines for inclusion in a narrative review of recommendations. Guidelines predominantly recommended the delivery of multi-component behaviour-change interventions aimed at improving nutrition and physical activity. Treatment outcomes were generally focussed on weight, with less emphasis on managing complications or improving quality-of-life. There was no evidence-based consensus on the best mode of delivery, setting, or treatment format. The guidelines rarely included recommendations for addressing the practical or social barriers to behaviour change, such as cooking skills or supervised physical activity. There is insufficient evidence to evaluate pharmaceutical and surgical interventions in children, and these were generally not recommended. It should be noted that this review addressed documents published in English only, and therefore the included guidelines were applicable predominantly to high-resource settings.
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Affiliation(s)
- Louise Tully
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Niamh Arthurs
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland,W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Cathy Wyse
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sarah Browne
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Lucinda Case
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Lois McCrea
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Jean M. O’Connell
- St. Columcille’s Hospital Weight Management Service, St.Vincent’s University Hospital, Dublin, Ireland
| | - Clodagh S. O’Gorman
- School of Medicine, University of Limerick, Limerick, Ireland,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - Susan M. Smith
- Discipline of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Aisling Walsh
- Department of Epidemiology, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Ward
- Department of Clinical Nutrition and Dietetics, Children’s Health Ireland at Crumlin, Dublin, Ireland
| | - Grace O’Malley
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland,W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland,*Correspondence: Grace O’Malley,
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13
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Usability, acceptability, and implementation strategies for the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm: a Delphi study. Support Care Cancer 2022; 30:7407-7418. [PMID: 35614154 DOI: 10.1007/s00520-022-07164-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Oncology guidelines recommend participation in cancer rehabilitation or exercise services (CR/ES) to optimize survivorship. Yet, connecting the right survivor, with the right CR/ES, at the right time remains a challenge. The Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm was developed to enhance CR/ES clinical decision-making and facilitate access to CR/ES. We used Delphi methodology to evaluate usability, acceptability, and determine pragmatic implementation priorities. METHODS Participants completed three online questionnaires including (1) simulated case vignettes, (2) 4-item acceptability questionnaire (0-5 pts), and (3) series of items to rank algorithm implementation priorities (potential users, platforms, strategies). To evaluate usability, we used Chi-squared test to compare frequency of accurate pre-exercise medical clearance and CR/ES triage recommendations for case vignettes when using EXCEEDS vs. without. We calculated mean acceptability and inter-rater agreement overall and in 4 domains. We used the Eisenhower Prioritization Method to evaluate implementation priorities. RESULTS Participants (N = 133) mostly represented the fields of rehabilitation (69%), oncology (25%), or exercise science (17%). When using EXCEEDS (vs. without), their recommendations were more likely to be guideline concordant for medical clearance (83.4% vs. 66.5%, X2 = 26.61, p < .0001) and CR/ES triage (60.9% vs. 51.1%, X2 = 73.79, p < .0001). Mean acceptability was M = 3.90 ± 0.47; inter-rater agreement was high for 3 of 4 domains. Implementation priorities include 1 potential user group, 2 platform types, and 9 implementation strategies. CONCLUSION This study demonstrates the EXCEEDS algorithm can be a pragmatic and acceptable clinical decision support tool for CR/ES recommendations. Future research is needed to evaluate algorithm usability and acceptability in real-world clinical pathways.
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Fraile Navarro D, López García-Franco A, Niño de Guzmán E, Rabassa M, Zamanillo Campos R, Pardo-Hernández H, Ricci-Cabello I, Canelo-Aybar C, Meneses-Echavez JF, Yepes-Nuñez JJ, Kuindersma J, Gich Saladich I, Alonso-Coello P. Vitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors. Int J Clin Pract 2021; 75:e14805. [PMID: 34486779 DOI: 10.1111/ijcp.14805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. METHODS We searched three databases and two guideline repositories from 2010 onwards. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, AGREE II domains' scores and pre-specified characteristics. RESULTS We included 34 guidelines, 44.1% recommended, 26.5% suggested and 29.4% did not recommend vitamin D supplementation. Guidelines that scored higher for "editorial independence" and "overall quality score" were less likely to recommend or suggest vitamin D supplementation (median 68.8 vs 35.4; P = .001 and 58.3 vs 37.5; P = .02). Guidance produced by government organisations and those that reported source of funding were associated with higher AGREE II scores. Unclear role of source of funding was associated with recommending or suggesting vitamin D supplementation (P = .034). Editorial independence was an independent predictor for recommending or suggesting vitamin D supplementation (OR 1.09; CI95% 1.02 to 1.16; P = .006). CONCLUSIONS Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
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Affiliation(s)
- David Fraile Navarro
- Health Centre Dr Mendiguchia Carriche, Servicio Madrileño de Salud, Leganes, Madrid, Spain
- Primary Care, Servicio Madrileño de Salud, Madrid, Spain
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Alberto López García-Franco
- Health Centre Dr Mendiguchia Carriche, Servicio Madrileño de Salud, Leganes, Madrid, Spain
- Primary Care, Servicio Madrileño de Salud, Madrid, Spain
| | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Montserrat Rabassa
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Rocío Zamanillo Campos
- Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain
- Department of Health, Valencian International University (VIU), Valencia, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Balearic Islands, Spain
| | - Héctor Pardo-Hernández
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Balearic Islands, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Jose F Meneses-Echavez
- Norwegian Institute of Public Health, Oslo, Norway
- Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia
| | - Juan José Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Jesse Kuindersma
- Biomedical Sciences, University of Groningen, Groningen, Netherlands
| | - Ignasi Gich Saladich
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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15
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Gyawali R, Toomey M, Stapleton F, Zangerl B, Dillon L, Ho KC, Keay L, Alkhawajah SMM, Liew G, Jalbert I. Systematic review of diabetic eye disease practice guidelines: more applicability, transparency and development rigor are needed. J Clin Epidemiol 2021; 140:56-68. [PMID: 34487836 DOI: 10.1016/j.jclinepi.2021.08.031] [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: 12/30/2020] [Revised: 06/09/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess the quality of diabetic eye disease clinical practice guidelines. STUDY DESIGN AND SETTING A systematic search of diabetic eye disease guidelines was conducted on six online databases and guideline repositories. Four reviewers independently rated quality using the Appraisal of Guidelines, Research, and Evaluation (AGREE II) instrument. Aggregate scores (%) for six domains and overall quality assessment were calculated. A "good quality" guideline was one with ≥60% score for "rigor of development" and in at least two other domains. RESULTS Eighteen guidelines met the inclusion criteria, of which 13 were evidence-based guidelines (involved systematic search and grading of evidence). The median scores (interquartile range (IQR)) for "scope and purpose," "stakeholder involvement," "rigor of development," "clarity of presentation," "applicability" and "editorial independence" were 73.6% (54.2%-80.6%), 48.6% (29.2%-71.5%), 60.2% (30.9%-78.1%), 86.6% (76.7%-94.4%), 28.6% (18.0%-37.8%) and 60.2% (30.9%-78.1%), respectively. The median overall score (out of 7) of all guidelines was 5.1 (IQR: 3.7-5.8). Evidence-based guidelines scored significantly higher compared to expert-consensus guidelines. Half (n = 9) of the guidelines (all evidence-based) were of "good quality." CONCLUSION A wide variation in methodological quality exists among diabetic eyecare guidelines, with nine demonstrating "good quality." Future iterations of guidelines could improve by appropriately engaging stakeholders, following a rigorous development process, including support for application in clinical practice and ensuring editorial transparency.
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Affiliation(s)
- Rajendra Gyawali
- School of Optometry and Vision Science, UNSW Sydney, Australia; Better Vision Foundation Nepal, Kathmandu, Nepal.
| | - Melinda Toomey
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Barbara Zangerl
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Lisa Dillon
- School of Optometry and Vision Science, UNSW Sydney, Australia; The George Institute for Global Health, Sydney, Australia
| | - Kam Chun Ho
- School of Optometry and Vision Science, UNSW Sydney, Australia; The George Institute for Global Health, Sydney, Australia; Singapore Eye Research Institute, Singapore
| | - Lisa Keay
- School of Optometry and Vision Science, UNSW Sydney, Australia; The George Institute for Global Health, Sydney, Australia
| | - Sally Marwan M Alkhawajah
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, King Saud University, Riyadh, Saudi Arabia
| | - Gerald Liew
- Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
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16
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Chan RJ, Nekhlyudov L, Duijts SFA, Hudson SV, Jones JM, Keogh J, Love B, Lustberg MB, Mehnert-Theuerkauf A, Nathan P, Ness KK, Sheppard VB, Smith K, Tevaarwerk A, Yu X, Feuerstein M. Future research in cancer survivorship. J Cancer Surviv 2021; 15:659-667. [PMID: 34460055 DOI: 10.1007/s11764-021-01102-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia.
| | | | - Saskia F A Duijts
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Brad Love
- Center for Health Communication, University of Texas, Austin, TX, USA
| | | | | | - Paul Nathan
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Kirsten K Ness
- FAPTA, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Vanessa B Sheppard
- School of Medicine and the Massey Cancer Center Office of Outreach Engagement and Health Disparities, Virginia Commonwealth University, Richmond, VA, USA
| | - Katherine Smith
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amye Tevaarwerk
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Xinhua Yu
- University of Memphis School of Public Health, Memphis, TN, USA
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17
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Fong AJ, Sabiston CM, Nadler MB, Sussman J, Langley H, Holden R, Stokes-Noonan M, Tomasone JR. Development of an evidence-informed recommendation guide to facilitate physical activity counseling between oncology care providers and patients in Canada. Transl Behav Med 2021; 11:930-940. [PMID: 33590874 DOI: 10.1093/tbm/ibaa127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Decision support aids help reduce decision conflict and are reported as acceptable by patients. Currently, an aid from the American College of Sports Medicine exists to help oncology care providers advise, assess, and refer patients to physical activity (PA). However, some limitations include the lack of specific resources and programs for referral, detailed PA, and physical function assessments and not being designed following an international gold standard (Appraisal of Guidelines for Research and Evaluation [AGREE] II). This study aimed to develop a recommendation guide to facilitate PA counseling by assessing the risk for PA-related adverse events and offering a referral to an appropriate recommendation. Recommendation guide development followed AGREE II, and an AGREE methodologist was consulted. Specifically, a stakeholder group of oncology care providers and cancer survivors were engaged to develop the assessment criteria for comorbidities, PA levels, and physical function. Assessment criteria were developed from published PA interventions, consultations with content experts, and targeted web-based searches for cancer-specific PA programs. Feedback on the recommendation guide was solicited from stakeholders and external reviewers with relevant knowledge and clinical experience. Independent AGREE methodologists appraised the development process. The recommendation guide is a five-page document, including a preamble, assessment criteria for absolute contraindications to PA, comorbidities, and PA/functional capacity with a list of appropriate resources. Independent AGREE methodologists rated the development process as strong and recommended the guide for use. The recommendation guide has the potential to facilitate PA counseling between oncology care providers and cancer survivors, thus, potentially impacting PA behavior.
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Affiliation(s)
- Angela J Fong
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Section of Behavioral Sciences, Rutgers Cancer Institute New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Michelle B Nadler
- Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre and University of Toronto, Toronto, ON, Canada
| | | | - Hugh Langley
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Rachel Holden
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | | | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Dijkers MP, Ward I, Annaswamy T, Dedrick D, Hoffecker L, Millis SR. What Determines the Quality of Rehabilitation Clinical Practice Guidelines?: An Overview Study. Am J Phys Med Rehabil 2021; 100:790-797. [PMID: 33214385 PMCID: PMC8265547 DOI: 10.1097/phm.0000000000001645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of the study was to determine what factors determine the quality of rehabilitation clinical practice guidelines. DESIGN Six databases were searched for articles that had applied the Appraisal of Guidelines for Research & Evaluation II quality assessment tool to rehabilitation clinical practice guidelines. The 573 deduplicated abstracts were independently screened by two authors, resulting in 81 articles, the full texts of which were independently screened by two authors for Appraisal of Guidelines for Research & Evaluation II application to rehabilitation clinical practice guidelines, resulting in a final selection of 40 reviews appraising 504 clinical practice guidelines. Data were extracted from these by one author and checked by a second. Data on each clinical practice guideline included the six Appraisal of Guidelines for Research & Evaluation II domain scores, as well as the two Appraisal of Guidelines for Research & Evaluation II global evaluations. RESULTS All six Appraisal of Guidelines for Research & Evaluation II domain scores were statistically significant predictors of overall clinical practice guideline quality rating; D3 (rigor of development) was the strongest and D1 (scope and purpose) the weakest (overall model P < 0.001, R2 = 0.53). Five of the six domain scores were significant predictors of the clinical practice guideline use recommendation, with D3 the strongest predictor and D5 (applicability) the weakest (overall model P < 0.001, pseudo R2 = 0.53). CONCLUSIONS Quality of rehabilitation clinical practice guidelines may be improved by addressing key domains such as rigor of development.
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Khorami AK, Oliveira CB, Maher CG, Bindels PJE, Machado GC, Pinto RZ, Koes BW, Chiarotto A. Recommendations for Diagnosis and Treatment of Lumbosacral Radicular Pain: A Systematic Review of Clinical Practice Guidelines. J Clin Med 2021; 10:jcm10112482. [PMID: 34205193 PMCID: PMC8200038 DOI: 10.3390/jcm10112482] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/29/2022] Open
Abstract
The management of patients with lumbosacral radicular pain (LRP) is of primary importance to healthcare professionals. This study aimed to: identify international clinical practice guidelines on LRP, assess their methodological quality, and summarize their diagnostic and therapeutic recommendations. A systematic search was performed (August 2019) in MEDLINE, PEDro, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence (NICE), New Zealand Guidelines Group (NZGG), International Guideline Library, Guideline central, and Google Scholar. Guidelines presenting recommendations on diagnosis and/or treatment of adult patients with LRP were included. Two independent reviewers selected eligible guidelines, evaluated quality with Appraisal of Guidelines Research & Evaluation (AGREE) II, and extracted recommendations. Recommendations were classified into 'should do', 'could do', 'do not do', or 'uncertain'; their consistency was labelled as 'consistent', 'common', or 'inconsistent'. Twenty-three guidelines of varying quality (AGREE II overall assessment ranging from 17% to 92%) were included. Consistent recommendations regarding diagnosis are ('should do'): Straight leg raise (SLR) test, crossed SLR test, mapping pain distribution, gait assessment, congruence of signs and symptoms. Routine use of imaging is consistently not recommended. The following therapeutic options are consistently recommended ('should do'): educational care, physical activity, discectomy under specific circumstances (e.g., failure of conservative treatment). Referral to a specialist is recommended when conservative therapy fails or when steppage gait is present. These recommendations provide a clear overview of the management options in patients with LRP.
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Affiliation(s)
- Ahmad Khoshal Khorami
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.K.K.); (P.J.E.B.); (B.W.K.)
| | - Crystian B. Oliveira
- Physical Therapy Department, Faculty of Medicine, University of Western São Paulo (UNOESTE), Presidente Prudente, Sao Paulo CEP 19060-900, Brazil;
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW 2050, Australia; (C.G.M.); (G.C.M.)
| | - Christopher G. Maher
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW 2050, Australia; (C.G.M.); (G.C.M.)
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Patrick J. E. Bindels
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.K.K.); (P.J.E.B.); (B.W.K.)
| | - Gustavo C. Machado
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW 2050, Australia; (C.G.M.); (G.C.M.)
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Rafael Z. Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30000-000, Brazil;
| | - Bart W. Koes
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.K.K.); (P.J.E.B.); (B.W.K.)
- Center for Muscle and Joint Health, University of Southern Denmark, 5230 Odense, Denmark
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.K.K.); (P.J.E.B.); (B.W.K.)
- Correspondence: ; Tel.: +31-1-0704-1038
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Almazrou SH, Alsubki LA, Alsaigh NA, Aldhubaib WH, Ghazwani SM. Assessing the Quality of Clinical Practice Guidelines in the Middle East and North Africa (MENA) Region: A Systematic Review. J Multidiscip Healthc 2021; 14:297-309. [PMID: 33603389 PMCID: PMC7881789 DOI: 10.2147/jmdh.s284689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/18/2020] [Indexed: 01/09/2023] Open
Abstract
Aim Clinical practice guidelines (CPGs) have progressively become a popular tool for making optimal clinical decisions. The literature shows that the poor quality of CPGs can form a barrier against adhering to them, resulting in a suboptimal level of healthcare. The objective of this systematic review is to evaluate the quality of CPGs in the Middle East and North Africa (MENA) region using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument. Methods The authors searched in the MEDLINE and EMBASE databases through the Ovid interface on May 25, 2019. Keywords relating to CPGs and MENA countries were combined using Boolean search operators. The search was not limited to specific diseases. The quality of guidelines was appraised by two reviewers independently using the AGREE II Instrument. Discrepancies within a group were resolved through the involvement of a principle investigator. Results A total of 61 CPGs were appraised. These guidelines were mainly from Saudi Arabia, and the most covered disease topic was cancer. Among the six domains of the AGREE II Instrument, CPGs scored the highest on clarity of presentation (mean 82%), while the lowest score was granted to the rigor of development domain (mean 28%). This indicates substantial deficiencies in reporting the developmental processes of CPGs and the resources used for the synthesis of evidence. Conclusion From this review, it was found that the number of retrieved guidelines published in the MENA region is limited considering the large geographical area of the MENA region. The main domains that have higher quality scores were clarity of presentation and scope and purpose, whereas domains with the lowest scores were rigor of development and applicability. The authors’ findings will help policymakers identify areas for improvement in CPGs, which can lead them to implement strategies such as the training of individuals and recruitment of international experts to ultimately develop high-quality CPGs.
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Affiliation(s)
- Saja H Almazrou
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Layan A Alsubki
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Norah A Alsaigh
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Wadha H Aldhubaib
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer. Palliat Support Care 2020; 19:615-630. [PMID: 33308368 DOI: 10.1017/s1478951520001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Despite improving survival rates, people with advanced cancer face several physical and psychosocial concerns. Leisure-time physical activity (LPA) has been found to be beneficial after cancer diagnosis, but little is known about the current state of research exploring LPA in advanced cancer. Our objectives were to (a) map the literature examining LPA in people with advanced cancer, (b) report on the terms used to describe the advanced cancer population within the literature, and (c) examine how the concept of LPA is operationalized within the literature. METHOD Our scoping review followed Arksey and O'Malley's methodological framework. We performed a search of 11 electronic databases and supplementary sources (February 2018; database search updated January 2020). Two reviewers independently reviewed and selected articles according to the inclusion criteria: English-language journal articles on original primary research studies exploring LPA in adults diagnosed with advanced cancer. Descriptive and thematic analyses were performed. RESULTS Ninety-two articles met our criteria. Most included studies were published in the last decade (80%) and used quantitative methods (77%). Many study populations included mixed (40%), breast (21%), or lung (17%) cancers. Stages 3-4 or metastatic disease were frequently indicated to describe study populations (77%). Several studies (68%) described LPA programs or interventions. Of these, 78% involved structured aerobic/resistance exercise, while 16% explored other LPA types. SIGNIFICANCE OF RESULTS This review demonstrates a recent surge in research exploring LPA in advanced cancer, particularly studies examining exercise interventions with traditional quantitative methods. There remains insufficient knowledge about patient experiences and perceptions toward LPA. Moreover, little is known about other leisure activities (e.g., Tai Chi, dance, and sports) for this population. To optimize the benefits of LPA in people with advanced cancer, research is needed to address the gaps in the current literature and to develop personalized, evidence-based supportive care strategies in cancer care.
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Dijkers MP, Ward I, Annaswamy T, Dedrick D, Feldpausch J, Moul A, Hoffecker L. Quality of Rehabilitation Clinical Practice Guidelines: An Overview Study of AGREE II Appraisals. Arch Phys Med Rehabil 2020; 101:1643-1655. [DOI: 10.1016/j.apmr.2020.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022]
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Paolucci T, Bernetti A, Bai AV, Segatori L, Monti M, Maggi G, Ippolitoni G, Tinelli L, Santilli V, Paoloni M, Agostini F, Mangone M. The sequelae of mastectomy and quadrantectomy with respect to the reaching movement in breast cancer survivors: evidence for an integrated rehabilitation protocol during oncological care. Support Care Cancer 2020; 29:899-908. [DOI: 10.1007/s00520-020-05567-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/05/2020] [Indexed: 01/05/2023]
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Hojan K, Procyk D, Horyńska-Kęstowicz D, Leporowska E, Litwiniuk M. The Preventive role of Regular Physical Training in Ventricular Remodeling, Serum Cardiac Markers, and Exercise Performance Changes in Breast Cancer in Women Undergoing Trastuzumab Therapy-An REH-HER Study. J Clin Med 2020; 9:jcm9051379. [PMID: 32392882 PMCID: PMC7291322 DOI: 10.3390/jcm9051379] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/03/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
Cardiotoxicity is known as a severe clinical problem in oncological practice that reduces the options for cancer therapy. Physical exercise is recognized as a well-established protective measure for many heart and cancer diseases. In our study, we hypothesized that supervised and moderate-intensity exercise training would prevent heart failure and its consequences induced by trastuzumab therapy. The aim of this study was to examine the effect of physical training on ventricular remodeling, serum cardiac markers, and exercise performance in women with human epidermal growth receptor 2 (HER2+) breast cancer (BC) undergoing trastuzumab therapy. This was a prospective, randomized, clinical controlled trial. Forty-six BC women were randomized into either an intervention group (IG) or a control group (CG). An exercise program (IG) was performed after 3–6 months of trastuzumab therapy at 5 d/week (to 80% maximum heart rate (HRmax)) for 9 weeks. We then evaluated their cardiac function using echocardiography, a 6-Minute Walk Test (6MWT), and plasma parameters (C-reactive protein (CRP), myoglobin (MYO), interleukin-6 (IL-6), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatine kinase (CK)). After the physical training program, we did not observe any significant changes in the left ventricular (LV) ejection fraction (LVEF) and 6MWT (p > 0.05) in the IG compared to the CG (decrease p < 0.05). The differences in the blood parameters were not significant (p < 0.05). To conclude, moderate-intensity exercise training prevented a decrease in the LVEF and physical capacity during trastuzumab therapy in HER2+ BC. Further research is needed to validate our results.
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Affiliation(s)
- Katarzyna Hojan
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
- Correspondence: ; Tel.: +48-601-509-967
| | - Danuta Procyk
- Central Labolatory, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (D.P.); (E.L.)
| | | | - Ewa Leporowska
- Central Labolatory, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (D.P.); (E.L.)
| | - Maria Litwiniuk
- Department of Chemotherapy, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
- Department of Oncologic Pathology and Prophylaxis, Poznan University of Medical Sciences, 61-866 Poznan, Poland
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Mascherini G, Ringressi MN, Castizo-Olier J, Badicu G, Irurtia A, Stefani L, Galanti G, Taddei A. Preliminary Results of an Exercise Program After Laparoscopic Resective Colorectal Cancer Surgery in Non-Metastatic Adenocarcinoma: A Pilot Study of a Randomized Control Trial. ACTA ACUST UNITED AC 2020; 56:medicina56020078. [PMID: 32075185 PMCID: PMC7073662 DOI: 10.3390/medicina56020078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 02/08/2023]
Abstract
Background and objectives: Performing physical exercise after a colorectal cancer diagnosis is associated with lower mortality related to the tumor itself. In order to improve physical recovery after elective surgery, there are no specific exercise protocols after discharge from the hospital. The purpose of this study is to show the preliminary results of an exercise program after colorectal cancer surgery. Materials and Methods: Six patients with non-metastatic colorectal adenocarcinoma addressed to respective laparoscopic were randomly assigned to a mixed supervised/home-based exercise program for six months and compared to a control group without exercise. To assess the effectiveness of the program, functional and body composition parameters were evaluated. Results: Three months after surgery, the exercise group increased flexibility (p <0.01, ES = 0.33), strength of lower limbs (p <0.01, ES = 0.42) and aerobic capacity (p <0.01, ES = 0.28). After surgery, the six patients experienced a significant reduction in body mass index (BMI) and free fat mass. More specifically, fat mass reached the lowest values, with a concomitant increase in cell mass after six months (p <0.01, ES = 0.33). This did not occur in the control group. Conclusions: Colorectal cancer treatment induces a reduction in physical function, particularly during the first six months after treatment. A mixed exercise approach appears promising in countering this process after colorectal cancer surgery.
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Affiliation(s)
- Gabriele Mascherini
- Sport and Exercise Medicine Unit, Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50134 Firenze, Italy; (G.M.); (L.S.); (G.G.)
| | - Maria Novella Ringressi
- Multidisciplinary Oncology Group, Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50134 Firenze, Italy; (M.N.R.); (A.T.)
| | - Jorge Castizo-Olier
- Tecno Campus Mataró-Maresme, EscuelaSuperior de Ciencias de la Salud, 08302 Mataró, Barcelona, Spain
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Brasov, 500068 Brasov, Romania
- Correspondence: ; Tel.: +40-769-219-271
| | - Alfredo Irurtia
- Departament de la Presidència, InstitutNacional d’EducacióFísica de Catalunya (INEFC), 08038 Barcelona, Spain;
| | - Laura Stefani
- Sport and Exercise Medicine Unit, Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50134 Firenze, Italy; (G.M.); (L.S.); (G.G.)
| | - Giorgio Galanti
- Sport and Exercise Medicine Unit, Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50134 Firenze, Italy; (G.M.); (L.S.); (G.G.)
| | - Antonio Taddei
- Multidisciplinary Oncology Group, Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50134 Firenze, Italy; (M.N.R.); (A.T.)
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Abdur Rahman M, Rashid MM, Le Kernec J, Philippe B, Barnes SJ, Fioranelli F, Yang S, Romain O, Abbasi QH, Loukas G, Imran M. A Secure Occupational Therapy Framework for Monitoring Cancer Patients' Quality of Life. SENSORS (BASEL, SWITZERLAND) 2019; 19:E5258. [PMID: 31795384 PMCID: PMC6928807 DOI: 10.3390/s19235258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 02/02/2023]
Abstract
Once diagnosed with cancer, a patient goes through a series of diagnosis and tests, which are referred to as "after cancer treatment". Due to the nature of the treatment and side effects, maintaining quality of life (QoL) in the home environment is a challenging task. Sometimes, a cancer patient's situation changes abruptly as the functionality of certain organs deteriorates, which affects their QoL. One way of knowing the physiological functional status of a cancer patient is to design an occupational therapy. In this paper, we propose a blockchain and off-chain-based framework, which will allow multiple medical and ambient intelligent Internet of Things sensors to capture the QoL information from one's home environment and securely share it with their community of interest. Using our proposed framework, both transactional records and multimedia big data can be shared with an oncologist or palliative care unit for real-time decision support. We have also developed blockchain-based data analytics, which will allow a clinician to visualize the immutable history of the patient's data available from an in-home secure monitoring system for a better understanding of a patient's current or historical states. Finally, we will present our current implementation status, which provides significant encouragement for further development.
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Affiliation(s)
- Md. Abdur Rahman
- Department of Cyber Security and Forensic Computing, College of Computer and Cyber Sciences (C3S), University of Prince Mugrin, Madinah 41499, Saudi Arabia
| | - Md. Mamunur Rashid
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Julien Le Kernec
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
- School of Information and Communication, University of Electronic, Science, and Technology of China, Chengdu 610000, China
| | - Bruno Philippe
- Pneumology Department, René Dubos Hospital, 95300 Pontoise, France;
| | - Stuart J. Barnes
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Francesco Fioranelli
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Shufan Yang
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Olivier Romain
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
| | - Qammer H. Abbasi
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - George Loukas
- Computing and Mathematical Sciences, University of Greenwich, London SE1 09LS, UK;
| | - Muhammad Imran
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
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