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Fakhri F, Mohammadi M, Eybpoosh S, Ahmadi S, Solaymani-Dodaran M. Iran's research prioritization: Are we meeting the goals? A study based on clinical trial registry data. PLoS One 2024; 19:e0301414. [PMID: 38578773 PMCID: PMC10997107 DOI: 10.1371/journal.pone.0301414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/23/2024] [Indexed: 04/07/2024] Open
Abstract
The prioritization of research topics in the health domain is a critical step toward channelling efforts and resources into areas that have received less attention. The objective of this study is to evaluate the implementation of research priorities determined at the national level within Iran for the period spanning five years between 2009 and 2013. We extracted the required data from the Iranian Registry of Clinical Trials (IRCT) website. Then we conducted a matching process between the titles of trials registered in the IRCT until December 3rd, 2013, and the list of national health research priorities in the domains of communicable and non-communicable diseases. The latter was compiled and regulated by the Research and Technology Deputy of the Ministry of Health since 2008. Out of the total 5,049 clinical trials registered in IRCT, 92.3% were carried out within the domain of non-communicable diseases, while 6.1% pertained to the field of communicable diseases and the remaining 1.3% in other fields. 56.4% of the clinical trials conducted in the field of communicable diseases and 32.8% of those conducted in the field of non-communicable diseases were consistent with the research priorities determined in these two fields. During the five-year period of the prioritization goal, there was no significant improvement in adherence to the list of priorities compared to the previous five-year period. Furthermore, certain priorities were neglected within both areas during these periods. It is possible to evaluate the effectiveness of research prioritization using the data obtained from the registration centers of clinical trials. Our study has revealed that the list of priorities has not garnered adequate attention from the research community within the country. Hence, remedial measures are imperative to ensure the priorities are given more attention after publication.
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Affiliation(s)
- Farshid Fakhri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohammadi
- Department of Cell and Molecular Biology, School of Advanced Sciences, Medical Branch, Islamic Azad University, Tehran, Iran
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Sharareh Ahmadi
- Student Research Committee, Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Solaymani-Dodaran
- Minimally Invasive Surgery Research Center, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
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Bjørneboe J, Bratsberg A, Brox JI, Skatteboe S, Wilhelmsen M, Samuelsen KM, Marchand GH, Flørenes T, Kielland MG, Røe C. Symptom burden and follow-up of patients with neck and back complaints in specialized outpatient care: a national register study. Sci Rep 2024; 14:3855. [PMID: 38361115 PMCID: PMC10869734 DOI: 10.1038/s41598-024-53879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
Back and neck pain are common in the population, especially among immigrants. In Norway's specialist care system, treating these patients typically involves a multidisciplinary approach based on the biopsychosocial model. However, language and cultural differences may create barriers to participation. Immigrants are often underrepresented in clinical studies, but a register-based approach can enhance their participation in research. This study aimed to compare both the symptom burden, and treatment, among Norwegians, non-Norwegians, and patients requiring translator service for back and neck pain within the Norwegian specialist care system. The Norwegian neck and back registry is a National Quality Register, established in 2012 and fully digitized in late 2020. The baseline data includes demographics and patient recorded outcome measures including Oswestry Disability Index, Fear-Avoidance Beliefs, pain rating on a numeric rating scale, Hopkins Symptom Checklist and EuroQol five-dimensional questionnaire on health related quality of life. During the two-year study period, a total of 14,124 patients were invited, and 10,060 (71%) participated. Norwegian patients reported less pain, better function assessed by Oswestry Disability Index, lower fear avoidance beliefs, less emotional distress, and higher health related quality of life compared to non-Norwegians. We found that patients with female gender, who were younger, more educated and exhibited fear-avoidance behavior were significantly more likely to receive multidisciplinary treatment. We found no difference in the proportion of Norwegian and non-Norwegian patients receiving multidisciplinary treatment [odds ratio (OR) 1.02 (95% confidence interval (CI) 0.90-1.16)]. However, patients needing a translator were less likely to receive multidisciplinary treatment compared to those who didn't require translation [OR 0.41 (95% CI (0.25-0.66)]. We found that non-Norwegian patients experience a higher symptom burden compared to Norwegian. We found that both non-Norwegians and patient in need of translator were to a greater extent recommended treatment in primary health care. The proportion of non-Norwegians patients receiving multidisciplinary treatment was similar to Norwegians, but those needing a translator were less likely to receive such treatment.
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Affiliation(s)
- John Bjørneboe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
| | - Andrea Bratsberg
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Jens Ivar Brox
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Medical Faculty, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Sigrid Skatteboe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Maja Wilhelmsen
- Department of Physical Medicine and Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Norwegian Neck and Back Registry, UNN Tromsø, Tromsø, Norway
| | - Kjetil Magne Samuelsen
- Department of Physical Medicine and Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Norwegian Neck and Back Registry, UNN Tromsø, Tromsø, Norway
| | - Gunn Hege Marchand
- Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tonje Flørenes
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Maja Garnaas Kielland
- Department of Health Care Coordination, Health Literacy and Health Equity, Oslo University Hospital, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Medical Faculty, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
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Karki P, Shahi PV, Sapkota KP, Bhandari R, Adhikari N, Shrestha B. Depressive symptoms and associated factors among persons with physical disabilities in disability care homes of Kathmandu district, Nepal: A mixed method study. PLOS Glob Public Health 2023; 3:e0001461. [PMID: 36962869 PMCID: PMC10021957 DOI: 10.1371/journal.pgph.0001461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 12/12/2022] [Indexed: 01/15/2023]
Abstract
Depression is one of the most common mental disorders, affecting 300 million people worldwide and 75% of these occur in low- and middle-income countries. Persons with physical disabilities are vulnerable groups and are more prone to experience depressive symptoms than the general population. This study investigated the prevalence of depressive symptoms and the associated factors among persons with a physical disability. We conducted a concurrent triangulation mixed methods design using Beck's Depression Inventory scale among 162 persons with physical disabilities in the Kathmandu district. In parallel, eight in-depth interviews were conducted with an interview guideline to collect the participants' perceptions and experiences of disability. Both quantitative and qualitative findings were integrated into the results. We found that about 77% of the participants with a physical disability had experienced depressive symptoms. Unemployment status (adjusted odds ratio (AOR) 2.7, 95% confidence interval (CI) 1.0-7.3) and comorbidity (AOR 2.5, 95% CI 1.0-6.0) had a statistically significant association with depressive symptoms. The majority of people with physical disabilities had negative experiences with societal prejudice and coping with their limitations. They were depressed as well as angry over having to stop their careers, education, and possibilities. Nevertheless, they were significantly happier and less sad than in their earlier years of life because of the possibilities, family environment, improved means of subsistence, therapeutic facilities, and supportive atmosphere at disability care homes. The policymakers should focus on preventing comorbidity and providing technical skills to persons with physical disabilities to improve their employment status and promote a healthy lifestyle.
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Affiliation(s)
- Prabin Karki
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Prasant Vikram Shahi
- Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Rabindra Bhandari
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Nabin Adhikari
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Department of Research and Development Division, Dhulikhel Hospital, Dhulikhel, Kavrepalanchowk, Nepal
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Zhao W, Wang L, Zhang L. How does academia respond to the burden of infectious and parasitic disease? Health Res Policy Syst 2022; 20:89. [PMID: 35964031 PMCID: PMC9375096 DOI: 10.1186/s12961-022-00889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 07/21/2022] [Indexed: 11/12/2022] Open
Abstract
Background Academic research is one of the main avenues through which humans can fight the threat of infectious diseases. However, there have been concerns regarding whether the academic system has provided sufficient efforts to fight infectious diseases we potentially face. Answering these questions could contribute to evidence-based recommendations for setting research priorities and third-mission policies. Methods With a focus on one of the most common categories of communicable diseases, infectious and parasitic diseases (IPDs), we searched Web of Science for articles and reviews relevant to IPDs published during the period 2000–2019 and retrieved WHO data on disease burden in corresponding years. The academic response patterns were explored by IPD subcategory and by human development level (an index established by the United Nations). We conduct the analysis in particular to gain insight into the dynamic relationship between disease burden and research effort on IPDs, scientific efforts contributed by countries with different development levels, and the variation trends in international joint efforts. Results The greatest burden of IPDs is clustered in the developing regions of Africa, but has received academic response from both developed and developing countries. Highly developed countries dominate the ranks of academic research in this area, yet there is also a clear increase in research efforts from the countries most affected, despite their low human development scale. In fact, the overall analysis reveals an improved capability for addressing local problems from African regions. In terms of international collaboration, highly developed countries such as the United States and United Kingdom have commonly collaborated with needy regions, whereas prolific but developing nations, like China, have not. Conclusions From a global perspective, academia has positively responded to health needs caused by IPDs. Although the relevant research output contribution is primarily from the highly developed countries, concentrated and specialized efforts from the undeveloped regions to ease their local burden can be clearly observed. Our findings also indicate a tendency to focus more on local health needs for both developed and undeveloped regions. The insights revealed in this study should benefit a more informed and systemic plan of research priorities.
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Affiliation(s)
- Wenjing Zhao
- School of Information Management, Wuhan University, Wuhan, China.,Center for Science, Technology & Education Assessment (CSTEA), Wuhan University, Wuhan, China
| | - Lili Wang
- UNU-MERIT, Maastricht University, Maastricht, The Netherlands
| | - Lin Zhang
- School of Information Management, Wuhan University, Wuhan, China. .,Center for Science, Technology & Education Assessment (CSTEA), Wuhan University, Wuhan, China. .,Centre for R&D Monitoring (ECOOM) and Department of MSI, KU Leuven, Leuven, Belgium.
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Merriman R, Galizia I, Tanaka S, Sheffel A, Buse K, Hawkes S. The gender and geography of publishing: a review of sex/gender reporting and author representation in leading general medical and global health journals. BMJ Glob Health 2021; 6:bmjgh-2021-005672. [PMID: 33986001 PMCID: PMC8118011 DOI: 10.1136/bmjgh-2021-005672] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction Diverse gender and geographical representation matters in research. We aimed to review medical and global health journals’ sex/gender reporting, and the gender and geography of authorship. Methods 542 research and non-research articles from 14 selected journals were reviewed using a retrospective survey design. Paper screening and systematic data extraction was conducted with descriptive statistics and regression analyses calculated from the coded data. Outcome measures were journal characteristics, the extent to which published articles met sex/gender reporting guidelines, plus author gender and location of their affiliated institution. Results Five of the fourteen journals explicitly encourage sex/gender analysis in their author instructions, but this did not lead to increased sex/gender reporting beyond the gender of study participants (OR=3.69; p=0.000 (CI 1.79 to 7.60)). Just over half of research articles presented some level of sex/gender analysis, while 40% mentioned sex/gender in their discussion. Articles with women first and last authors were 2.4 times more likely to discuss sex/gender than articles with men in those positions (p=0.035 (CI 1.062 to 5.348)). First and last authors from high-income countries (HICs) were 19 times as prevalent as authors from low-income countries; and women from low-income and middle-income countries were at a disadvantage in terms of the impact factor of the journals they published in. Conclusion Global health and medical research fails to consistently apply a sex/gender lens and remains largely the preserve of authors in HIC. Collaborative partnerships and funding support are needed to promote gender-sensitive research and dismantle historical power dynamics in authorship.
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Affiliation(s)
| | - Ilaria Galizia
- Global Health 50/50, London, UK.,C&H Mental Health Medical Adult, East London NHS Foundation Trust, London, UK
| | | | - Ashley Sheffel
- Global Health 50/50, London, UK.,Department of International Health, Johns Hopkins Bloomberg School of Public Health Center for Teaching and Learning, Baltimore, Maryland, USA
| | - Kent Buse
- Global Health 50/50, London, UK.,Director, Healthier Societies Program, the George Institute for Global Health, Newtown, New South Wales, Australia
| | - Sarah Hawkes
- Global Health 50/50, London, UK .,Institute for Global Health, University College London, London, UK
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Ferrand Devouge E, Biard M, Beuzeboc J, Tavolacci MP, Schuers M. Motivations and willingness of general practitioners in France to participate in primary care research as investigators. Fam Pract 2019; 36:552-559. [PMID: 30605509 DOI: 10.1093/fampra/cmy126] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinical research is mostly conducted among hospitalized patients, which restricts the generalizability of research results. The involvement of GPs in research has been consistently highlighted as a factor associated with successful study recruitment. OBJECTIVES To assess GPs' motivations and willingness to participate in primary care research as investigators and to identify factors associated with their willingness. METHODS We conducted an observational, cross-sectional study in Normandy, France, with a self-questionnaire sent to 3002 GPs. We collected data on GPs' socio-demographic characteristics, their experiences and their expectations regarding research, and their reasons for non-participation. RESULTS Overall, 489 questionnaires were collected. Two hundred and forty-six GPs (50.3%) were interested in participating in clinical research as investigators. The two main conditions for participation as investigators were the relevance of the study topic for clinical practice (80.5%) and the feedback of study results (80.1%). The two main reasons for non-participation were lack of time (79.4%) and administrative burden (43.6%). Age between 27 and 34 years (adjusted odds ratio [AOR] = 2.86, P = 0.004) and GP trainer status (AOR = 2.41, P < 0.001) were associated with willingness to participate in primary care research. Age between 60 and 70 years (AOR = 0.53, P = 0.03) and locum status (AOR = 0.40, P = 0.04) were associated with non-participation in research. CONCLUSIONS Based on our results, we were able to establish a profile of GPs willing to participate in primary care research as investigators. GPs' involvement should be based on their preferred areas of research. Different incentives such as a dedicated clinical research nurse or financial support could also be considered.
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Affiliation(s)
- Eglantine Ferrand Devouge
- Department of General Practice, University of Rouen, Rouen, France.,INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France
| | - Morgane Biard
- Department of General Practice, University of Rouen, Rouen, France.,INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France
| | - Jean Beuzeboc
- Department of General Practice, University of Rouen, Rouen, France
| | - Marie-Pierre Tavolacci
- INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France.,INSERM U 1073, Normandy University, Rouen, France
| | - Matthieu Schuers
- Department of General Practice, University of Rouen, Rouen, France.,Department of Medical Informatics, Rouen University Hospital, Rouen, France.,INSERM U 1142, LIMICS, Paris, France
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Ray S, Al Mamun Choudhury A, Biswas S, Bhutta ZA, Nundy S. The research output from medical institutions in South Asia between 2012 and 2017: An analysis of their quantity and quality. ACTA ACUST UNITED AC 2019; 9:129-37. [DOI: 10.1016/j.cmrp.2019.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Keating EM, Haq H, Rees CA, Dearden KA, Luboga SA, Schutze GE, Kazembe PN. Global Disparities Between Pediatric Publications and Disease Burden From 2006 to 2015. Glob Pediatr Health 2019; 6:2333794X19831298. [PMID: 30828594 PMCID: PMC6390220 DOI: 10.1177/2333794x19831298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 12/10/2018] [Accepted: 12/18/2019] [Indexed: 11/17/2022] Open
Abstract
There is a disproportionate burden of pediatric disease in low- and middle-income countries (LMICs); however, the proportion and relation of published articles to childhood disease burden in LMICs have not been assessed previously. This study aimed to determine whether published articles and disease topics from research conducted in LMICs in the most widely cited pediatric journals reflected the global burden of childhood disease. We reviewed all articles published from 2006 to 2015 in the 3 pediatric journals with the highest Eigenfactor scores to identify studies conducted in the World Bank-designated LMICs. We abstracted study topic, design, purpose, country, and funding sources. We derived descriptive statistics, Fisher's exact χ2 test, Monte Carlo estimates, and Spearman's rank order coefficients. Of the 19 676 articles reviewed, 10 494 were original research articles. Of those, 965 (9.2%) were conducted in LMICs. Over the study period, the proportion of published articles originating from LMICs increased (r 2 = 0.77). Disease topics did not reflect the underlying burden of disease as measured in disability-adjusted life years (Spearman's rank order coefficient = 0.25). Despite bearing the majority of the world's burden of disease, articles from LMICs made up a small proportion of all published articles in the 3 pediatric journals with the highest Eigenfactor scores. The number of published articles from LMICs increased over the study period; nevertheless, the topics did not coincide with the burden of disease in LMICs. These discrepancies highlight the need for development of a research agenda to address the diseases that are the greatest threat to the majority of children worldwide.
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Affiliation(s)
| | - Heather Haq
- Baylor College of Medicine, Houston, TX,
USA
| | | | | | | | | | - Peter N. Kazembe
- Baylor College of Medicine, Houston, TX,
USA
- Baylor College of Medicine Children’s
Foundation Malawi, Lilongwe, Malawi
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9
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Mashari A, Wasowicz M. The gas has the last laugh. Can J Anaesth 2018; 65:148-151. [DOI: 10.1007/s12630-017-1014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022] Open
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Atal I, Trinquart L, Ravaud P, Porcher R. A mapping of 115,000 randomized trials revealed a mismatch between research effort and health needs in non-high-income regions. J Clin Epidemiol 2018; 98:123-132. [PMID: 29360559 DOI: 10.1016/j.jclinepi.2018.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/18/2017] [Accepted: 01/15/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Concerns exist as to whether the allocation of resources in clinical research is aligned with public health needs. We evaluated the alignment between the effort of clinical research through the conduct of randomized controlled trials (RCTs) and health needs measured as the burden of diseases for all regions and a broad range of diseases. METHODS We grouped countries into seven regions and diseases into 27 groups. We mapped all RCTs initiated between 2006 and 2015 that were registered at the WHO International Clinical Trials Registry Platform to regions and diseases. The burden of diseases in 2005 was mapped as disability-adjusted life years (DALYs), based on the 2010 Global Burden of Diseases study. Within regions, we defined a research gap when the proportion of RCTs concerning a disease in the region was less than half the relative burden of the disease. RESULTS We mapped 117,180 RCTs planning to enroll 42.6 million patients and 2,220 million DALYs. In high- versus non-high-income countries, 130.9 versus 6.9 RCTs per million DALYs were conducted. We did not identify any research gap in high-income countries. We identified research gaps for all other regions. In particular, for Sub-Saharan Africa, we identified research gaps for common infectious diseases (CID) and neonatal disorders (ND): 5.8% (95% uncertainty interval 4.7-6.9) and 2.0% (0.9-4.5) of RCTs in Sub-Saharan Africa concerned CID and ND, although these diseases represented 22.9% and 11.6% of the burden in the region, respectively. For South Asia, we identified research gaps for the same two groups of diseases. CONCLUSIONS In non-high-income regions, the conduct of RCTs was misaligned with the distribution of major causes of burden, in particular infectious diseases and neonatal disorders in Sub-Saharan Africa and South Asia.
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Affiliation(s)
- Ignacio Atal
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; Team METHODS, INSERM U1153, Paris, France; Faculté de Médecine, Université Paris Descartes, Paris, France.
| | - Ludovic Trinquart
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; Team METHODS, INSERM U1153, Paris, France; Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA; School of Public Health, Boston University, MA, USA
| | - Philippe Ravaud
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; Team METHODS, INSERM U1153, Paris, France; Faculté de Médecine, Université Paris Descartes, Paris, France; Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Raphaël Porcher
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; Team METHODS, INSERM U1153, Paris, France; Faculté de Médecine, Université Paris Descartes, Paris, France
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Affiliation(s)
- Tania M Winzenberg
- Menzies Institute for Medical Research and Faculty of Health, University of Tasmania, Hobart, TAS
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12
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Okhovati M, Zare M, Bazrafshan A. Variations in Ischemic Heart Disease Research by Country, Income, Development and Burden of Disease: A Scientometric Approach. J Cardiovasc Thorac Res 2015; 7:164-7. [PMID: 26702346 PMCID: PMC4685283 DOI: 10.15171/jcvtr.2015.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/22/2015] [Indexed: 12/30/2022] Open
Abstract
Introduction: Ischemic heart diseases (IHDs) are the leading cause of mortality worldwide. However the global burden of IHD has been concentrated on developing countries, where limited research efforts have been made to address these needs. This study aimed to understand the global distribution of IHD research activities by looking at the countries’ burden of disease, income and development data.
Methods: As a scientometric study, Scopus database was searched for research publications indexed under the medical subject heading (MeSH) ‘myocardial ischemia’ including the following terms: coronary artery disease, coronary heart disease, and ischemic heart disease. The number of research publications in Scopus database was recorded for each individual year 2000-2012, and for each country. Data for estimated IHD disability-adjusted life-year’s (DALY’s), gross domestic product (GDP) per capita and human development index were also included for the analysis.
Results: IHD research publications were most likely produced by European and Western pacific countries. High-income countries produced the greatest share of about 81% of the global IHD research. However, no significant association observed between the countries’ GDP and number of research publications worldwide (OR = 0.98, P = 0.939). Global IHD research found to be strongly associated with the burden of disease (P < 0.0001) and the countries’ HDI values worldwide (OR = 16.8, P = 0.016).
Conclusion: Our study suggested that global research on IHD were geographically distributed and highly concentrated among the world’s richest countries. Estimated DALYs and HDI were found as important predictors of IHD research and the key drivers of health research disparities across the world.
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Affiliation(s)
- Maryam Okhovati
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Morteza Zare
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Azam Bazrafshan
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Verbeek T, Arjadi R, Vendrik JJ, Burger H, Berger MY. Anxiety and depression during pregnancy in Central America: a cross-sectional study among pregnant women in the developing country Nicaragua. BMC Psychiatry 2015; 15:292. [PMID: 26576551 PMCID: PMC4650953 DOI: 10.1186/s12888-015-0671-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 11/03/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Around the world, maternal psychopathology during pregnancy is associated with a range of negative consequences for mother and child. Nevertheless, in Central America the magnitude of this public health problem is still unknown. The objective of this first explorative study was to investigate the prevalence and severity of anxiety and depression during pregnancy in the Central American developing country Nicaragua, as well as the availability of mental health care and to compare with a developed country. METHODS A population-based cohort of pregnant women in Nicaragua (N = 98) was compared with a parallel cohort in the Netherlands (N = 4725) on symptoms of anxiety (Spielberger State Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale). Associations with the women's knowledge how to reach professional psychological support were assessed using multivariable linear regression analyses. RESULTS Of the Nicaraguan women, 41 % had symptoms of anxiety and 57 % symptoms of depression, versus 15 % and 6 % of the Dutch women. Symptom scores of both anxiety and depression were significantly higher in Nicaragua (p < 0.001). However, only 9.6 % of the women indicated that professional psychological help was available for the Nicaraguan pregnant women, which was associated with an increased anxiety score. CONCLUSIONS In Nicaragua, both prevalence and severity of symptoms of antenatal anxiety and depression are substantially higher than in developed countries. However, availability of psychological help is very limited for pregnant Nicaraguan women. These findings indicate that there is need for further research and support for these women, to prevent negative consequences for both mother and child.
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Affiliation(s)
- T. Verbeek
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, HPC FA40, Postbus 30.001, 9700 RB Groningen, The Netherlands ,Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R. Arjadi
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - J. J. Vendrik
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H. Burger
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M. Y. Berger
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Emdin CA, Odutayo A, Hsiao AJ, Shakir M, Hopewell S, Rahimi K, Altman DG. Association between randomised trial evidence and global burden of disease: cross sectional study (Epidemiological Study of Randomized Trials--ESORT). BMJ 2015; 350:h117. [PMID: 25630558 PMCID: PMC4309646 DOI: 10.1136/bmj.h117] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine whether an association exists between the number of published randomised controlled trials and the global burden of disease, whether certain diseases are under-investigated relative to their burden, and whether the relation between the output of randomised trials and global burden of disease can be explained by the relative disease burden in high and low income regions. DESIGN Cross sectional investigation. STUDY SAMPLE All primary reports of randomised trials published in December 2012 and indexed in PubMed by 17 November 2013. MAIN OUTCOME MEASURES Number of trials conducted and number of participants randomised for each of 239 different diseases or injuries; variation in each outcome explainable by total disability adjusted life years (a measure of the overall burden of each disease) and the ratio of disability adjusted life years in low income to high income regions (a measure of whether a disease is more likely to affect people living in high income regions) quantified using multivariable regression. RESULTS 4190 abstracts were reviewed and 1351 primary randomised trials identified, of which 1097 could be classified using the global burden of disease taxonomy. Total disability adjusted life years was poorly associated with number of randomised trials and number of participants randomised in univariable analysis (Spearman's r=0.35 and 0.33, respectively), although it was a significant predictor in the univariable and multivariable models (P<0.001). Diseases for which the burden was predominantly located in low income regions had sevenfold fewer trials per million disability adjusted life years than diseases predominantly located in high income regions. However, only 26% of the variation in number of trials among diseases could be explained by total disability adjusted life years and the ratio of disability adjusted life years in low income regions to high income regions. Many high income type diseases (for example, neck pain, glomerulonephritis) have proportionally fewer randomised trials compared with low income type diseases (for example, vitamin A deficiency). CONCLUSIONS Overall, a weak association existed between global burden of disease and number of published randomised trials. A global observatory for research is needed to monitor and reduce the discordance between the output of randomised trials and global burden of disease.
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Affiliation(s)
- Connor A Emdin
- George Institute for Global Health, University of Oxford, Oxford OX1 3DB, UK
| | - Ayodele Odutayo
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKJ Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKJ Centre d'Epidémiologie Clinique, Université Paris Descartes, INSERM U1153, France
| | - Kazem Rahimi
- George Institute for Global Health, University of Oxford, Oxford OX1 3DB, UK
| | - Douglas G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKJ
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Rochon PA, Wu W, Gurwitz JH, Kalkar SR, Thomson J, Gill SS. Prospective evaluation of the accessibility of Internet references in leading general medical journals. Scientometrics 2014. [DOI: 10.1007/s11192-014-1489-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vanni T, Mesa-Frias M, Sanchez-Garcia R, Roesler R, Schwartsmann G, Goldani MZ, Foss AM. International scientific collaboration in HIV and HPV: a network analysis. PLoS One 2014; 9:e93376. [PMID: 24682041 DOI: 10.1371/journal.pone.0093376] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/03/2014] [Indexed: 12/25/2022] Open
Abstract
Research endeavours require the collaborative effort of an increasing number of individuals. International scientific collaborations are particularly important for HIV and HPV co-infection studies, since the burden of disease is rising in developing countries, but most experts and research funds are found in developed countries, where the prevalence of HIV is low. The objective of our study was to investigate patterns of international scientific collaboration in HIV and HPV research using social network analysis. Through a systematic review of the literature, we obtained epidemiological data, as well as data on countries and authors involved in co-infection studies. The collaboration network was analysed in respect to the following: centrality, density, modularity, connected components, distance, clustering and spectral clustering. We observed that for many low- and middle-income countries there were no epidemiological estimates of HPV infection of the cervix among HIV-infected individuals. Most studies found only involved researchers from the same country (64%). Studies derived from international collaborations including high-income countries and either low- or middle-income countries had on average three times larger sample sizes than those including only high-income countries or low-income countries. The high global clustering coefficient (0.9) coupled with a short average distance between researchers (4.34) suggests a “small-world phenomenon.” Researchers from high-income countries seem to have higher degree centrality and tend to cluster together in densely connected communities. We found a large well-connected community, which encompasses 70% of researchers, and 49 other small isolated communities. Our findings suggest that in the field of HIV and HPV, there seems to be both room and incentives for researchers to engage in collaborations between countries of different income-level. Through international collaboration resources available to researchers in high-income countries can be efficiently used to enroll more participants in low- and middle-income countries.
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Affiliation(s)
- Gustavo Saposnik
- From the Division of Neurology, Department of Medicine, Stroke Outcomes Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Clinical and Translational Science Institute, University of California, San Francisco (S.C.J.); Applied Health Research Center, Li Ka Shin Institute, St. Michael’s Hospital, Toronto, Canada (S.R.); Department of Neurology, Medical University of South Carolina (MUSC), Charleston, SC (B.O.); Editor Stroke
| | - S. Claiborne Johnston
- From the Division of Neurology, Department of Medicine, Stroke Outcomes Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Clinical and Translational Science Institute, University of California, San Francisco (S.C.J.); Applied Health Research Center, Li Ka Shin Institute, St. Michael’s Hospital, Toronto, Canada (S.R.); Department of Neurology, Medical University of South Carolina (MUSC), Charleston, SC (B.O.); Editor Stroke
| | - Stavroula Raptis
- From the Division of Neurology, Department of Medicine, Stroke Outcomes Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Clinical and Translational Science Institute, University of California, San Francisco (S.C.J.); Applied Health Research Center, Li Ka Shin Institute, St. Michael’s Hospital, Toronto, Canada (S.R.); Department of Neurology, Medical University of South Carolina (MUSC), Charleston, SC (B.O.); Editor Stroke
| | - Bruce Ovbiagele
- From the Division of Neurology, Department of Medicine, Stroke Outcomes Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Clinical and Translational Science Institute, University of California, San Francisco (S.C.J.); Applied Health Research Center, Li Ka Shin Institute, St. Michael’s Hospital, Toronto, Canada (S.R.); Department of Neurology, Medical University of South Carolina (MUSC), Charleston, SC (B.O.); Editor Stroke
| | - Marc Fisher
- From the Division of Neurology, Department of Medicine, Stroke Outcomes Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Clinical and Translational Science Institute, University of California, San Francisco (S.C.J.); Applied Health Research Center, Li Ka Shin Institute, St. Michael’s Hospital, Toronto, Canada (S.R.); Department of Neurology, Medical University of South Carolina (MUSC), Charleston, SC (B.O.); Editor Stroke
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Goldani MZ. The researchers and the scientifc production in Pediatrics: what is its value? Rev paul pediatr 2013; 31:276-7. [PMID: 24142307 PMCID: PMC4182977 DOI: 10.1590/s0103-05822013000300001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Indexed: 11/21/2022]
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Abstract
BACKGROUND: Discussion of the influence of money on bioethics research seems particularly salient in the context of research on the ethical, legal and social implications (ELSI) of human genomics, as this research may be financially supported by the ELSI Research Program. Empirical evidence regarding the funding of ELSI research and where such research is disseminated, in relation to the specific topics of the research and methods used, can help to further discussions regarding the appropriate influence of specific institutions and institutional contexts on ELSI and other bioethics research agendas. METHODS: We reviewed 642 ELSI publications (appearing between 2003-2008) for reported sources of funding, forum for dissemination, empirical and non-empirical methods, and topic of investigation. RESULTS: Most ELSI research is independent of direct grant-based funding sources; 66% reported no such sources of funding. The National Human Genome Research Institute (NHGRI) is the most dominant source of funding; 16% of publications acknowledged at least one source of NHGRI grant funding. Funding is acknowledged more frequently in empirical than non-empirical publications, and more frequently in publications in public health journals than in any other ELSI research dissemination forums. Dominant research topics vary by publication forum and by reported funding. CONCLUSIONS: ELSI research is surprisingly independent of direct grant-based funding, yet correlations are apparent between this type of funding and publication placement, topics addressed, and methods used, implying a not insignificant influence on ELSI research agenda-setting. However, given the relatively low percentage of publications acknowledging external grant-based funding, as well as other significant correlations between publication placement and topics addressed, additional institutional contexts, perhaps related to professional advancement or valuation, may shape research agendas in ways that potentially exceed the direct influences of grant-based funding in this area. In some cases, grant-based funding may actually counter other potentially problematic institutional influences.
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Affiliation(s)
- Preeti Yadav
- Department of Pharmacology, Govt. Medical College, Surat, India
| | - Jaykaran
- Department of Pharmacology, Govt. Medical College, Surat, India
| | - Mayur Chaudhari
- Department of Pharmacology, B. J. Medical College, Ahmedabad, India
| | - Deepak Saxena
- Indian Institute of Public Health, Ahmedabad, Gujarat, India
| | - N. D. Kantharia
- Department of Pharmacology, Govt. Medical College, Surat, India
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Abstract
BACKGROUND Recruiting GPs is an issue faced by most research teams in primary care. OBJECTIVES To assess GPs' willingness and expectations with regard to research in French primary care and to identify factors that may increase their participation in research projects. METHODS Cross-sectional study conducted with a representative sample of 452 GPs from the Rhone-Alpes region in France. RESULTS Among 284 GPs (63%) who participated, 85 [29.9%, 95% confidence interval (CI) = 26.4-35.3%] were willing to participate in research as investigators and 83 (29.2%, 95% CI: 23.9-34.5%) had already participated in research projects. Multivariate analysis showed that an earlier participation in research projects [odds ratio (OR) = 3.3], a training practice (OR = 2.3), membership in a research network (OR = 2.1) and younger age (OR = 1.9 for 10 years less) were associated with the willingness to participate in future research projects. Whereas 55% of practitioners who already had an experience in research had participated in a therapeutic trial, those willing to participate in the future preferred to participate in descriptive (26%) or etiologic (22%) studies. Preventive, diagnostic and therapeutic procedures and quality of care were the domains, which interested GPs most. The most expected clinical themes concerned cardiovascular, metabolic, musculoskeletal and respiratory problems. CONCLUSIONS To meet the expectations of French GPs willing to participate in primary care research, it is advisable to diversify studies with respect to their types, domains and themes. Linkage to universities and research networks should also be encouraged.
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Affiliation(s)
- Irène Supper
- Department of General Practice, University of Lyon 1, Lyon, France
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Ahmad N, Boutron I, Dechartres A, Durieux P, Ravaud P. Geographical representativeness of published and ongoing randomized controlled trials. The example of: Tobacco consumption and HIV infection. PLoS One 2011; 6:e16878. [PMID: 21347383 DOI: 10.1371/journal.pone.0016878] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 01/06/2011] [Indexed: 12/12/2022] Open
Abstract
Background The challenge for evidence-based healthcare is to reduce mortality and the burden of diseases. This study aimed to compare where research is conducted to where research is needed for 2 public health priorities: tobacco consumption and HIV infection. Methods We identified randomized controlled trials (RCTs) included in Cochrane systematic reviews published between 1997 and 2007 and registered ongoing RCTs identified in January 2009 through the World Health Organization's International Clinical Trials Registry Platform (WHO-ICTRP) evaluating interventions aimed at reducing or stopping tobacco use and treating or preventing HIV infection. We used the WHO and World Bank reports to classify the countries by income level, as well as map the global burden of disease and mortality attributable to tobacco use and HIV infection to the countries where the trials performed. Results We evaluated 740 RCTs included in systematic reviews and 346 ongoing RCTs. For tobacco use, 4% of RCTs included in systematic reviews and 2% of ongoing trials were performed in low- and middle-income countries, even though these countries represented 70% of the mortality related to tobacco use. For HIV infection, 31% of RCTs included in systematic reviews and 33% of ongoing trials were performed in low- and middle-income countries, even though these countries represented 99% of the mortality related to HIV infection. Conclusions Our results highlight an important underrepresentation of low- and middle-income countries in currently available evidence (RCTs included in systematic reviews) and awaiting evidence (registered ongoing RCTs) for reducing or stopping tobacco use and treating or preventing HIV infection.
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Abstract
BACKGROUND The greatest burden of disease in children lies in the developing world; however, previous reviews have suggested that few randomized controlled trials (RCTs) involving children take place in developing countries. Children in developing countries deserve the same standard of medicines as those in developed countries, i.e. appropriate medications for the specific diseases that occur. OBJECTIVE To elucidate published pediatric therapeutic RCTs that have taken place in the developing world and to determine whether they are appropriate for the major diseases occurring there, and to explore their approach to safety monitoring. METHODS A previously assembled database of pediatric RCTs published between 1996 and 2002, from journals indexed in MEDLINE, was analyzed. The main country of setting of the RCTs was categorized as having low, medium or high development status according to the Human Development Index (HDI). Articles were read to add the WHO International Classification of Diseases 10th Revision (ICD-10) category of the disease studied, the WHO Collaborating Centre for Drug Statistics Methodology Anatomical Therapeutic Chemical (ATC) classification system category of the main drug therapy studied, the source of funding, and ethical approval to the variables already recorded in the database. RESULTS One hundred and fifty-eight (22%) of the 733 RCTs analyzed took place in medium and low HDI (developing) countries. The disease areas studied seemed appropriate, with 89 (56%) of the 158 RCTs studying infectious and parasitic diseases. Ninety-nine (63%) RCTs from developing countries were trials of antiparasitic and anti-infective drugs. Compared with studies from high HDI countries, a significantly lower proportion of articles from medium and low HDI countries mentioned ethical committee or institutional review board approval, and safety monitoring. Only one paper from low and medium HDI countries mentioned the presence of a safety monitoring committee/data safety monitoring board. CONCLUSIONS Published pediatric drug RCTs conducted in developing countries appear to study appropriate diseases but the results show that fewer RCTs are undertaken compared with the developed world. The standard of reporting for RCTs from developing countries needs attention to ensure that adequate information can be obtained, especially with regard to safety monitoring.
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Affiliation(s)
- Khairun N B Nor Aripin
- Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby DE22 3DT, UK.
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Hsia R, Razzak J, Tsai AC, Hirshon JM. Placing emergency care on the global agenda. Ann Emerg Med 2010; 56:142-9. [PMID: 20138398 DOI: 10.1016/j.annemergmed.2010.01.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 11/26/2009] [Accepted: 01/11/2010] [Indexed: 11/20/2022]
Abstract
Emergency care serves a key function within health care systems by providing an entry point to health care and by decreasing morbidity and mortality. Although primarily focused on evaluation and treatment for acute conditions, emergency care also serves as an important locus of provision for preventive care with regard to injuries and disease progression. Despite its important and increasing role, however, emergency care has been frequently overlooked in the discussion of health systems and delivery platforms, particularly in developing countries. Little research has been done in lower- and middle-income countries on the burden of disease reduction attributable to emergency care, whether through injury treatment and prevention, urgent and emergency treatment of acute conditions, or emergency treatment of complications from chronic conditions. There is a critical need for research documenting the role of emergency care services in reducing the global burden of disease. In addition to applying existing methodologies toward this aim, new methodologies should be developed to determine the cost-effectiveness of these interventions and how to effectively cover the costs of and demands for emergency care needs. These analyses could be used to emphasize the public health and clinical importance of emergency care within health systems as policymakers determine health and budgeting priorities in resource-limited settings.
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Wiles L, Olds T, Williams M. Evidence base, quantitation and collaboration: three novel indices for bibliometric content analysis. Scientometrics 2010; 85:317-28. [DOI: 10.1007/s11192-010-0163-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sharan P, Gallo C, Gureje O, Lamberte E, Mari JJ, Mazzotti G, Patel V, Swartz L, Olifson S, Levav I, de Francisco A, Saxena S. Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean. Br J Psychiatry 2009; 195:354-63. [PMID: 19794206 PMCID: PMC3432479 DOI: 10.1192/bjp.bp.108.050187] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries. AIMS To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries. METHOD We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research. RESULTS The study identified broad agreement between researchers and stakeholders and across regions regarding research priorities. Epidemiology (burden and risk factors), health systems and social science ranked highest for type of research. Depression/anxiety, substance use disorders and psychoses; and children and adolescents, women, and people exposed to violence/trauma were prioritised among the disorders and population groups respectively. Important criteria for prioritising research were burden of disease, social justice, and availability of funds. Stakeholder groups differed in the importance they gave to the personal interest of researchers as a criterion for prioritising research. Researchers' and stakeholders' priorities were consistent with burden of disease estimates, however suicide was underprioritised compared with its burden. Researchers' and stakeholders' priorities were also largely congruent with the researchers' projects. CONCLUSIONS The results of this first ever conducted survey of researchers and stakeholders regarding research priorities in mental health suggest that it should be possible to develop consensus at regional and international levels regarding the research agenda that is necessary to support health system objectives in LAMI countries.
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Affiliation(s)
- P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi - 110029, India.
| | - C Gallo
- Departamento de Bioquímica, Biología Molecular y Farmacología, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia
,Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - O Gureje
- Department of Psychiatry, University of Ibadan, Nigeria
| | - E Lamberte
- Social Development Research Center, De La Salle University, Manila, Philippines
| | - JJ Mari
- Department of Psychiatry, Federal University of São Paulo, Brazil
| | - G Mazzotti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
,Department of Psychiatry, Federal University of São Paulo, Brazil
| | - V Patel
- Departamento de Psiquiatría, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L Swartz
- London School of Hygiene & Tropical Medicine, UK and Sangath, India
| | - S Olifson
- Department of Psychology, Stellenbosch University and Human Sciences Research Council, Cape Town, South Africa
| | - I Levav
- Global Forum for Health Research, Geneva, Switzerland
| | - A de Francisco
- Department of Psychology, Stellenbosch University and Human Sciences Research Council, Cape Town, South Africa
| | - S Saxena
- Mental Health Services, Ministry of Health, Jerusalem, Israel
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Kopic D, Sedensky M, Owen M. The impact of a teaching program on obstetric anesthesia practices in Croatia. Int J Obstet Anesth 2009; 18:4-9. [DOI: 10.1016/j.ijoa.2008.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 04/17/2008] [Accepted: 04/25/2008] [Indexed: 11/24/2022]
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Perel P, Miranda JJ, Ortiz Z, Casas JP. Relation between the global burden of disease and randomized clinical trials conducted in Latin America published in the five leading medical journals. PLoS One 2008; 3:e1696. [PMID: 18301772 PMCID: PMC2246037 DOI: 10.1371/journal.pone.0001696] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 01/25/2008] [Indexed: 11/26/2022] Open
Abstract
Background Since 1990 non communicable diseases and injuries account for the majority of death and disability-adjusted life years in Latin America. We analyzed the relationship between the global burden of disease and Randomized Clinical Trials (RCTs) conducted in Latin America that were published in the five leading medical journals. Methodology/Principal Findings We included all RCTs in humans, exclusively conducted in Latin American countries, and published in any of the following journals: Annals of Internal Medicine, British Medical Journal, Journal of the American Medical Association, Lancet, and New England Journal of Medicine. We described the trials and reported the number of RCTs according to the main categories of the global burden of disease. Sixty-six RCTs were identified. Communicable diseases accounted for 38 (57%) reports. Maternal, perinatal, and nutritional conditions accounted for 19 (29%) trials. Non-communicable diseases represent 48% of the global burden of disease but only 14% of reported trials. No trial addressed injuries despite its 18% contribution to the burden of disease in 2000. Conclusions/Significance A poor correlation between the burden of disease and RCTs publications was found. Non communicable diseases and injuries account for up to two thirds of the burden of disease in Latin America but these topics are seldom addressed in published RCTs in the selected sample of journals. Funding bodies of health research and editors should be aware of the increasing burden of non communicable diseases and injuries occurring in Latin America to ensure that this growing epidemic is not neglected in the research agenda and not affected by publication bias.
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Affiliation(s)
- Pablo Perel
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J. Jaime Miranda
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- * To whom correspondence should be addressed. E-mail:
| | - Zulma Ortiz
- Epidemiological Research Institute, National Academy of Medicine, Buenos Aires, Argentina
| | - Juan Pablo Casas
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
The use of drugs to treat human disease is a pursuit that extends back into our evolutionary ancestors. Drugs are powerful substances with a great capacity to cause harm if misused or overused. Even when used correctly, pharmaceuticals can elicit disputes about their relative harms and benefits in specific situations. The establishment of modern intermediaries – physicians or pharmacists – in the allocation of the most powerful drugs increases the potential for conflict between those who control the resource and those who desire access to it. The size and influence of the pharmaceutical–industrial complex places disproportionate power in those whose interests lie in promoting and expanding pharmaceutical use in society. The expense of certain drugs complicates equitable allocation, and the concentration of pharmaceutical power in Western, industrialized countries promotes research and drug discovery disproportionately for diseases that are prevalent in the wealthier nations. The increasing sophistication of drug action challenges the traditional model of using drugs as a means to treat pathological conditions and processes, and raises the specter of lifestyle and enhancement uses of pharmaceuticals. New means of drug discovery – such as the use of stem cells – have elicited debate about the relative values placed on the status of the embryo and the potential treatment for intractable conditions that could result from stem cell research. Finally, the overall emphasis on drugs as the first line defense against what ails us has provoked some societal soul-searching. In this chapter, we review some of the ethical issues attendant to drug production and distribution, including issues of safety, justice, economic inequality, and the changing demands for drugs that exceed therapeutic uses. Suggestions are made to make pharmaceutical companies more responsive to these issues and to make oversight bodies more responsible for their roles.
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Cohen E, Uleryk E, Jasuja M, Parkin PC. An absence of pediatric randomized controlled trials in general medical journals, 1985-2004. J Clin Epidemiol 2006; 60:118-23. [PMID: 17208117 DOI: 10.1016/j.jclinepi.2006.03.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2006] [Revised: 03/08/2006] [Accepted: 03/25/2006] [Indexed: 12/27/2022]
Abstract
OBJECTIVE There are numerous potential barriers to conducting randomized controlled trials (RCTs) in children. The purpose of this study was to compare the quantity, trends over time, characteristics, and quality of pediatric RCTs published in general medical journals (GMJs) with adult RCTs. STUDY DESIGN AND SETTING We conducted an electronic search of adult and pediatric RCTs from 1985-2004 and a manual search of published RCTs in the year 2000 in five high-impact GMJs (New England Journal of Medicine, Journal of the American Medical Association [JAMA], the Lancet, British Medical Journal [BMJ], Canadian Medical Association Journal [CMAJ]). Linear trends were identified and the 1-year sample was analyzed for publication characteristics (location of recruitment, sample size, number of centers, funding sources, and results) and quality scoring (Jadad score, intention-to-treat analysis, and citation frequency since publication). RESULTS Adult RCTs increased by 4.71 RCTs/year (95% confidence interval (CI) 3.62-5.80; P<0.001), which was significantly higher (P<0.0001) than pediatric RCTs, which increased by 0.4 RCTs/year (95% CI -0.02 to 0.9; P=0.06). Adult RCTs were more likely to be hospital-based (P=.001) and to involve more centers in multicenter studies (P=0.02). Quality scores were similar, although adult RCTs were cited more frequently (P=0.003). CONCLUSION There may be significant barriers to the publication of high-quality pediatric RCTs in GMJs.
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Affiliation(s)
- Eyal Cohen
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Faculty of Medicine, Toronto, ON, Canada.
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Saxena S, Jané-Llopis E, Hosman C. Prevention of mental and behavioural disorders: implications for policy and practice. World Psychiatry 2006; 5:5-14. [PMID: 16757984 PMCID: PMC1472261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice.
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Affiliation(s)
- Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Abstract
A search (precision value 94%, recall value 93%) of the ISI Web of Science database (1992-2001) revealed that mental health publications accounted for 3-4% of the health literature. A 10/90 divide in internationally accessible mental health literature was evident and remained undiminished through 10 years as low- and middle-income countries (n=152) contributed only 6%, high-income countries (n=54) 94%, and 14 leading high-income countries (with more than 1% contribution for majority of years under consideration) contributed 90% of internationally accessible mental health research. Steps should be taken to improve the research infrastructure and capacity to conduct and disseminate mental health research in general, and on a priority basis in low- and middle-income countries.
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Affiliation(s)
- Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Health Organization, CH-1211 Geneva, Switzerland.
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Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals. BMC Med Ethics 2004; 5:E5. [PMID: 15461820 PMCID: PMC524359 DOI: 10.1186/1472-6939-5-5] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 10/04/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is widely acknowledged that there is a global divide on health care and health research known as the 10/90 divide. METHODS A retrospective survey of articles published in the BMJ, Lancet, NEJM, Annals of Internal Medicine & JAMA in a calendar year to examine the contribution of the developing world to medical literature. We categorized countries into four regions: UK, USA, Other Euro-American countries (OEAC) and (RoW). OEAC were European countries other than the UK but including Australia, New Zealand and Canada. RoW comprised all other countries. RESULTS The average contribution of the RoW to the research literature in the five journals was 6.5%. In the two British journals 7.6% of the articles were from the RoW; in the three American journals 4.8% of articles were from RoW. The highest proportion of papers from the RoW was in the Lancet (12%). An analysis of the authorship of 151 articles from RoW showed that 104 (68.9%) involved authorship with developed countries in Europe or North America. There were 15 original papers in these journals with data from RoW but without any authors from RoW. CONCLUSIONS There is a marked under-representation of countries in high-impact general medical journals. The ethical implications of this inequity and ways of reducing it are discussed.
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Affiliation(s)
- Athula Sumathipala
- Section of Epidemiology, Institute of Psychiatry, Kings College, London SE5 8AF UK
- Forum for Research and Development in Sri Lanka
| | - Sisira Siribaddana
- Sri Jayewardenepura Postgraduate Teaching Hospital, Thalapathpitiya, Nugegoda, 10250, Sri Lanka
- Forum for Research and Development in Sri Lanka
| | - Vikram Patel
- London School of Hygiene & Tropical Medicine, London, UK
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Affiliation(s)
- Prabhat Jha
- Centre for Global Health Research, St. Michael's Hospital, University of Toronto, 70 Richmond Street East, 3rd Floor, Toronto, Ontario M5C 1N8, Canada.
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