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Senanayake S, Barnett A, Brain D, Allen M, Powell EE, O'Beirne J, Valery P, Hickman IJ, Kularatna S. A discrete choice experiment to elicit preferences for a chronic disease screening programme in Queensland, Australia. Public Health 2024; 228:105-111. [PMID: 38354579 DOI: 10.1016/j.puhe.2024.01.007] [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: 07/11/2023] [Revised: 12/25/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Patient-centred care, increasingly highlighted in healthcare strategies, necessitates understanding public preferences for healthcare service attributes. We aimed to understand the preferences of the Australian population regarding the attributes of chronic disease screening programmes. STUDY DESIGN The preferences were elicited using the discrete choice experiment (DCE) methodology. METHODS A DCE was administered to a sample of the Australian general population. Respondents were asked to make choices, each offering two hypothetical screening scenarios defined by screening conduct, quality and accuracy of the test results, cost to the patient, wait time and source of information. Data were analysed using a panel mixed multinomial logit model. RESULTS A strong preference for highly accurate screening tests and nurse-led screenings at local health clinics was evident. They expressed disutility for waiting time and out-of-pocket costs but were indifferent about the source of information. Their preference for a nurse-led programme was highlighted by the fact that they were willing to pay $81 and $88 to get a nurse-led programme when they were offered a general practitioner-led and a specialist-led programme, respectively. Furthermore, they were willing to pay $32 to reduce a week of waiting time and $205 for a 95% accurate test compared to a 75% accurate test. Preferences remained consistent irrespective of the respondent's place of residence. CONCLUSIONS Our findings highlight the importance of diagnostic test accuracy and nurse-led service delivery in chronic disease screening programmes. These insights could guide the development of patient-centric services by enhancing test accuracy, reducing waiting times and promoting nurse-led care models.
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Affiliation(s)
- S Senanayake
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - A Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - D Brain
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia.
| | - M Allen
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - E E Powell
- The University of Queensland, St Lucia, QLD 4072, Australia; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - J O'Beirne
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
| | - P Valery
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, QLD 4029, Australia
| | - I J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; The University of Queensland, St Lucia, QLD 4072, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Duch R, Asiedu E, Nakamura R, Rouyard T, Mayol A, Barnett A, Roope L, Violato M, Sowah D, Kotlarz P, Clarke P. Author Correction: Financial incentives for COVID-19 vaccines in a rural low-resource setting: a cluster-randomized trial. Nat Med 2024; 30:905. [PMID: 38135823 PMCID: PMC10957464 DOI: 10.1038/s41591-023-02772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Affiliation(s)
- Raymond Duch
- Nuffield College, University of Oxford, Oxford, UK.
| | - Edward Asiedu
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- City University of New York (CUNY) Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Alberto Mayol
- Department of Public Administration, FAE University of Santiago Chile, Santiago, Chile
| | - Adrian Barnett
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Dorcas Sowah
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | | | - Philip Clarke
- University of Oxford, Oxford, UK
- University of Melbourne, Melbourne, Victoria, Australia
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Griffee MJ, Thomson DA, Fanning J, Rosenberger D, Barnett A, White NM, Suen J, Fraser JF, Li Bassi G, Cho SM. Race and ethnicity in the COVID-19 Critical Care Consortium: demographics, treatments, and outcomes, an international observational registry study. Int J Equity Health 2023; 22:260. [PMID: 38087346 PMCID: PMC10717789 DOI: 10.1186/s12939-023-02051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Improving access to healthcare for ethnic minorities is a public health priority in many countries, yet little is known about how to incorporate information on race, ethnicity, and related social determinants of health into large international studies. Most studies of differences in treatments and outcomes of COVID-19 associated with race and ethnicity are from single cities or countries. METHODS We present the breadth of race and ethnicity reported for patients in the COVID-19 Critical Care Consortium, an international observational cohort study from 380 sites across 32 countries. Patients from the United States, Australia, and South Africa were the focus of an analysis of treatments and in-hospital mortality stratified by race and ethnicity. Inclusion criteria were admission to intensive care for acute COVID-19 between January 14th, 2020, and February 15, 2022. Measurements included demographics, comorbidities, disease severity scores, treatments for organ failure, and in-hospital mortality. RESULTS Seven thousand three hundred ninety-four adults met the inclusion criteria. There was a wide variety of race and ethnicity designations. In the US, American Indian or Alaska Natives frequently received dialysis and mechanical ventilation and had the highest mortality. In Australia, organ failure scores were highest for Aboriginal/First Nations persons. The South Africa cohort ethnicities were predominantly Black African (50%) and Coloured* (28%). All patients in the South Africa cohort required mechanical ventilation. Mortality was highest for South Africa (68%), lowest for Australia (15%), and 30% in the US. CONCLUSIONS Disease severity was higher for Indigenous ethnicity groups in the US and Australia than for other ethnicities. Race and ethnicity groups with longstanding healthcare disparities were found to have high acuity from COVID-19 and high mortality. Because there is no global system of race and ethnicity classification, researchers designing case report forms for international studies should consider including related information, such as socioeconomic status or migration background. *Note: "Coloured" is an official, contemporary government census category of South Africa and is a term of self-identification of race and ethnicity of many citizens of South Africa.
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Affiliation(s)
- Matthew J Griffee
- Department of Anesthesiology, University of Utah School of Medicine, 30 N Mario Capecchi Drive, HELIX Tower 5N100, Salt Lake City, UT, 84112, USA.
| | - David A Thomson
- Department of Anaesthesia and Perioperative Medicine, Division of Critical Care, University of Cape Town, Cape Town, South Africa
| | - Jonathon Fanning
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nicole M White
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jacky Suen
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- St Andrew's War Memorial Hospital, UnitingCare, Spring Hill, QLD, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- St Andrew's War Memorial Hospital, UnitingCare, Spring Hill, QLD, Australia
- Wesley Medical Research Foundation, Auchenflower, QLD, Australia
- Wesley Hospital, Spring Hill, Auchenflower, QLD, Australia
- Queensland University of Technology, Brisbane, Australia
| | - Sung-Min Cho
- Departments of Neurology, Surgery, Anesthesia and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
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Duch R, Asiedu E, Nakamura R, Rouyard T, Mayol A, Barnett A, Roope L, Violato M, Sowah D, Kotlarz P, Clarke P. Financial incentives for COVID-19 vaccines in a rural low-resource setting: a cluster-randomized trial. Nat Med 2023; 29:3193-3202. [PMID: 38012315 PMCID: PMC10719106 DOI: 10.1038/s41591-023-02670-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023]
Abstract
We implemented a clustered randomized controlled trial with 6,963 residents in six rural Ghana districts to estimate the causal impact of financial incentives on coronavirus disease 2019 (COVID-19) vaccination uptake. Villages randomly received one of four video treatment arms: a placebo, a standard health message, a high cash incentive (60 Ghana cedis) and a low cash incentive (20 Ghana cedis). For the first co-primary outcome-COVID-19 vaccination intentions-non-vaccinated participants assigned to the cash incentive treatments had an average rate of 81% (1,733 of 2,168) compared to 71% (1,895 of 2,669) for those in the placebo treatment arm. For the other co-primary outcome of self-reported vaccinations 2 months after the initial intervention, the average rate for participants in the cash treatment was 3.5% higher than for participants in the placebo treatment (95% confidence interval (CI): 0.001, 6.9; P = 0.045): 40% (602 of 1,486) versus 36.3% (672 of 1,850). We also verified vaccination status of participants: in the cash treatment arm, 36.6% (355 of 1,058) of verified participants had at least one dose of the COVID-19 vaccine compared to 30.3% (439 of 1,544) for those in the placebo-a difference of 6.3% (95% CI: 2.4, 10.2; P = 0.001). For the intention and the vaccination outcomes, the low cash incentive (20 Ghana cedis) had a larger positive effect on COVID-19 vaccine uptake than the high cash incentive (60 Ghana cedis). Trial identifier: AEARCTR-0008775 .
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Affiliation(s)
- Raymond Duch
- Nuffield College, University of Oxford, Oxford, UK.
| | - Edward Asiedu
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- City University of New York (CUNY) Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Alberto Mayol
- Department of Public Administration, FAE University of Santiago Chile, Santiago, Chile
| | - Adrian Barnett
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Dorcas Sowah
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | | | - Philip Clarke
- University of Oxford, Oxford, UK
- University of Melbourne, Melbourne, Victoria, Australia
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Hewage SA, Noviyani R, Brain D, Sharma P, Parsonage W, McPhail SM, Barnett A, Kularatna S. Cost-effectiveness of left atrial appendage closure for stroke prevention in atrial fibrillation: a systematic review appraising the methodological quality. Cost Eff Resour Alloc 2023; 21:76. [PMID: 37872572 PMCID: PMC10591401 DOI: 10.1186/s12962-023-00486-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The increasing global prevalence of atrial fibrillation (AF) has led to a growing demand for stroke prevention strategies, resulting in higher healthcare costs. High-quality economic evaluations of stroke prevention strategies can play a crucial role in maximising efficient allocation of resources. In this systematic review, we assessed the methodological quality of such economic evaluations. METHODS We searched electronic databases of PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Econ Lit to identify model-based economic evaluations comparing the left atrial appendage closure procedure (LAAC) and oral anticoagulants published in English since 2000. Data on study characteristics, model-based details, and analyses were collected. The methodological quality was evaluated using the modified Economic Evaluations Bias (ECOBIAS) checklist. For each of the 22 biases listed in this checklist, studies were categorised into one of four groups: low risk, partial risk, high risk due to inadequate reporting, or high risk. To gauge the overall quality of each study, we computed a composite score by assigning + 2, 0, - 1 and - 2 to each risk category, respectively. RESULTS In our analysis of 12 studies, majority adopted a healthcare provider or payer perspective and employed Markov Models with the number of health states varying from 6 to 16. Cost-effectiveness results varied across studies. LAAC displayed a probability exceeding 50% of being the cost-effective option in six out of nine evaluations compared to warfarin, six out of eight evaluations when compared to dabigatran, in three out of five evaluations against apixaban, and in two out of three studies compared to rivaroxaban. The methodological quality scores for individual studies ranged from 10 to - 12 out of a possible 24. Most high-risk ratings were due to inadequate reporting, which was prevalent across various biases, including those related to data identification, baseline data, treatment effects, and data incorporation. Cost measurement omission bias and inefficient comparator bias were also common. CONCLUSIONS While most studies concluded LAAC to be the cost-effective strategy for stroke prevention in AF, shortcomings in methodological quality raise concerns about reliability and validity of results. Future evaluations, free of these shortcomings, can yield stronger policy evidence.
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Affiliation(s)
- Sumudu A Hewage
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia.
| | - Rini Noviyani
- Department of Pharmacy, Udayana University, Bali, Indonesia
| | - David Brain
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - Pakhi Sharma
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - William Parsonage
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
- Cardiology department, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
- Digital Health and Informatics Directorate, Metro South Health, Brisbane, QLD, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, No.61, Musk Avenue, Kelvin Grove, QLD, 4059, Australia
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Allen MJ, Doran R, Brain D, Powell EE, O'Beirne J, Valery PC, Barnett A, Hettiarachchi R, Hickman IJ, Kularatna S. A discrete choice experiment to elicit preferences for a liver screening programme in Queensland, Australia: a mixed methods study to select attributes and levels. BMC Health Serv Res 2023; 23:950. [PMID: 37670274 PMCID: PMC10481473 DOI: 10.1186/s12913-023-09934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 08/17/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND In Australia, the overall prevalence of liver disease is increasing. Maximising uptake of community screening programmes by understanding patient preferences is integral to developing consumer-centred care models for liver disease. Discrete choice experiments (DCEs) are widely used to elicit preferences for various healthcare services. Attribute development is a vital component of a well-designed DCE and should be described in sufficient detail for others to assess the validity of outcomes. Hence, this study aimed to create a list of potential attributes and levels which can be used in a DCE study to elicit preferences for chronic liver disease screening programmes. METHODS Key attributes were developed through a multi-stage, mixed methods design. Focus groups were held with consumers and health care providers on attributes of community screening programmes for liver disease. Stakeholders then prioritised attributes generated from the focus group in order of importance via an online prioritisation survey. The outcomes of the prioritisation exercise were then reviewed and refined by an expert panel to ensure clinically meaningful levels and relevance for a DCE survey. RESULTS Fifteen attributes were generated during the focus group sessions deemed necessary to design liver disease screening services. Outcomes of the prioritisation exercise and expert panel stages recognised five attributes, with three levels each, for inclusion in a DCE survey to elicit consumer preferences for community screening for liver disease. This study also highlights broader social issues such as the stigma around liver disease that require careful consideration by policy makers when designing or implementing a liver screening programme. CONCLUSIONS The attributes and levels identified will inform future DCE surveys to understand consumer preferences for community screening programmes for liver disease. In addition, the outcomes will help inform the implementation of the LOCATE-NAFLD programme in real-world practice, and could be relevant for other liver and non-liver related chronic disease screening programmes.
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Affiliation(s)
- Michelle J Allen
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Rachael Doran
- Department of Economics and Related Studies, University of York, York, UK
| | - David Brain
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Elizabeth E Powell
- The University of Queensland, St Lucia, QLD, Australia
- Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - James O'Beirne
- University of the Sunshine Coast, Maroochydore DC, QLD, Australia
- Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | | | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Ingrid J Hickman
- The University of Queensland, St Lucia, QLD, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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White N, Parsons R, Collins G, Barnett A. Evidence of questionable research practices in clinical prediction models. BMC Med 2023; 21:339. [PMID: 37667344 PMCID: PMC10478406 DOI: 10.1186/s12916-023-03048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Clinical prediction models are widely used in health and medical research. The area under the receiver operating characteristic curve (AUC) is a frequently used estimate to describe the discriminatory ability of a clinical prediction model. The AUC is often interpreted relative to thresholds, with "good" or "excellent" models defined at 0.7, 0.8 or 0.9. These thresholds may create targets that result in "hacking", where researchers are motivated to re-analyse their data until they achieve a "good" result. METHODS We extracted AUC values from PubMed abstracts to look for evidence of hacking. We used histograms of the AUC values in bins of size 0.01 and compared the observed distribution to a smooth distribution from a spline. RESULTS The distribution of 306,888 AUC values showed clear excesses above the thresholds of 0.7, 0.8 and 0.9 and shortfalls below the thresholds. CONCLUSIONS The AUCs for some models are over-inflated, which risks exposing patients to sub-optimal clinical decision-making. Greater modelling transparency is needed, including published protocols, and data and code sharing.
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Affiliation(s)
- Nicole White
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Rex Parsons
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Gary Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
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Barnett A, Byrne J. Retract or be damned: the "bystander effect" is worsening the situation. BMJ 2023; 382:p1654. [PMID: 37463682 DOI: 10.1136/bmj.p1654] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| | - Jennifer Byrne
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
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Flaws D, Allen C, Baker S, Barnett A, Metcalf O, Pollock H, Ramanan M, Tabah A, Varker T. A protocol for a pilot randomised controlled trial of an Early Psychiatric Assessment, Referral, and Intervention Study (EPARIS) for intensive care patients. PLoS One 2023; 18:e0287470. [PMID: 37384627 PMCID: PMC10309621 DOI: 10.1371/journal.pone.0287470] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 06/02/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Up to 80% of Intensive Care Unit patients experience physical, cognitive, and/or psychological complications post-discharge, known as 'Post Intensive Care Syndrome' (PICS). Early diagnosis and intervention are a priority, but while current post-intensive care follow-up processes endorse a multidisciplinary model, incorporating a psychiatric consultation has not been studied. METHODS A pilot, open-label randomised controlled trial was developed by a multidisciplinary team to evaluate the feasibility and acceptability of incorporating a psychiatric review into an existing post-ICU clinic. The study will run for 12 months and aim to recruit 30 participants. Inclusion criteria for participants: a) ICU admission greater than 48 hours, b) no cognitive impairment that prevents participation, c) ≥ 18 years old, d) residing in Australia, e) fluent in English, f) able to provide GP information, and g) likely to be contactable in 6 months. Patient recruitment will be at Redcliffe Hospital, Queensland, Australia, and will involve patients attending the Redcliffe post intensive care clinic. Participants will be allocated to intervention or control using block randomisation and allocation concealment. Participants allocated to the control arm will receive the standard cares provided by the clinic, which involves an unstructured interview about their ICU experience and a battery of surveys about their psychological, cognitive, and physical function. Those allocated to the intervention arm will receive these same cares as well as an appointment with a psychiatrist for a single session intervention. The psychiatric intervention will involve a comprehensive review, including comorbid disorders, substance use, suicidal ideation, psychosocial stressors, social/emotional supports. Psychoeducation and initial treatment will be provided as indicated and recommendations given to the patient and their GP about how to access ongoing care. In addition to surveys conducted as part of standard clinic cares, all participants will complete additional questionnaires about their history, hospital experience, mental and physical health as well as employment circumstances. All participants will be followed up 6 months after their appointment and will be invited to complete follow-up questionnaires about their mental and physical health, as well as health service use and employment circumstances. The trial has been registered with ANZCTR (ACTRN12622000894796). RESULTS To evaluate the feasibility and acceptability of the intervention to the patient population. Differences between groups will be assessed using an independent samples t-test. Resource requirements to administer the intervention will be evaluated by reporting the mean duration of the EPARIS assessment and approximate cost per patient to provide this service. To estimate the effect size of any treatment effects, changes in secondary outcome measures between baseline and 6 months will be compared between intervention and control groups using Analysis of Covariance regression. As this is a pilot, we will not use p-values or test a null hypothesis, but will give confidence intervals. CONCLUSIONS This protocol provides a pragmatic evaluation of the acceptability of introducing early psychiatric assessment into an existing post-ICU follow-up process, and if considered acceptable will inform future research into the efficacy and generalisability of the intervention. The strengths of EPARIS are the prospective, longitudinal design with a control population, and its use of validated post-ICU outcome measures.
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Affiliation(s)
- Dylan Flaws
- Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Queensland, Australia
- Metro North Mental Health, Caboolture Hospital, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Chelsea Allen
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Queensland, Australia
| | - Stuart Baker
- Department of Intensive Care, Redcliffe Hospital, Queensland, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Queensland, Australia
| | - Olivia Metcalf
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Hamish Pollock
- Department of Intensive Care, Redcliffe Hospital, Queensland, Australia
| | - Mahesh Ramanan
- Department of Intensive Care, Caboolture Hospital, Queensland, Australia
- Adult Intensive Care Services, The Prince Charles Hospital, Queensland, Australia
- Mayne Academy of Critical Care, University of Queensland, Queensland, Australia
- Critical Care Division, The George Institute for Global Health, University of New South Wales, New South Wales, Australia
| | - Alexis Tabah
- School of Clinical Sciences, Queensland University of Technology, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
- Department of Intensive Care, Redcliffe Hospital, Queensland, Australia
| | - Tracey Varker
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Victoria, Australia
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Barnett A. Automated detection of over- and under-dispersion in baseline tables in randomised controlled trials. F1000Res 2023; 11:783. [PMID: 37360941 PMCID: PMC10285343 DOI: 10.12688/f1000research.123002.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Papers describing the results of a randomised trial should include a baseline table that compares the characteristics of randomised groups. Researchers who fraudulently generate trials often unwittingly create baseline tables that are implausibly similar (under-dispersed) or have large differences between groups (over-dispersed). I aimed to create an automated algorithm to screen for under- and over-dispersion in the baseline tables of randomised trials. Methods: Using a cross-sectional study I examined 2,245 randomised controlled trials published in health and medical journals on PubMed Central. I estimated the probability that a trial's baseline summary statistics were under- or over-dispersed using a Bayesian model that examined the distribution of t-statistics for the between-group differences, and compared this with an expected distribution without dispersion. I used a simulation study to test the ability of the model to find under- or over-dispersion and compared its performance with an existing test of dispersion based on a uniform test of p-values. My model combined categorical and continuous summary statistics, whereas the uniform test used only continuous statistics. Results: The algorithm had a relatively good accuracy for extracting the data from baseline tables, matching well on the size of the tables and sample size. Using t-statistics in the Bayesian model out-performed the uniform test of p-values, which had many false positives for skewed, categorical and rounded data that were not under- or over-dispersed. For trials published on PubMed Central, some tables appeared under- or over-dispersed because they had an atypical presentation or had reporting errors. Some trials flagged as under-dispersed had groups with strikingly similar summary statistics. Conclusions: Automated screening for fraud of all submitted trials is challenging due to the widely varying presentation of baseline tables. The Bayesian model could be useful in targeted checks of suspected trials or authors.
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Affiliation(s)
- Adrian Barnett
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
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11
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Abstract
Background: Papers describing the results of a randomised trial should include a baseline table that compares the characteristics of randomised groups. Researchers who fraudulently generate trials often unwittingly create baseline tables that are implausibly similar (under-dispersed) or have large differences between groups (over-dispersed). I aimed to create an automated algorithm to screen for under- and over-dispersion in the baseline tables of randomised trials. Methods: Using a cross-sectional study I examined 2,245 randomised controlled trials published in health and medical journals on PubMed Central. I estimated the probability that a trial's baseline summary statistics were under- or over-dispersed using a Bayesian model that examined the distribution of t-statistics for the between-group differences, and compared this with an expected distribution without dispersion. I used a simulation study to test the ability of the model to find under- or over-dispersion and compared its performance with an existing test of dispersion based on a uniform test of p-values. My model combined categorical and continuous summary statistics, whereas the uniform test used only continuous statistics. Results: The algorithm had a relatively good accuracy for extracting the data from baseline tables, matching well on the size of the tables and sample size. Using t-statistics in the Bayesian model out-performed the uniform test of p-values, which had many false positives for skewed, categorical and rounded data that were not under- or over-dispersed. For trials published on PubMed Central, some tables appeared under- or over-dispersed because they had an atypical presentation or had reporting errors. Some trials flagged as under-dispersed had groups with strikingly similar summary statistics. Conclusions: Automated screening for fraud of all submitted trials is challenging due to the widely varying presentation of baseline tables. The Bayesian model could be useful in targeted checks of suspected trials or authors.
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Affiliation(s)
- Adrian Barnett
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
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Sharma N, Al-Mouazzen L, Kuiper JH, Gallacher P, Barnett A. Functional outcomes after Medial Patellofemoral Ligament Reconstruction show inverted J-shaped relation with Body Mass Index. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07391-2. [PMID: 37036473 DOI: 10.1007/s00167-023-07391-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE Medial patellofemoral ligament reconstruction (MPFL-R) is a recognised surgical procedure for the treatment of recurrent patellofemoral instability with excellent outcomes reported. The aim of this study is to determine if body mass index can influence these outcomes. METHODS This is a single-centre retrospective analysis of a longitudinal patellofemoral database. Patients with recurrent patellar instability, without patellar alta or severe trochlear dysplasia were treated using a MPFL-R between 2015 and 2019 at The Robert Jones & Agnes Hunt Orthopaedic Hospital. The clinical efficacy following surgery was assessed by Kujula, International Knee Documentation Committee Score (IKDC), and EuroQol-5 score (EQ-5D) at baseline and up to 26 months post-operatively; their safety assessed by complication rate and requirement for further surgery. The effect of Body Mass Index (BMI) on clinical outcome was analysed using linear, curvilinear, and segmented models following propensity score weighting. RESULTS A total of 97 patients (97 Knees, mean age 25y) were analysed. Of these, 61 patients had a BMI < 30 kg/m2 (mean age 23y, mean BMI 24) of which 7 patients (12.3%) required additional surgery. A further 36 patients had a BMI > 30 kg/m2 (mean age 27y, mean BMI 36) of which 2 patients (5.6%) required additional surgery. The re-dislocation rate was 0% in each BMI group. Both groups had a significantly improved mean outcome following surgery, with improvements in mean IKDC above the minimum clinical important differences (MCID) of 20.5. BMI had an inverted J-shaped association with functional outcome, showing peak outcomes at BMI of 20.5 (95% CI 18.5 to 22.4; IKDC and Kujala) or BMI of 28 (EQ-5D index). No evidence for an association between BMI and complication risk was found. CONCLUSION BMI influences the functional outcomes in MPFL-R with an inverted J-shaped relation, without evidence it affected the complication or re-dislocation rate. In the absence of patella alta and severe trochlear dysplasia, an isolated MPFL reconstruction is a safe and effective procedure to treat patellar instability, with the best functional outcome in patients with a BMI around 20 to 21. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- N Sharma
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK.
- , 28 Buckingham Road, Penn, Wolverhampton, WV4-5TJ, UK.
| | - L Al-Mouazzen
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - J H Kuiper
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
- Keele University, Stoke-on-Trent, UK
| | - P Gallacher
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - A Barnett
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
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Coutinho P, Barnett A, Cavalcanti C, MarinhoValença Y, Bezerra B. Observation of Masturbation After Visual Sexual Stimuli From Conspecifics in a Captive Male Bearded Capuchin (Sapajus libidinosus). Arch Sex Behav 2023; 52:1333-1337. [PMID: 36422729 DOI: 10.1007/s10508-022-02475-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 05/11/2023]
Abstract
Masturbation is part of the natural behavioral repertoire of primates, with visual sexual stimuli known to trigger this behavior. Here, we report masturbation events triggered by visual sexual stimulus (VSS) in the South American primate Sapajus libidinosus. We observed a multi-male multi-female captive colony of 17 bearded capuchins between January and October 2014. Over this period, we registered 11 copulation events, 68 attempt copulations, and five masturbation events. The same low-ranking male (named Fu) performed all masturbation events. Fu directly looked at other individuals engaged in sexual displays while he masturbated in three events. The masturbation events associated with VSS lasted up to 2 min and 40 s. Our observations show that VSS can trigger masturbation in capuchin monkeys. The low hierarchy rank of the male, and the consequent lack of mating opportunities in the multi-male multi-female recently formed group in captivity, may have prompted the masturbation events.
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Affiliation(s)
- Paula Coutinho
- Programa de Pós-Graduação em Biologia Animal, Departamento de Zoologia, Laboratório de Ecologia Comportamento e Conservação, Centro de Biociências, Universidade Federal de Pernambuco, Av Prof Moraes Rego, 1235. Cidade Universitária, 50670-420, Recife, Pernambuco, Brasil
| | - Adrian Barnett
- Programa de Pós-Graduação em Biologia Animal, Departamento de Zoologia, Laboratório de Ecologia Comportamento e Conservação, Centro de Biociências, Universidade Federal de Pernambuco, Av Prof Moraes Rego, 1235. Cidade Universitária, 50670-420, Recife, Pernambuco, Brasil
| | - Cynthia Cavalcanti
- Laboratório de Ecologia Comportamento e Conservação, Centro de Biociências, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil
| | - Yuri MarinhoValença
- Programa de Pós-Graduação em Biologia Animal, Departamento de Zoologia, Laboratório de Ecologia Comportamento e Conservação, Centro de Biociências, Universidade Federal de Pernambuco, Av Prof Moraes Rego, 1235. Cidade Universitária, 50670-420, Recife, Pernambuco, Brasil
| | - Bruna Bezerra
- Programa de Pós-Graduação em Biologia Animal, Departamento de Zoologia, Laboratório de Ecologia Comportamento e Conservação, Centro de Biociências, Universidade Federal de Pernambuco, Av Prof Moraes Rego, 1235. Cidade Universitária, 50670-420, Recife, Pernambuco, Brasil.
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McGee RG, Graves LE, Barnett A. Timing of submissions to The Journal of Paediatrics and Child Health: Associations with the COVID-19 pandemic and editorial decisions. J Paediatr Child Health 2023; 59:89-94. [PMID: 36206278 PMCID: PMC10092035 DOI: 10.1111/jpc.16242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 01/14/2023]
Abstract
AIM To determine if the timing of manuscript submissions to The Journal of Paediatrics and Child Health (JPCH) changed following the onset of the COVID-19 pandemic and to determine if the timing of manuscript submissions influenced editorial decisions. METHODS A retrospective observational study of submissions to JPCH from 1 January 2015 to 1 August 2022 was performed. Regression models were used to explore the change over time. Editorial decisions were examined using a multinomial regression model with the three-category ordinal outcome of reject, revise and accept. All statistical models were fitted using a Bayesian approach and show 95% credible intervals (CI). RESULTS The analyses included 11 499 manuscript submissions between 2015 and 2022. The mean number of manuscript submissions increased by 17 papers per month (CI 15-19), with a larger 4-month long increase after the COVID-19 pandemic was declared of 86 submissions per month (CI 67-103). There was no clear effect of the pandemic on weekend submissions, mean difference in probability 0.003 (CI -0.021 to 0.026). Throughout the study period, the peak submission time was later in the day and was shifted +37 min later post-March 2020 (CI +22 to +52 min). Throughout the study period, submissions out-of-hours and on weekends were less likely to get an editorial decision of 'accept' or 'revise': odds ratio weekend versus weekday 0.87 (CI 0.78-0.97). CONCLUSION The COVID-19 pandemic had a limited effect on the timing of manuscript submissions to JPCH. However, the timing of manuscript submission impacted the likelihood of a more positive editorial decision. While the time of manuscript submission is only one part of the research process, it is postulated that it may be associated with research quality.
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Affiliation(s)
- Richard G McGee
- Department of Paediatrics, Gosford Hospital, Gosford, New South Wales, Australia.,Central Coast Clinical School, The University of Newcastle, Gosford, New South Wales, Australia
| | - Lara E Graves
- The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Sydney, New South Wales, Australia.,Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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15
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Mitchell JD, Drymon JM, Vardon J, Coulson PG, Simpfendorfer CA, Scyphers SB, Kajiura SM, Hoel K, Williams S, Ryan KL, Barnett A, Heupel MR, Chin A, Navarro M, Langlois T, Ajemian MJ, Gilman E, Prasky E, Jackson G. Shark depredation: future directions in research and management. Rev Fish Biol Fish 2023; 33:475-499. [PMID: 36404946 PMCID: PMC9664043 DOI: 10.1007/s11160-022-09732-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/28/2022] [Indexed: 05/19/2023]
Abstract
Shark depredation is a complex social-ecological issue that affects a range of fisheries worldwide. Increasing concern about the impacts of shark depredation, and how it intersects with the broader context of fisheries management, has driven recent research in this area, especially in Australia and the United States. This review synthesises these recent advances and provides strategic guidance for researchers aiming to characterise the occurrence of depredation, identify the shark species responsible, and test deterrent and management approaches to reduce its impacts. Specifically, the review covers the application of social science approaches, as well as advances in video camera and genetic methods for identifying depredating species. The practicalities and considerations for testing magnetic, electrical, and acoustic deterrent devices are discussed in light of recent research. Key concepts for the management of shark depredation are reviewed, with recommendations made to guide future research and policy development. Specific management responses to address shark depredation are lacking, and this review emphasizes that a "silver bullet" approach for mitigating depredation does not yet exist. Rather, future efforts to manage shark depredation must rely on a diverse range of integrated approaches involving those in the fishery (fishers, scientists and fishery managers), social scientists, educators, and other stakeholders.
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Affiliation(s)
- J. D. Mitchell
- Queensland Government, Department of Agriculture and Fisheries, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102 Australia
| | - J. M. Drymon
- Mississippi State University, Coastal Research and Extension Center, 1815 Popps Ferry Road, Biloxi, MS 39532 USA
- Mississippi-Alabama Sea Grant Consortium, 703 East Beach Drive, Ocean Springs, MS 39564 USA
| | - J. Vardon
- Southern Cross University, Lismore, NSW Australia
| | - P. G. Coulson
- Department of Primary Industries and Regional Development, Western Australian Fisheries and Marine Research Laboratories, 39 Northside Drive, Hillarys, WA 6025 Australia
| | - C. A. Simpfendorfer
- Institute for Marine and Antarctic Studies, University of Tasmania, 20 Castray Esplanade, Battery Point, TAS 7004 Australia
| | - S. B. Scyphers
- Coastal Sustainability Institute, Department of Marine and Environmental Sciences, Northeastern University, Nahant, MA 01908 USA
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA 02115 USA
| | - S. M. Kajiura
- Department of Biological Sciences, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431 USA
| | - K. Hoel
- Centre for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Bldg 34 James Cook Drive, Douglas, QLD 4811 Australia
| | - S. Williams
- Queensland Government, Department of Agriculture and Fisheries, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102 Australia
- School of Biological Sciences, The University of Queensland, St Lucia, Qld 4072 Australia
| | - K. L. Ryan
- Department of Primary Industries and Regional Development, Western Australian Fisheries and Marine Research Laboratories, 39 Northside Drive, Hillarys, WA 6025 Australia
| | - A. Barnett
- Biopixel Oceans Foundation, Cairns, QLD Australia
- Marine Data Technology Hub, James Cook University, Townsville, QLD 4811 Australia
| | - M. R. Heupel
- Institute for Marine and Antarctic Studies, University of Tasmania, 20 Castray Esplanade, Battery Point, TAS 7004 Australia
| | - A. Chin
- Centre for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Bldg 34 James Cook Drive, Douglas, QLD 4811 Australia
| | - M. Navarro
- School of Biological Sciences, The University of Western Australia, Crawley, WA Australia
- The Oceans Institute, University of Western Australia, Crawley, WA Australia
| | - T. Langlois
- School of Biological Sciences, The University of Western Australia, Crawley, WA Australia
- The Oceans Institute, University of Western Australia, Crawley, WA Australia
| | - M. J. Ajemian
- Harbor Branch Oceanographic Institute, Florida Atlantic University, 5600 US 1 North, Fort Pierce, FL 34946 USA
| | - E. Gilman
- Pelagic Ecosystems Research Group, Honolulu, HI USA
- Heriot-Watt University, Edinburgh, UK
| | - E. Prasky
- Coastal Sustainability Institute, Department of Marine and Environmental Sciences, Northeastern University, Nahant, MA 01908 USA
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA 02115 USA
| | - G. Jackson
- Department of Primary Industries and Regional Development, Western Australian Fisheries and Marine Research Laboratories, 39 Northside Drive, Hillarys, WA 6025 Australia
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Bolt G, Piercy H, Barnett A, Manning V. ‘A circuit breaker’ – Interrupting the alcohol autopilot: A qualitative exploration of participants’ experiences of a personalised mHealth approach bias modification intervention for alcohol use. Addict Behav Rep 2022; 16:100471. [DOI: 10.1016/j.abrep.2022.100471] [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: 07/21/2022] [Revised: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
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Iosilevskii G, Kong JD, Meyer CG, Watanabe YY, Papastamatiou YP, Royer MA, Nakamura I, Sato K, Doyle TK, Harman L, Houghton JDR, Barnett A, Semmens JM, Maoiléidigh NÓ, Drumm A, O'Neill R, Coffey DM, Payne NL. A general swimming response in exhausted obligate swimming fish. R Soc Open Sci 2022. [PMID: 36147936 DOI: 10.5061/dryad.7pvmcvdv4] [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] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Marine organisms normally swim at elevated speeds relative to cruising speeds only during strenuous activity, such as predation or escape. We measured swimming speeds of 29 ram ventilating sharks from 10 species and of three Atlantic bluefin tunas immediately after exhaustive exercise (fighting a capture by hook-and-line) and unexpectedly found all individuals exhibited a uniform mechanical response, with swimming speed initially two times higher than the cruising speeds reached approximately 6 h later. We hypothesized that elevated swimming behaviour is a means to increase energetic demand and drive the removal of lactate accumulated during capture via oxidation. To explore this hypothesis, we estimated the mechanical work that must have been spent by an animal to elevate its swim speed and then showed that the amount of lactate that could have been oxidized to fuel it comprises a significant portion of the amount of lactate normally observed in fishes after exhaustive exercise. An estimate for the full energetic cost of the catch-and-release event ensued.
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Affiliation(s)
- G Iosilevskii
- Department of Aerospace Engineering, Technion Haifa, 32000 Israel
| | - J D Kong
- School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - C G Meyer
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | - Y Y Watanabe
- National Institute of Polar Research, Tachikawa, Japan
| | - Y P Papastamatiou
- Biological Sciences, Florida International University, Miami, FL 33180, USA
| | - M A Royer
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | - I Nakamura
- Organization for Marine Science and Technology, Nagasaki University, Nagasaki, Nagasaki 851-2213, Japan
| | - K Sato
- International Coastal Research Center, Atmosphere and Ocean Research Institute, University of Tokyo, Iwate, Japan
| | - T K Doyle
- Zoology, Ecology and Plant Science, Environmental Research Institute, University College Cork, Cork T23 XE10, Ireland
| | - L Harman
- Zoology, Ecology and Plant Science, Environmental Research Institute, University College Cork, Cork T23 XE10, Ireland
| | - J D R Houghton
- Biological Sciences, Queen's University Belfast, Belfast, County Antrim BT9 7BL, UK
| | - A Barnett
- James Cook University, Cairns, Queensland, Australia
| | - J M Semmens
- Institute of Marine and Antarctic Studies, University of Tasmania, Hobart, Tasmania 7001, Australia
| | | | - A Drumm
- Marine Institute, Newport, County Mayo, Ireland
| | - R O'Neill
- Marine Institute, Newport, County Mayo, Ireland
| | - D M Coffey
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | - N L Payne
- School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
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Iosilevskii G, Kong JD, Meyer CG, Watanabe YY, Papastamatiou YP, Royer MA, Nakamura I, Sato K, Doyle TK, Harman L, Houghton JDR, Barnett A, Semmens JM, Maoiléidigh NÓ, Drumm A, O'Neill R, Coffey DM, Payne NL. A general swimming response in exhausted obligate swimming fish. R Soc Open Sci 2022; 9:211869. [PMID: 36147936 PMCID: PMC9490326 DOI: 10.1098/rsos.211869] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/25/2022] [Indexed: 05/08/2023]
Abstract
Marine organisms normally swim at elevated speeds relative to cruising speeds only during strenuous activity, such as predation or escape. We measured swimming speeds of 29 ram ventilating sharks from 10 species and of three Atlantic bluefin tunas immediately after exhaustive exercise (fighting a capture by hook-and-line) and unexpectedly found all individuals exhibited a uniform mechanical response, with swimming speed initially two times higher than the cruising speeds reached approximately 6 h later. We hypothesized that elevated swimming behaviour is a means to increase energetic demand and drive the removal of lactate accumulated during capture via oxidation. To explore this hypothesis, we estimated the mechanical work that must have been spent by an animal to elevate its swim speed and then showed that the amount of lactate that could have been oxidized to fuel it comprises a significant portion of the amount of lactate normally observed in fishes after exhaustive exercise. An estimate for the full energetic cost of the catch-and-release event ensued.
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Affiliation(s)
- G. Iosilevskii
- Department of Aerospace Engineering, Technion Haifa, 32000 Israel
| | - J. D. Kong
- School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - C. G. Meyer
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | | | | | - M. A. Royer
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | - I. Nakamura
- Organization for Marine Science and Technology, Nagasaki University, Nagasaki, Nagasaki 851-2213, Japan
| | - K. Sato
- International Coastal Research Center, Atmosphere and Ocean Research Institute, University of Tokyo, Iwate, Japan
| | - T. K. Doyle
- Zoology, Ecology and Plant Science, Environmental Research Institute, University College Cork, Cork T23 XE10, Ireland
| | - L. Harman
- Zoology, Ecology and Plant Science, Environmental Research Institute, University College Cork, Cork T23 XE10, Ireland
| | - J. D. R. Houghton
- Biological Sciences, Queen's University Belfast, Belfast, County Antrim BT9 7BL, UK
| | - A. Barnett
- James Cook University, Cairns, Queensland, Australia
| | - J. M. Semmens
- Institute of Marine and Antarctic Studies, University of Tasmania, Hobart, Tasmania 7001, Australia
| | | | - A. Drumm
- Marine Institute, Newport, County Mayo, Ireland
| | - R. O'Neill
- Marine Institute, Newport, County Mayo, Ireland
| | - D. M. Coffey
- Hawaii Institute of Marine Biology, University of Hawaii, Kaneohe, HI 96744, USA
| | - N. L. Payne
- School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
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Blythe R, White N, Kularatna S, McPhail S, Barnett A. A Bayesian Approach for Incorporating the EQ-5D Visual Analog Scale When Estimating the Health-Related Quality of Life. Value Health 2022; 25:1575-1581. [PMID: 35304036 DOI: 10.1016/j.jval.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/10/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The EuroQoL 3-level version of EQ-5D and 5-level version of EQ-5D questionnaires are often used to quantify health states. They include ordinal responses across 5 health dimensions (EQ-5D index) and an EQ-visual analog scale (EQ-VAS) overall health rating. We investigated the value of incorporating the EQ-VAS to update health utility estimates using a Bayesian framework. METHODS We created a joint bivariate normal EQ-VAS and EQ-5D index utility model and compared this to a univariate normal EQ-5D index utility model. We tested these models for 1026 Sri Lankan patients with chronic kidney disease and 94 Australian patients with wounds. We validated our approach by simulating EQ-VAS and EQ-5D index responses and applying our Bayesian model and then comparing the modeled estimates to our observed data. RESULTS The combined model showed a reduction in estimate uncertainty for all respondents. Compared with the EQ-5D index-only model, the mean utility for Sri Lankan respondents dropped from 0.556 (0.534-0.579) to 0.540 (0.521-0.559) in men and increased from 0.489 (0.461-0.518) to 0.528 (0.506-0.550) in women, with reduced credible interval width by 13% and 23%, respectively. The mean utility in Australian respondents moved from 0.715 (0.633-0.800) to 0.716 (0.652-0.782) in men, and 0.652 (0.581-0.723) to 0.652 (0.593-0.711) in women, with reduced credible interval width by 23% and 17%, respectively. The credible interval width for simulated data also narrowed, ranging from 8.3 to 8.5%. CONCLUSIONS Including the EQ-VAS through Bayesian methods can add value by reducing requisite sample sizes and decision uncertainty using small amounts of additional data that is often collected but rarely used.
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Affiliation(s)
- Robin Blythe
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
| | - Nicole White
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Steven McPhail
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Shipton E, Meloncelli N, D'Emden M, McIntyre HD, Callaway L, Barnett A, de Jersey S. Gestational diabetes screening from the perspective of consumers: Insights from early in the COVID-19 pandemic and opportunities to optimise experiences. Aust N Z J Obstet Gynaecol 2022; 63:154-162. [PMID: 35962529 DOI: 10.1111/ajo.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Consumer perspectives are a cornerstone of value-based healthcare. Screening and diagnosis of gestational diabetes mellitus (GDM) were among many of the rapid changes to health care recommended during the COVID-19 pandemic. The changes provided a unique opportunity to add information about women's perspectives on the debate on GDM screening. AIMS The aim of this qualitative study was to explore women's perspectives and understanding of GDM screening and diagnosis comparing the modified COVID-19 recommendations to standard GDM screening and diagnostic practices. METHODS Women who had experienced both the standard and modified GDM screening and diagnostic processes were recruited for telephone interviews. Data analysis used inductive reflexive thematic analysis. Online surveys were disseminated to any registrant not included in interviews to provide an opportunity for all interested participants to provide their perspective. RESULTS Twenty-nine telephone interviews were conducted and 19 survey responses were received. Seven themes were determined: (1) information provision from clinicians; (2) acceptability of GDM screening; (3) individualisation of GDM screening methods; (4) safety nets to avoid a missed diagnosis; (5) informed decision making; (6) women want information and evidence; and (7) preferred GDM screening methods for the future. CONCLUSIONS Overall, women preferred the modified GDM screening recommendations put in place due to the COVID-19 pandemic. However, their preference was influenced by their prior screening experience and perception of personal risk profile. Women expressed a strong need for clear communication from health professionals and the opportunity to be active participants in decision making.
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Affiliation(s)
- Emma Shipton
- Women's and Newborn Services Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Nina Meloncelli
- Faculty of Medicine, Centre for Clinical Research and Perinatal Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael D'Emden
- Department of Endocrinology and Diabetes, The Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, Queensland, Australia
| | - H David McIntyre
- Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Leonie Callaway
- Women's and Newborn Services Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
- Faculty of Medicine, Centre for Clinical Research and Perinatal Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Susan de Jersey
- Faculty of Medicine, Centre for Clinical Research and Perinatal Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
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21
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Schulz R, Barnett A, Bernard R, Brown NJL, Byrne JA, Eckmann P, Gazda MA, Kilicoglu H, Prager EM, Salholz-Hillel M, Ter Riet G, Vines T, Vorland CJ, Zhuang H, Bandrowski A, Weissgerber TL. Is the future of peer review automated? BMC Res Notes 2022; 15:203. [PMID: 35690782 PMCID: PMC9188010 DOI: 10.1186/s13104-022-06080-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 12/19/2022] Open
Abstract
The rising rate of preprints and publications, combined with persistent inadequate reporting practices and problems with study design and execution, have strained the traditional peer review system. Automated screening tools could potentially enhance peer review by helping authors, journal editors, and reviewers to identify beneficial practices and common problems in preprints or submitted manuscripts. Tools can screen many papers quickly, and may be particularly helpful in assessing compliance with journal policies and with straightforward items in reporting guidelines. However, existing tools cannot understand or interpret the paper in the context of the scientific literature. Tools cannot yet determine whether the methods used are suitable to answer the research question, or whether the data support the authors' conclusions. Editors and peer reviewers are essential for assessing journal fit and the overall quality of a paper, including the experimental design, the soundness of the study's conclusions, potential impact and innovation. Automated screening tools cannot replace peer review, but may aid authors, reviewers, and editors in improving scientific papers. Strategies for responsible use of automated tools in peer review may include setting performance criteria for tools, transparently reporting tool performance and use, and training users to interpret reports.
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Affiliation(s)
- Robert Schulz
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - René Bernard
- NeuroCure Cluster of Excellence, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Jennifer A Byrne
- Faculty of Medicine and Health, New South Wales Health Pathology, The University of Sydney, New South Wales, Australia
| | - Peter Eckmann
- Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA
| | - Małgorzata A Gazda
- UMR 3525, Institut Pasteur, Université de Paris, CNRS, INSERM UA12, Comparative Functional Genomics group, Paris, France
| | - Halil Kilicoglu
- School of Information Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Eric M Prager
- Translational Research and Development, Cohen Veterans Bioscience, New York, NY, USA
| | - Maia Salholz-Hillel
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gerben Ter Riet
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Science, Amsterdam, The Netherlands
| | - Timothy Vines
- DataSeer Research Data Services Ltd, Vancouver, BC, Canada
| | - Colby J Vorland
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Han Zhuang
- School of Information Studies, Syracuse University, Syracuse, NY, USA
| | - Anita Bandrowski
- Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA
| | - Tracey L Weissgerber
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin, Germany.
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22
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Visvalingam R, Ridley E, Barnett A, Rahman T, Fraser JF. Nutrition adequacy, gastrointestinal and hepatic function during extracorporeal membrane oxygenation in critically ill adults: a retrospective observational study. Artif Organs 2022; 46:1886-1892. [PMID: 35451130 DOI: 10.1111/aor.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/17/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
AIMS To identify clinical and biochemical markers associated with nutrition adequacy and gastrointestinal and liver dysfunction in adults on extracorporeal membrane oxygenation (ECMO). METHODS A retrospective, observational, study was conducted at 2 centres in Australia. Adult patients who received ECMO from July 2011 to June 2015 were included. Mode of ECMO used, fluid balance, number of systemic inflammatory response syndrome (SIRS) criteria present, vasoactive-inotropic scores (VIS) and liver function tests (LFTs) were collected for the duration of ECMO until 7 days after ECMO cessation. Multiple regression models were used to determine if the collected variables were associated with nutrition adequacy. The mean LFTs during ECMO were also compared to mean LFTs post ECMO cessation. RESULTS During the first 5 days of ECMO commencement, mean nutrition adequacy was 10% higher in the veno-venous (VV) ECMO group than in the veno-arterial (VA) group (95% confidence interval [CI], 2% to 17%). For every 5,000 ml increase of fluid balance, an associated decrease in nutrition adequacy was observed (-8%, 95% CI, -15% to -2%). A doubling of bilirubin and VIS were associated with a mean reduction in nutrition adequacy of -5% (CI -8% to -2%) and -2% (CI, -3% to -1%), respectively. CONCLUSIONS In the first 5 days of ECMO commencement, higher nutrition adequacy was associated with the VV mode of ECMO and reduced nutrition adequacy with increased fluid balance, more vasopressor and inotropic support and raised bilirubin. Prospective investigation is required to confirm whether these associations have a causal relationship.
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Affiliation(s)
- R Visvalingam
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | - E Ridley
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.,Nutrition Department, The Alfred Hospital, Melbourne, Australia
| | - A Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia
| | - T Rahman
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Australia
| | - J F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
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23
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Marsden E, Craswell A, Taylor A, Barnett A, Wong PK, Wallis M. Translation of the geriatric emergency department intervention into other emergency departments: a post implementation evaluation of outcomes for older adults. BMC Geriatr 2022; 22:290. [PMID: 35392828 PMCID: PMC8988321 DOI: 10.1186/s12877-022-02999-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/26/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Increasing numbers of older adults with complex health deficits presenting to emergency departments has prompted the development of innovative models of care. One such model designed to reduce poor outcomes associated with acute healthcare, is the Geriatric Emergency Department Intervention. This intervention is a nurse-led, physician-championed, Emergency Department intervention that improves the health outcomes for frail older adults in the emergency department. Methods This quantitative cohort study aimed to evaluate the healthcare outcomes and costs associated with the implementation of the Geriatric Emergency Department Intervention (GEDI) for adults aged 70 years and over at two hospital sites that implemented the model using the integrated-Promoting Action on Research Implementation in Health Services (i-PARHIS) framework. Hospital A was large teaching hospital located in the tropical north of Australia. Hospital B was a medium sized teaching hospital near Brisbane, Queensland Australia. The effect of the intervention was examined in two ways. Outcomes were compared between: 1) all patients in the pre- and post- implementation periods, and 2) patients seen or not seen by the Geriatric Emergency Department Intervention team in the post-implementation period. The outcomes measured were disposition (discharged home, admitted); emergency department length of stay; hospital length of stay; all cause in-hospital mortality within 28 days; time to re-presentation up to 28 days post-discharge; emergency department and in-hospital costs. Survival analyses were used for the primary and secondary outcome variables and a Cox survival model was used to estimate the associations between variables and outcomes. Multiple regression models were used to examine other secondary outcomes whilst controlling for a range of confounders. Results The Geriatric Emergency Department Intervention was successfully translated into two different emergency departments. Both demonstrated an increased likelihood of discharge, decreased emergency department length of stay, decreased hospital costs for those who were admitted, with an associated reduction in risk of mortality, for adults aged 70 years and over. Conclusions The Geriatric Emergency Department Intervention was successfully translated into new sites that adapted the model design. Improvement in healthcare outcomes for older adults presenting to the emergency department was demonstrated, although this was more subtle than in the original model setting.
Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02999-4.
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Affiliation(s)
- Elizabeth Marsden
- Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, 4 Doherty Street, Birtinya, QLD, 4575, Australia
| | - Alison Craswell
- University of the Sunshine Coast, Sunshine Coast Health Institute, 4 Doherty Street, Birtinya, QLD, Australia.
| | - Andrea Taylor
- Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, 4 Doherty Street, Birtinya, QLD, 4575, Australia
| | - Adrian Barnett
- Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, Qld, 4059, Australia
| | - Pan-Kar Wong
- Gold Coast Hospital and Health Service, Gold Coast University Hospital, 1 Hospital Blvd, Gold Coast, Qld, 4215, Australia
| | - Marianne Wallis
- University of the Sunshine Coast, Sunshine Coast Health Institute, 4 Doherty Street, Birtinya, QLD, Australia.,Southern Cross University, Southern Cross Drive, Bilinga, QLD, 4225, Australia
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24
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Barnett A, Page K, Dyer C, Cramb S. Meta-research: Justifying career disruption in funding applications, a survey of Australian researchers. eLife 2022; 11:76123. [PMID: 35373737 PMCID: PMC9038190 DOI: 10.7554/elife.76123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 04/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background: When researchers’ careers are disrupted by life events – such as illness or childbirth – they often need to take extended time off. This creates a gap in their research output that can reduce their chances of winning funding. In Australia, applicants can disclose their career disruptions and peer reviewers are instructed to make appropriate adjustments. However, it is not clear if and how applicants use career disruption sections or how reviewers adjust and if they do it consistently. Methods: To examine career disruption, we used surveys of the Australian health and medical research community. We used both a random sample of Australian authors on PubMed and a non-random convenience sample. Results: Respondents expressed concerns that sharing information on career disruption would harm their chances of being funded, with 13% saying they have medical or social circumstances but would not include it in their application, with concerns about appearing ‘weak’. Women were more reluctant to include disruption. There was inconsistency in how disruption was adjusted for, with less time given for those with depression compared with caring responsibilities, and less time given for those who did not provide medical details of their disruption. Conclusions: The current system is likely not adequately adjusting for career disruption and this may help explain the ongoing funding gap for senior women in Australia. Funding: National Health and Medical Research Council Senior Research Fellowship (Barnett). Science is an expensive endeavor. To pursue their ideas, most researchers need to win funding by submitting applications to highly competitive schemes with low success rates. Funding decisions depend on many factors, but usually take into consideration a researcher’s track record: publications, collaborations with other researchers and even other awards they have received. Researchers whose careers have been disrupted by life events, including childbearing or being ill, may have a gap in their track record that reduces their chances of winning funding. Historically, female researchers have experienced career disruptions more often, leading to a funding gap between male and female researchers. To increase fairness and reduce this gap, many funding agencies have instructed the peer reviewers – other scientists – who assess funding applications to adjust their scores to account for career disruptions. However, large funding gaps are still frequently observed between female and male researchers. Barnett et al. wanted to know how career disruption is considered in practice by establishing what personal details are shared in applications by researchers with disruption, and how reviewers treat this information. To find out, they surveyed medical researchers in Australia and asked them for their views on career disruption as both funding applicants and reviewers of funding applications. The answers to the survey indicated that 13% of the applicants responding had experienced career disruptions, but would not include them in funding applications. In many cases, this reluctance to disclose career disruptions was due to concerns that it would harm an applicant’s chances of winning funding, a concern that was greater in the women who responded to the survey. Researchers who answered the survey would claim less time off on average if their career disruption was for severe depression compared with caring for a child or elderly relative. Additionally, the answers to the survey show that, on average, peer reviewers – the scientists who assessed the applications – would give more time off to applicants who provided details about the medical issues that caused a career disruption than to those who did not. The results of this survey suggest that changes in the systems used to apply for funding and in how applications are assessed could make funding fairer. One suggestion would be to modify funding applications to make disruptions easier to report. Another would be to make changes to the reviewing procedures to increase privacy and reduce variability in how disruption is assessed. Changes in these directions could help researchers gain access to funding more fairly, increasing the quality and output of scientific research.
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Affiliation(s)
- Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Katie Page
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Carly Dyer
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Susanna Cramb
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
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25
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Barnett A, Beasley R, Buchan C, Chien J, Farah CS, King G, McDonald CF, Miller B, Munsif M, Psirides A, Reid L, Roberts M, Smallwood N, Smith S. Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: 'Swimming between the flags'. Respirology 2022; 27:262-276. [PMID: 35178831 PMCID: PMC9303673 DOI: 10.1111/resp.14218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/28/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022]
Abstract
Oxygen is a life-saving therapy but, when given inappropriately, may also be hazardous. Therefore, in the acute medical setting, oxygen should only be given as treatment for hypoxaemia and requires appropriate prescription, monitoring and review. This update to the Thoracic Society of Australia and New Zealand (TSANZ) guidance on acute oxygen therapy is a brief and practical resource for all healthcare workers involved with administering oxygen therapy to adults in the acute medical setting. It does not apply to intubated or paediatric patients. Recommendations are made in the following six clinical areas: assessment of hypoxaemia (including use of arterial blood gases); prescription of oxygen; peripheral oxygen saturation targets; delivery, including non-invasive ventilation and humidified high-flow nasal cannulae; the significance of high oxygen requirements; and acute hypercapnic respiratory failure. There are three sections which provide (1) a brief summary, (2) recommendations in detail with practice points and (3) a detailed explanation of the reasoning and evidence behind the recommendations. It is anticipated that these recommendations will be disseminated widely in structured programmes across Australia and New Zealand.
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Affiliation(s)
- Adrian Barnett
- Department of Respiratory and Sleep MedicineMater Public HospitalSouth BrisbaneQueenslandAustralia
| | - Richard Beasley
- Medical Research Institute of New Zealand & Capital Coast District Health BoardWellingtonNew Zealand
| | - Catherine Buchan
- Department of Respiratory and Sleep MedicineThe Alfred HospitalMelbourneVictoriaAustralia
- Department of Immunology and Respiratory MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Jimmy Chien
- Department of Respiratory and Sleep MedicineWestmead Hospital, Ludwig Engel Centre for Respiratory Research and University of SydneySydneyNew South WalesAustralia
| | - Claude S. Farah
- Department of Respiratory Medicine, Concord HospitalMacquarie University and University of SydneySydneyNew South WalesAustralia
| | - Gregory King
- Department of Respiratory and Sleep Medicine, Royal North Shore HospitalWoolcock Institute of Medical Research and University of SydneySydneyNew South WalesAustralia
| | - Christine F. McDonald
- Department of Respiratory and Sleep MedicineAustin Health and University of MelbourneMelbourneVictoriaAustralia
| | - Belinda Miller
- Department of Respiratory MedicineThe Alfred Hospital and Monash UniversityMelbourneVictoriaAustralia
| | - Maitri Munsif
- Department of Respiratory and Sleep MedicineAustin Health and University of MelbourneMelbourneVictoriaAustralia
| | - Alex Psirides
- Intensive Care UnitWellington Regional Hospital, Capital and Coast District Health BoardWellingtonNew Zealand
| | - Lynette Reid
- Respiratory MedicineRoyal Hobart HospitalHobartTasmaniaAustralia
| | - Mary Roberts
- Department of Respiratory and Sleep MedicineWestmead Hospital, Ludwig Engel Centre for Respiratory Research and University of SydneySydneyNew South WalesAustralia
| | - Natasha Smallwood
- Department of Respiratory and Sleep MedicineThe Alfred HospitalMelbourneVictoriaAustralia
- Department of Immunology and Respiratory MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Sheree Smith
- School of Nursing and MidwiferyWestern Sydney UniversitySydneyNew South WalesAustralia
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26
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Mudge AM, McRae P, Banks M, Blackberry I, Barrimore S, Endacott J, Graves N, Green T, Harvey G, Hubbard R, Kurrle S, Lim WK, Lee-Steere K, Masel P, Pandy S, Young A, Barnett A, Inouye SK. Effect of a Ward-Based Program on Hospital-Associated Complications and Length of Stay for Older Inpatients: The Cluster Randomized CHERISH Trial. JAMA Intern Med 2022; 182:274-282. [PMID: 35006265 PMCID: PMC8749692 DOI: 10.1001/jamainternmed.2021.7556] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 01/12/2023]
Abstract
IMPORTANCE Hospital-associated complications of older people (HAC-OPs) include delirium, hospital-associated disability, incontinence, pressure injuries, and falls. These complications may be preventable by age-friendly principles of care, including early mobility, good nutrition and hydration, and meaningful cognitive engagement; however, implementation is challenging. OBJECTIVES To implement and evaluate a ward-based improvement program ("Eat Walk Engage") to more consistently deliver age-friendly principles of care to older individuals in acute inpatient wards. DESIGN, SETTING, AND PARTICIPANTS This cluster randomized CHERISH (Collaboration for Hospitalised Elders Reducing the Impact of Stays in Hospital) trial enrolled 539 consecutive inpatients aged 65 years or older, admitted for 3 days or more to study wards, from October 2, 2016, to April 3, 2017, with a 6-month follow-up. The study wards comprised 8 acute medical and surgical wards in 4 Australian public hospitals. Randomization was stratified by hospital, providing 4 clusters in intervention and in control groups. Statistical analysis was performed from August 28, 2018, to October 17, 2021, on an intention-to-treat basis. INTERVENTION A trained facilitator supported a multidisciplinary work group on each intervention ward to improve the care practices, environment, and culture to support key age-friendly principles. MAIN OUTCOMES AND MEASURES Primary outcomes were incidence of any HAC-OP and length of stay. Secondary outcomes were incidence of individual HAC-OPs, facility discharge, 6-month mortality, and all-cause readmission. Outcomes were analyzed at the individual level, adjusted for confounders and clustering. RESULTS A total of 265 participants on 4 intervention wards (124 women [46.8%]; mean [SD] age, 75.9 [7.3] years) and 274 participants on 4 control wards (145 women [52.9%]; mean [SD] age, 78.0 [8.2] years) were enrolled. The composite primary outcome of any HAC-OP occurred for 115 of 248 intervention participants (46.4%) and 129 of 249 control participants (51.8%) (intervention group: adjusted odds ratio, 1.07; 95% CI, 0.71-1.61). The median length of stay was 6 days (IQR, 4-9 days) for the intervention group and 7 days (IQR, 5-10 days) for the control group (adjusted hazard ratio, 0.96; 95% credible interval, 0.80-1.15). The incidence of delirium was significantly lower for intervention participants (adjusted odds ratio, 0.53; 95% CI, 0.31-0.90). There were no significant differences in other individual HAC-OPs, facility discharge, mortality, or readmissions. CONCLUSIONS AND RELEVANCE The Eat Walk Engage program did not reduce the composite primary outcome of any HAC-OP or length of stay, but there was a significant reduction in the incidence of delirium. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12615000879561.
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Affiliation(s)
- Alison M Mudge
- Internal Medicine and Aged Care Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Prue McRae
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.,Eat Walk Engage Program, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Merrilyn Banks
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Irene Blackberry
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Melbourne, Victoria, Australia
| | - Sally Barrimore
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - John Endacott
- Geriatrics Department, Nambour Hospital, Nambour, Queensland, Australia
| | - Nicholas Graves
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.,Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Theresa Green
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia.,STARS Research and Education Alliance, Metro North Health Surgical Treatment and Rehabilitation Service, Brisbane, Queensland, Australia
| | - Gill Harvey
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Ruth Hubbard
- Centre for Research in Geriatric Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Sue Kurrle
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Wen Kwang Lim
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Aged Care Services, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Karen Lee-Steere
- Eat Walk Engage Program, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Phil Masel
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Shaun Pandy
- Department of Internal Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Adrienne Young
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sharon K Inouye
- Marcus Institute for Ageing Research, Hebrew SeniorLife, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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27
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Hewage S, Noviyani R, Barnett A, Parsonage W, Brain D, McPhail S, Sharma P, Kularatna S. Cost-Effectiveness of Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Meta-Analysis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.156] [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] [Indexed: 10/16/2022]
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28
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Roope LSJ, Barnett A, Candio P, Violato M, Duch R, Clarke PM. Is There Broad-Based Support in High-Income Countries for COVID-19 Vaccine Donation? Evidence from Seven Countries. Appl Health Econ Health Policy 2022; 20:55-65. [PMID: 34841474 PMCID: PMC8627792 DOI: 10.1007/s40258-021-00696-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many high-income countries (HICs) have now vaccinated a substantial proportion of their population against COVID-19. Many low-income countries (LICs) may need to wait until at least 2022 before even the most vulnerable 20% of their populations are vaccinated. Beyond ethical considerations, some redistribution of doses would reduce the risk of the emergence and spread of new variants and benefit the economy, both globally and in donor countries. However, the willingness of HIC governments to donate vaccine doses is likely to depend on public support. While previous work has indicated strong average levels of public support in HIC for donation, little is known about how broad-based this support is. OBJECTIVE To investigate the extent to which support for donation holds across both pre-specified and exploratory subgroups. METHODS From 24 November-28 December 2020 we conducted an online survey of 8209 members of the general public in seven HIC (Australia, Canada, France, Italy, Spain, UK and USA). We conducted tests of proportions and used Bayesian ordinal logistic regression models to assess the extent of support for donation across population subgroups. RESULTS We found broad-based support for donations in terms of age, gender, socio-economic status and political ideology. We found no strong evidence that support for donations was higher among those with greater income or a university education. Support for donation among those on the political right and centre was lower than on the left, but 51% (95% confidence interval 48-53%) of respondents who identified with the right supported some level of donation. Those in the more altruistic half of the sample (as captured by willingness to donate money to a good cause) were more likely to support donation than those who were not, but around half of the less altruistic group supported some level of donation. CONCLUSION There is broad-based support for policymakers in HICs to donate some of their countries' COVID-19 vaccine doses for distribution to LICs.
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Affiliation(s)
- Laurence S J Roope
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK.
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Paolo Candio
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- Centre for Economics of Obesity, University of Birmingham, Birmingham, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Raymond Duch
- Nuffield College, University of Oxford, Oxford, UK
| | - Philip M Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia
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Cho SM, Premraj L, Fanning J, Huth S, Barnett A, Whitman G, Arora RC, Battaglini D, Porto DB, Choi H, Suen J, Bassi GL, Fraser JF, Robba C, Griffee M. Ischemic and Hemorrhagic Stroke Among Critically Ill Patients With Coronavirus Disease 2019: An International Multicenter Coronavirus Disease 2019 Critical Care Consortium Study. Crit Care Med 2021; 49:e1223-e1233. [PMID: 34269719 PMCID: PMC8594524 DOI: 10.1097/ccm.0000000000005209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Stroke has been reported in observational series as a frequent complication of coronavirus disease 2019, but more information is needed regarding stroke prevalence and outcomes. We explored the prevalence and outcomes of acute stroke in an international cohort of patients with coronavirus disease 2019 who required ICU admission. DESIGN Retrospective analysis of prospectively collected database. SETTING A registry of coronavirus disease 2019 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with acute stroke during their stay. PATIENTS Patients older than 18 years old with acute coronavirus disease 2019 infection in ICU. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of 2,699 patients identified (median age 59 yr; male 65%), 59 (2.2%) experienced acute stroke: 0.7% ischemic, 1.0% hemorrhagic, and 0.5% unspecified type. Systemic anticoagulant use was not associated with any stroke type. The frequency of diabetes, hypertension, and smoking was higher in patients with ischemic stroke than in stroke-free and hemorrhagic stroke patients. Extracorporeal membrane oxygenation support was more common among patients with hemorrhagic (56%) and ischemic stroke (16%) than in those without stroke (10%). Extracorporeal membrane oxygenation patients had higher cumulative 90-day probabilities of hemorrhagic (relative risk = 10.5) and ischemic stroke (relative risk = 1.7) versus nonextracorporeal membrane oxygenation patients. Hemorrhagic stroke increased the hazard of death (hazard ratio = 2.74), but ischemic stroke did not-similar to the effects of these stroke types seen in noncoronavirus disease 2019 ICU patients. CONCLUSIONS In an international registry of ICU patients with coronavirus disease 2019, stroke was infrequent. Hemorrhagic stroke, but not ischemic stroke, was associated with increased mortality. Further, both hemorrhagic stroke and ischemic stroke were associated with traditional vascular risk factors. Extracorporeal membrane oxygenation use was strongly associated with both stroke and death.
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Affiliation(s)
- Sung-Min Cho
- Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Jonathon Fanning
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
| | - Samuel Huth
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Glenn Whitman
- Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rakesh C Arora
- Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Griffith University School of Medicine, Gold Coast, QLD, Australia
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cardiac Science Program, St Boniface General Hospital Research Centre, Winnipeg, MB, Canada
- University of Toronto, Toronto, ON, Canada
- University of Manitoba, Winnipeg, MB, Canada
- Department of Surgical Science and Integrated Diagnostic, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, University of Genoa, Genoa, Italy
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Hospital Sao Camilo de Esteio, Esteio, Brazil
- University of Texas Health Sciences Center, Houston, TX
- Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain
- St Andrew's War Memorial Hospital, UnitingCare, Spring Hill, QLD, Australia
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
| | - Denise Battaglini
- Department of Surgical Science and Integrated Diagnostic, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, University of Genoa, Genoa, Italy
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - HuiMahn Choi
- University of Texas Health Sciences Center, Houston, TX
| | - Jacky Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine University of Queensland, Brisbane, QLD, Australia
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- St Andrew's War Memorial Hospital, UnitingCare, Spring Hill, QLD, Australia
| | - Chiara Robba
- Department of Surgical Science and Integrated Diagnostic, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, University of Genoa, Genoa, Italy
| | - Matthew Griffee
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
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30
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Abrantes K, Barnett A, Soetaert M, Kyne PM, Laird A, Squire L, Seymour J, Wueringer BE, Sleeman J, Huveneers C. Potential of electric fields to reduce bycatch of highly threatened sawfishes. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sawfishes are among the most threatened families of marine fishes and are susceptible to incidental capture in net fisheries. Since bycatch reduction devices currently used in trawl fisheries are not effective at reducing sawfish catches, new methods to minimise sawfish bycatch are needed. Ideally, these should affect sawfish behaviour and prevent contact with the fishing gear. We tested the effects of electric fields on sawfish behaviour to assess the potential of electric pulses in mitigating sawfish bycatch. Experiments were conducted in a tank where 2 electrodes were suspended in the water column, connected to a pulse generator, and placed across the swimming path of sawfish. Two largetooth sawfish Pristis pristis were tested in control conditions, in the presence of a baseline pulse, and of 5 variations of that pulse where 1 parameter (polarity, voltage, frequency, pulse shape, pulse duration) was altered at a time. Conditional inference trees were used to identify the effects of various parameters (e.g. treatment, individual) on reaction type, reaction distance, twitching presence and duration, and inter-approach times. Sawfish reacted to electric fields, but reaction distances were small (typically <1.2 m), and no field tested consistently led to reactions conducive to escaping from moving nets. The following parameters induced the most response in both individuals: bipolar current, rectangular shaped, 5-10 Hz, ~1500 µs duration, and 100 V. We recommend further research focussing on moving nets, testing a V-shaped electric array preceding the net mouth by at least 5 m, and testing a setup similar to electrotrawling.
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Affiliation(s)
- K Abrantes
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
- Biopixel Oceans Foundation, Cairns, Qld 4870, Australia
| | - A Barnett
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
- Biopixel Oceans Foundation, Cairns, Qld 4870, Australia
| | - M Soetaert
- Institute for Agricultural and Fisheries Research, Animal Sciences - Fisheries, Ankerstraat 1, 8400 Oostende, Belgium
| | - PM Kyne
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, NT 0815, Australia
| | - A Laird
- Northern Prawn Fishery Industry Pty Ltd, Caloundra, Qld 4551, Australia
| | - L Squire
- Cairns Marine, Cairns, Qld 4870, Australia
| | - J Seymour
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Qld 4870, Australia
| | - BE Wueringer
- Sharks and Rays Australia, PO Box 575, Bungalow, Cairns, Qld 4870, Australia
| | - J Sleeman
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Qld 4870, Australia
| | - C Huveneers
- College of Science and Engineering, Flinders University, Bedford Park, Adelaide, SA 5042, Australia
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31
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Wildi K, Li Bassi G, Barnett A, Panigada M, Colombo SM, Bandera A, Muscatello A, McNicholas B, Laffey JG, Battaglini D, Robba C, Torres A, Motos A, Luna CM, Rainieri F, Hodgson C, Burrell AJC, Buscher H, Dalton H, Cho SM, Choi HA, Thomson D, Suen J, Fraser JF. Design and Rationale of a Prospective International Follow-Up Study on Intensive Care Survivors of COVID-19: The Long-Term Impact in Intensive Care Survivors of Coronavirus Disease-19-AFTERCOR. Front Med (Lausanne) 2021; 8:738086. [PMID: 34568393 PMCID: PMC8455846 DOI: 10.3389/fmed.2021.738086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/09/2021] [Indexed: 01/16/2023] Open
Abstract
Background: In a disease that has only existed for 18 months, it is difficult to be fully informed of the long-term sequelae of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Evidence is growing that most organ systems can be affected by the virus, causing severe disabilities in survivors. The extent of the aftermath will declare itself over the next 5-10 years, but it is likely to be substantial with profound socio-economic impact on society. Methods: This is an international multi-center, prospective long-term follow-up study of patients who developed severe coronavirus disease-2019 (COVID-19) and were admitted to Intensive Care Units (ICUs). The study will be conducted at international tertiary hospitals. Patients will be monitored from time of ICU discharge up to 24 months. Information will be collected on demographics, co-existing illnesses before ICU admission, severity of illness during ICU admission and post-ICU quality of life as well as organ dysfunction and recovery. Statistical analysis will consist of patient trajectories over time for the key variables of quality of life and organ function. Using latent class analysis, we will determine if there are distinct patterns of patients in terms of recovery. Multivariable regression analyses will be used to examine associations between baseline characteristics and severity variables upon admission and discharge in the ICU, and how these impact outcomes at all follow-up time points up to 2 years. Ethics and Dissemination: The core study team and local principal investigators will ensure that the study adheres to all relevant national and local regulations, and that the necessary approvals are in place before a site may enroll patients. Clinical Trial Registration:anzctr.org.au: ACTRN12620000799954.
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Affiliation(s)
- Karin Wildi
- Critical Care Research Group, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Cardiovascular Research Institute Basel, Basel, Switzerland
| | - Gianluigi Li Bassi
- Critical Care Research Group, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology QUT, Brisbane, QLD, Australia
| | - Mauro Panigada
- Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Sebastiano M Colombo
- Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Bairbre McNicholas
- Galway University Hospitals, National University of Ireland, Galway, Ireland
| | - John G Laffey
- Galway University Hospitals, National University of Ireland, Galway, Ireland
| | - Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Chiara Robba
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Antoni Torres
- Servei de Pneumologia, Hospital Clinic, University of Barcelona, IDIBAPS, ICREA, CIBERESUCICOVID, Barcelona, Spain
| | - Ana Motos
- Servei de Pneumologia, Hospital Clinic, University of Barcelona, IDIBAPS, ICREA, CIBERESUCICOVID, Barcelona, Spain
| | | | | | - Carol Hodgson
- The Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | | | - Hergen Buscher
- St. Vincent's Hospital Sydney, University of New South Wales, Darlinghurst, NSW, Australia
| | - Heidi Dalton
- Inova Fairfax Hospital, Falls Church, VA, United States
| | - Sung-Min Cho
- Departments of Neurology, Neurosurgery, Anesthesia and Critical Care Medicine, John Hopkins Hospital, Baltimore, MD, United States
| | | | - David Thomson
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Jacky Suen
- Critical Care Research Group, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - John F Fraser
- Critical Care Research Group, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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32
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Duch R, Roope LSJ, Violato M, Fuentes Becerra M, Robinson TS, Bonnefon JF, Friedman J, Loewen PJ, Mamidi P, Melegaro A, Blanco M, Vargas J, Seither J, Candio P, Gibertoni Cruz A, Hua X, Barnett A, Clarke PM. Citizens from 13 countries share similar preferences for COVID-19 vaccine allocation priorities. Proc Natl Acad Sci U S A 2021; 118:2026382118. [PMID: 34526400 DOI: 10.1101/2021.01.31.21250866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 05/26/2023] Open
Abstract
How does the public want a COVID-19 vaccine to be allocated? We conducted a conjoint experiment asking 15,536 adults in 13 countries to evaluate 248,576 profiles of potential vaccine recipients who varied randomly on five attributes. Our sample includes diverse countries from all continents. The results suggest that in addition to giving priority to health workers and to those at high risk, the public favors giving priority to a broad range of key workers and to those with lower income. These preferences are similar across respondents of different education levels, incomes, and political ideologies, as well as across most surveyed countries. The public favored COVID-19 vaccines being allocated solely via government programs but were highly polarized in some developed countries on whether taking a vaccine should be mandatory. There is a consensus among the public on many aspects of COVID-19 vaccination, which needs to be taken into account when developing and communicating rollout strategies.
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Affiliation(s)
- Raymond Duch
- Nuffield College, University of Oxford, Oxford OX1 1NF, United Kingdom;
| | - Laurence S J Roope
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | | | - Thomas S Robinson
- School of Government and International Affairs, Durham University, Durham DH1 3TU, United Kingdom
| | - Jean-Francois Bonnefon
- Toulouse School of Economics, CNRS, Université Toulouse Capitole, 31000 Toulouse, France
| | - Jorge Friedman
- Facultad de Administracion y Economia, Universidad de Santiago de Chile, Santiago 9170022, Chile
| | - Peter John Loewen
- Department of Political Science, Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, ON M5S1A4, Canada
| | - Pavan Mamidi
- Center for Social and Behavioral Change, Ashoka University, Sonipat, Haryana 131029, India
| | - Alessia Melegaro
- Dondena Centre for Research on Social Dynamics and Public Policies, Department of Social and Political Science, Bocconi University, 20136 Milan, Italy
| | - Mariana Blanco
- Facultad de Economia, Universidad del Rosario, Bogotá 111711, D.C. Colombia
| | - Juan Vargas
- Facultad de Economia, Universidad del Rosario, Bogotá 111711, D.C. Colombia
| | - Julia Seither
- Facultad de Economia, Universidad del Rosario, Bogotá 111711, D.C. Colombia
| | - Paolo Candio
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Ana Gibertoni Cruz
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Xinyang Hua
- Centre For Health Policy, University of Melbourne, Parkville, VIC 3010, Australia
| | - Adrian Barnett
- Institute of Health Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Philip M Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
- Centre For Health Policy, University of Melbourne, Parkville, VIC 3010, Australia
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33
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Cramb DS, Lazzarini DP, Barnett A, Daniel M. 899Stepping up: identifying small-area variation in diabetes-related lower limb amputations. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.146] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Diabetes-related foot disease is the leading cause of lower limb amputations in Queensland. Amputations can be either minor (below the ankle joint) or major (above the ankle joint). Minor amputations may be performed to prevent major amputations prophylactically, but how these forms of amputations interrelate, and where their interrelationships are weakest and strongest, is unknown. Knowledge of small-area variation in interrelations between minor and major amputations is relevant to prevention and improved management of foot disease.
Methods
Data on lower limb amputations performed between 2014 and 2018 on patients aged 20+ years with diabetes were obtained from the Queensland Hospital Admitted Patient Data Collection. Rates were calculated using the number of people, rather than the number of amputation procedures. A Bayesian hierarchical spatial multivariate model was used to examine patterns over 516 populated statistical areas 2 in Queensland.
Results
During 2014 to 2018, 3,548 Queenslanders had at least one minor amputation, and 1,114 had at least one major amputation. Modelled amputation rates varied markedly across the State (standardised morbidity ratio (SMR) IQR: 0.67 to 1.22), with areas in far north Queensland having extremely high rates. There was consistently high area-level correlation between minor and major amputation rates. The highest SMRs for both minor and major amputations were in the Northern Peninsula.
Conclusions
Elevated rates of minor and major amputations in areas in Queensland, most noticeably the far north, indicate an urgent need for greater support for people with diabetes-related foot disease.
Key messages
Text: Large differences in minor and major amputation rates across Queensland indicate that certain regions require greater assistance in managing diabetes-related foot disease.
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Affiliation(s)
- Doctor Susanna Cramb
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| | - Doctor Peter Lazzarini
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| | - Mark Daniel
- Health Research Institute, University of Canberra, Canberra, Australia
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34
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Diong J, Kroeger CM, Reynolds KJ, Barnett A, Bero LA. Strengthening the incentives for responsible research practices in Australian health and medical research funding. Res Integr Peer Rev 2021; 6:11. [PMID: 34340719 PMCID: PMC8328133 DOI: 10.1186/s41073-021-00113-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/16/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Australian health and medical research funders support substantial research efforts, and incentives within grant funding schemes influence researcher behaviour. We aimed to determine to what extent Australian health and medical funders incentivise responsible research practices. METHODS We conducted an audit of instructions from research grant and fellowship schemes. Eight national research grants and fellowships were purposively sampled to select schemes that awarded the largest amount of funds. The funding scheme instructions were assessed against 9 criteria to determine to what extent they incentivised these responsible research and reporting practices: (1) publicly register study protocols before starting data collection, (2) register analysis protocols before starting data analysis, (3) make study data openly available, (4) make analysis code openly available, (5) make research materials openly available, (6) discourage use of publication metrics, (7) conduct quality research (e.g. adhere to reporting guidelines), (8) collaborate with a statistician, and (9) adhere to other responsible research practices. Each criterion was answered using one of the following responses: "Instructed", "Encouraged", or "No mention". RESULTS Across the 8 schemes from 5 funders, applicants were instructed or encouraged to address a median of 4 (range 0 to 5) of the 9 criteria. Three criteria received no mention in any scheme (register analysis protocols, make analysis code open, collaborate with a statistician). Importantly, most incentives did not seem strong as applicants were only instructed to register study protocols, discourage use of publication metrics and conduct quality research. Other criteria were encouraged but were not required. CONCLUSIONS Funders could strengthen the incentives for responsible research practices by requiring grant and fellowship applicants to implement these practices in their proposals. Administering institutions could be required to implement these practices to be eligible for funding. Strongly rewarding researchers for implementing robust research practices could lead to sustained improvements in the quality of health and medical research.
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Affiliation(s)
- Joanna Diong
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Cynthia M Kroeger
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Katherine J Reynolds
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, QLD, Brisbane, 4000, Australia
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Centre for Bioethics and Humanities, University of Colorado, Boulder, CO, 80309-0552, USA
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35
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Senanayake S, Kularatna S, Healy H, Graves N, Baboolal K, Sypek MP, Barnett A. Development and validation of a risk index to predict kidney graft survival: the kidney transplant risk index. BMC Med Res Methodol 2021; 21:127. [PMID: 34154541 PMCID: PMC8215818 DOI: 10.1186/s12874-021-01319-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/24/2021] [Accepted: 05/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Kidney graft failure risk prediction models assist evidence-based medical decision-making in clinical practice. Our objective was to develop and validate statistical and machine learning predictive models to predict death-censored graft failure following deceased donor kidney transplant, using time-to-event (survival) data in a large national dataset from Australia. Methods Data included donor and recipient characteristics (n = 98) of 7,365 deceased donor transplants from January 1st, 2007 to December 31st, 2017 conducted in Australia. Seven variable selection methods were used to identify the most important independent variables included in the model. Predictive models were developed using: survival tree, random survival forest, survival support vector machine and Cox proportional regression. The models were trained using 70% of the data and validated using the rest of the data (30%). The model with best discriminatory power, assessed using concordance index (C-index) was chosen as the best model. Results Two models, developed using cox regression and random survival forest, had the highest C-index (0.67) in discriminating death-censored graft failure. The best fitting Cox model used seven independent variables and showed moderate level of prediction accuracy (calibration). Conclusion This index displays sufficient robustness to be used in pre-transplant decision making and may perform better than currently available tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01319-5.
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Affiliation(s)
- Sameera Senanayake
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia. .,Australian Centre for Health Services Innovation, Queensland University of Technology, 60 Musk Ave, QLD, 4059, Kelvin Grove, Australia.
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Helen Healy
- Royal Brisbane and Women's Hospital, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | | | - Keshwar Baboolal
- Royal Brisbane and Women's Hospital, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Matthew P Sypek
- Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, South Australia, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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36
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Senanayake S, Graves N, Healy H, Baboolal K, Barnett A, Kularatna S. Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney. Health Econ Rev 2021; 11:13. [PMID: 33856573 PMCID: PMC8051030 DOI: 10.1186/s13561-021-00312-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Economic-evaluations using decision analytic models such as Markov-models (MM), and discrete-event-simulations (DES) are high value adds in allocating resources. The choice of modelling method is critical because an inappropriate model yields results that could lead to flawed decision making. The aim of this study was to compare cost-effectiveness when MM and DES were used to model results of transplanting a lower-quality kidney versus remaining waitlisted for a kidney. METHODS Cost-effectiveness was assessed using MM and DES. We used parametric survival models to estimate the time-dependent transition probabilities of MM and distribution of time-to-event in DES. MMs were simulated in 12 and 6 monthly cycles, out to five and 20-year time horizon. RESULTS DES model output had a close fit to the actual data. Irrespective of the modelling method, the cycle length of MM or the time horizon, transplanting a low-quality kidney as compared to remaining waitlisted was the dominant strategy. However, there were discrepancies in costs, effectiveness and net monetary benefit (NMB) among different modelling methods. The incremental NMB of the MM in the 6-months cycle lengths was a closer fit to the incremental NMB of the DES. The gap in the fit of the two cycle lengths to DES output reduced as the time horizon increased. CONCLUSION Different modelling methods were unlikely to influence the decision to accept a lower quality kidney transplant or remain waitlisted on dialysis. Both models produced similar results when time-dependant transition probabilities are used, most notable with shorter cycle lengths and longer time-horizons.
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Affiliation(s)
- Sameera Senanayake
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.
| | - Nicholas Graves
- Duke-NUS Medical School, 8 College road, Singapore, Singapore
| | - Helen Healy
- Royal Brisbane Hospital for Women, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Keshwar Baboolal
- Royal Brisbane Hospital for Women, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
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Flaws DF, Barnett A, Fraser J, Latu J, Ramanan M, Tabah A, Tippett V, Tronstad O, Patterson S. A protocol for tracking outcomes post intensive care. Nurs Crit Care 2021; 27:341-347. [PMID: 33609311 DOI: 10.1111/nicc.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/23/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Critically ill patients are more likely to survive intensive care than ever before due to advances in treatment. However, a proportion subsequently experiences post-intensive care syndrome (PICS) incurring substantial personal, social, and economic costs. PICS is a debilitating set of physical, psychological, and cognitive sequelae but the size and characteristics of the affected population have been difficult to describe, impeding progress in intensive care rehabilitation. AIMS AND OBJECTIVES The aim of this protocol is to describe recovery after admission to intensive care unit (ICU) and the predictors, correlates, and patient-reported outcomes for those experiencing PICS. The study will support the development of screening, diagnostic, and outcome measures to improve post-ICU recovery. DESIGN A prospective, multi-site observational study in three ICUs in Brisbane, Australia. Following consent, data will be collected from clinical records and using validated self-report instruments from 300 patients, followed up at 6 weeks and 6 months post ICU discharge. METHODS TOPIC is a prospective, multi-site observational study using self-report and clinical data on risk factors, including comorbidities, and outcomes. Data will be collected with consent from hospital records and participants 6 weeks and 6months post ICU discharge. RESULTS The main outcome measures will be self-reported physical, cognitive, and psychological function 6 weeks and 6 months post-ICU discharge. RELEVANCE TO CLINICAL PRACTICE This protocol provides a methodological framework to measure recovery and understand PICS. Data analysis will describe characteristics associated with recovery and PICS. The subsequent prediction and screening tools developed then aim to improve the effectiveness of post-ICU prevention and rehabilitation through more targeted screening and prediction and found a program of research developing a more tailored approach to PICS.
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Affiliation(s)
- Dylan F Flaws
- Department of Mental Health, Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Department of Intensive Care, Critical Care Research Group, Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - John Fraser
- Department of Intensive Care, Critical Care Research Group, Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Jiville Latu
- Department of Intensive Care, Intensive Care Unit, Redcliffe Hospital, Brisbane, Queensland, Australia
| | - Mahesh Ramanan
- Department of Intensive Care, Intensive Care Unit, Caboolture Hospital, Brisbane, Queensland, Australia.,Department of Intensive Care, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexis Tabah
- Department of Intensive Care, Intensive Care Unit, Redcliffe Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Vivienne Tippett
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Oystein Tronstad
- Department of Intensive Care, Critical Care Research Group, Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Physiotherapy Department, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Sue Patterson
- Department of Mental Health, Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Department of Intensive Care, Critical Care Research Group, Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
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Scott AM, Chalmers I, Barnett A, Stephens A, Kolstoe SE, Clark J, Glasziou P. 'The ethics approval took 20 months on a trial which was meant to help terminally ill cancer patients. In the end we had to send the funding back': a survey of views on human research ethics reviews. J Med Ethics 2021; 47:medethics-2020-106785. [PMID: 33431648 DOI: 10.1136/medethics-2020-106785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/03/2020] [Accepted: 11/10/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND We conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia. METHODS We surveyed Australian health/medical researchers and Human Research Ethics Committee (HREC) members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide (optional) comments. Qualitative data were analysed thematically; quantitative data in R. RESULTS We received 514 responses. Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review (to prioritise systematic review topics 84%, on software strengths/weaknesses 85%); scenarios involving surplus samples (82%) and N-of-1 (single case) studies (76%) were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively. CONCLUSIONS Considerable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties-the same principle should apply to ethics reviews.
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Affiliation(s)
- Anna Mae Scott
- Institute for Evidence Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | | | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Simon E Kolstoe
- Institute of Biomedical and Bimolecular Science, University of Portsmouth, Portsmouth, Hampshire, UK
| | - Justin Clark
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Paul Glasziou
- Institute for Evidence Based Healthcare, Bond University, Gold Coast, Queensland, Australia
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Raynal J, Weeks R, Pressey R, Adams A, Barnett A, Cooke S, Sheaves M. Habitat-dependent outdoor recreation and conservation organizations can enable recreational fishers to contribute to conservation of coastal marine ecosystems. Glob Ecol Conserv 2020. [DOI: 10.1016/j.gecco.2020.e01342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Roope LSJ, Buckell J, Becker F, Candio P, Violato M, Sindelar JL, Barnett A, Duch R, Clarke PM. How Should a Safe and Effective COVID-19 Vaccine be Allocated? Health Economists Need to be Ready to Take the Baton. Pharmacoecon Open 2020; 4:557-561. [PMID: 32880878 PMCID: PMC7471481 DOI: 10.1007/s41669-020-00228-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Laurence S J Roope
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Buckell
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Frauke Becker
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paolo Candio
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jody L Sindelar
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Raymond Duch
- Nuffield College, University of Oxford, Oxford, UK
| | - Philip M Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
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Senanayake S, Graves N, Healy H, Baboolal K, Barnett A, Sypek MP, Kularatna S. Donor Kidney Quality and Transplant Outcome: An Economic Evaluation of Contemporary Practice. Value Health 2020; 23:1561-1569. [PMID: 33248511 DOI: 10.1016/j.jval.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The study had two main aims. First, we assessed the cost-effectiveness of transplanting deceased donor kidneys of differing quality levels based on the Kidney Donor Profile Index (KDPI). Second, we assessed the cost-effectiveness of remaining on the waiting list until a high-quality kidney becomes available compared to transplanting a lower-quality kidney. METHODS A decision analytic model to estimate cost-effectiveness was developed using a Markov process. Separate models were developed for 4 separate KDPI bands, with higher values indicating lower quality. Models were simulated in 1-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient from the healthcare payer's perspective. Weibull regression was used to calculate the time-dependent transition probabilities in the base analysis. The impact uncertainty arising in model parameters was included by probabilistic sensitivity analysis using the Monte Carlo simulation method. Willingness to pay was considered as Australian $28 000. RESULTS Transplanting a kidney of any quality is cost-effective compared to remaining on a waitlist. Transplanting a lower KDPI kidney is cost-effective compared to a higher KDPI kidney. Transplanting lower KDPI kidneys to younger patients and higher KDPI kidneys to older patients is also cost-effective. Depending on dialysis in hopes of receiving a lower KDPI kidney is not a cost-effective strategy for any age group. CONCLUSION Efforts should be made by the health systems to reduce the discard rates of low-quality kidneys with the view of increasing the transplant rates.
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Affiliation(s)
- Sameera Senanayake
- Queensland University of Technology, Australian Center for Health Service Innovation, Brisbane, Australia; Ministry of Health, Colombo, Sri Lanka.
| | - Nicholas Graves
- Queensland University of Technology, Australian Center for Health Service Innovation, Brisbane, Australia
| | - Helen Healy
- Royal Brisbane Hospital for Women, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Keshwar Baboolal
- Royal Brisbane Hospital for Women, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Adrian Barnett
- Queensland University of Technology, Australian Center for Health Service Innovation, Brisbane, Australia
| | - Matthew P Sypek
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
| | - Sanjeewa Kularatna
- Queensland University of Technology, Australian Center for Health Service Innovation, Brisbane, Australia
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Dhanani JA, Goodman S, Ahern B, Cohen J, Fraser JF, Barnett A, Diab S, Bhatt M, Roberts JA. Comparative lung distribution of radiolabeled tobramycin between nebulized and intravenous administration in a mechanically-ventilated ovine model, an observational study. Int J Antimicrob Agents 2020; 57:106232. [PMID: 33232733 DOI: 10.1016/j.ijantimicag.2020.106232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/15/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Ventilator-associated pneumonia is common and is treated using nebulized antibiotics. Although adequate pulmonary biodistribution is important for antibiotic effect, there is a lack of data for both intravenous (IV) and nebulized antibiotic administration during mechanical ventilation. OBJECTIVE To describe the comparative pulmonary regional distribution of IV and nebulized technetium-99m-labeled tobramycin (99mTc-tobramycin) 400 mg in a mechanically-ventilated ovine model. METHODS The study was performed in a mechanically-ventilated ovine model. 99mTc-tobramycin 400 mg was obtained using a radiolabeling process. Computed tomography (CT) was performed. Ten sheep were given 99mTc-tobramycin 400 mg via either an IV (five sheep) or nebulized (five sheep) route. Planar images (dorsal, ventral, left lateral and right lateral) were obtained using a gamma camera. Blood samples were obtained every 15 min for 1 h (4 time points) and lung, liver, both kidney, and urine samples were obtained post-mortem. RESULTS Ten sheep were anesthetized and mechanically ventilated. Whole-lung deposition of nebulized 99mTc-tobramycin 400 mg was significantly lower than with IV (8.8% vs. 57.1%, P<0.001). For both administration routes, there was significantly lower deposition in upper lung zones compared with the rest of the lungs. Dorsal deposition was significantly higher with nebulized 99mTc-tobramycin 400 mg compared with IV (68.9% vs. 58.9%, P=0.003). Lung concentrations of 99mTc-tobramycin were higher with IV compared with nebulized administration. There were significantly higher concentrations of 99mTc-tobramycin in blood, liver and urine with IV administration compared with nebulized. CONCLUSIONS Nebulization resulted in lower whole and regional lung deposition of 99mTc-tobramycin compared with IV administration and appeared to be associated with low blood and extra-pulmonary organ concentrations.
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Affiliation(s)
- Jayesh A Dhanani
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia; Critical Care Research Group, The University of Queensland, Brisbane, Australia.
| | - Steven Goodman
- Department of Nuclear Medicine and Specialised PET Services Queensland, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Benjamin Ahern
- School of Veterinary Science, Faculty of Science, University of Queensland, Gatton, Australia
| | - Jeremy Cohen
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - John F Fraser
- Critical Care Research Group, The University of Queensland, Brisbane, Australia
| | - Adrian Barnett
- Institute of Health and Biomedical Innovation & School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Sara Diab
- Critical Care Research Group, The University of Queensland, Brisbane, Australia
| | - Manoj Bhatt
- Department of Nuclear Medicine and Specialised PET Services Queensland, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jason A Roberts
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia; Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Australia; Department of Pharmacy, Royal Brisbane & Women's Hospital, Brisbane, Australia
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Meloncelli N, Barnett A, de Jersey S. An implementation science approach for developing and implementing a dietitian-led model of care for gestational diabetes: a pre-post study. BMC Pregnancy Childbirth 2020; 20:661. [PMID: 33143693 PMCID: PMC7607700 DOI: 10.1186/s12884-020-03352-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background There is strong evidence that women with gestational diabetes mellitus (GDM) who receive a minimum of three appointments with a dietitian may require medication less often. The aim of this study was to evaluate the impact of a dietitian-led model of care on clinical outcomes and to understand the utility of the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework as a prospective tool for implementation. Methods This was a pre-post intervention study measuring outcomes before-and-after changing a gestational diabetes (GDM) model of care and included women with GDM managed at a large, regional hospital in Queensland, Australia. The i-PARIHS framework was used to develop, implement and evaluate a dietitian-led model of care which increased dietetic input for women with GDM to a minimum of one initial education and two review appointments. The outcomes were adherence to the schedule of appointments, clinician perspective of the implementation process, pharmacotherapy use, gestational age at commencement of pharmacotherapy and birth weight. Pre- and post- comparisons of outcomes were made using t-tests and chi-squared tests. Results Adherence to the dietetic schedule of appointments was significantly increased from 29 to 82% (p < 0.001) but pharmacotherapy use also increased by 10% (p = 0.10). There were significantly more women in the post-intervention group who were diagnosed with GDM prior to 24 weeks gestation, a strong independent predictor of pharmacotherapy use. Infant birthweight remained unchanged. The i-PARIHS framework was used as a diagnostic tool and checklist in the model of care development phase; a facilitation tool during the implementation phase; and during the evaluation phase was used as a reflection tool to identify how the i-PARIHS constructs and their interactions that may have impacted on clinical outcomes. Conclusions The i-PARIHS framework was found to be useful in the development, implementation and evaluation of a dietitian-led model of care which saw almost 90% of women with GDM meet the minimum schedule of dietetic appointments. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03352-6.
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Affiliation(s)
- Nina Meloncelli
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia. .,Nutrition and Dietetics, Allied Health, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Susan de Jersey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Australia
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Senanayake S, Graves N, Healy H, Baboolal K, Barnett A, Sypek MP, Kularatna S. Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices. BMC Health Serv Res 2020; 20:931. [PMID: 33036621 PMCID: PMC7547436 DOI: 10.1186/s12913-020-05736-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Matching survival of a donor kidney with that of the recipient (longevity matching), is used in some kidney allocation systems to maximize graft-life years. It is not part of the allocation algorithm for Australia. Given the growing evidence of survival benefit due to longevity matching based allocation algorithms, development of a similar kidney allocation system for Australia is currently underway. The aim of this research is to estimate the impact that changes to costs and health outcomes arising from 'longevity matching' on the Australian healthcare system. METHODS A decision analytic model to estimate cost-effectiveness was developed using a Markov process. Four plausible competing allocation options were compared to the current kidney allocation practice. Models were simulated in one-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient. Willingness to pay was considered as AUD 28000. RESULTS Base case analysis indicated that allocating the worst 20% of Kidney Donor Risk Index (KDRI) donor kidneys to the worst 20% of estimated post-transplant survival (EPTS) recipients (option 2) and allocating the oldest 25% of donor kidneys to the oldest 25% of recipients are both cost saving and more effective compared to the current Australian allocation practice. Option 2, returned the lowest costs, greatest health benefits and largest gain to net monetary benefits (NMB). Allocating the best 20% of KDRI donor kidneys to the best 20% of EPTS recipients had the lowest expected incremental NMB. CONCLUSION Of the four longevity-based kidney allocation practices considered, transplanting the lowest quality kidneys to the worst kidney recipients (option 2), was estimated to return the best value for money for the Australian health system.
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Affiliation(s)
- Sameera Senanayake
- Australian Center for Health Service Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.
| | - Nicholas Graves
- Australian Center for Health Service Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Helen Healy
- Royal Brisbane Hospital for Women, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Keshwar Baboolal
- Royal Brisbane Hospital for Women, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Adrian Barnett
- Australian Center for Health Service Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Matthew P Sypek
- Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, SA, Australia
| | - Sanjeewa Kularatna
- Australian Center for Health Service Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
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Wolkewitz M, Lambert J, von Cube M, Bugiera L, Grodd M, Hazard D, White N, Barnett A, Kaier K. Statistical Analysis of Clinical COVID-19 Data: A Concise Overview of Lessons Learned, Common Errors and How to Avoid Them. Clin Epidemiol 2020; 12:925-928. [PMID: 32943941 PMCID: PMC7478365 DOI: 10.2147/clep.s256735] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/19/2020] [Indexed: 01/16/2023] Open
Abstract
By definition, in-hospital patient data are restricted to the time between hospital admission and discharge (alive or dead). For hospitalised cases of COVID-19, a number of events during hospitalization are of interest regarding the influence of risk factors on the likelihood of experiencing these events. The same is true for predicting times from hospital admission of COVID-19 patients to intensive care or from start of ventilation (invasive or non-invasive) to extubation. This logical restriction of the data to the period of hospitalisation is associated with a substantial risk that inappropriate methods are used for analysis. Here, we briefly discuss the most common types of bias which can occur when analysing in-hospital COVID-19 data.
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Affiliation(s)
- Martin Wolkewitz
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jerome Lambert
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maja von Cube
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lars Bugiera
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marlon Grodd
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Derek Hazard
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nicole White
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Senanayake S, Graves N, Healy H, Baboolal K, Barnett A, Sypek M, Kularatna S. PUK5 Remaining Waitlisted for a Superior Quality Kidney; An Economic Evaluation of Contemporary Transplant Practice. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.566] [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] [Indexed: 10/23/2022]
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Abstract
Some acronyms are useful and are widely understood, but many of the acronyms used in scientific papers hinder understanding and contribute to the increasing fragmentation of science. Here we report the results of an analysis of more than 24 million article titles and 18 million article abstracts published between 1950 and 2019. There was at least one acronym in 19% of the titles and 73% of the abstracts. Acronym use has also increased over time, but the re-use of acronyms has declined. We found that from more than one million unique acronyms in our data, just over 2,000 (0.2%) were used regularly, and most acronyms (79%) appeared fewer than 10 times. Acronyms are not the biggest current problem in science communication, but reducing their use is a simple change that would help readers and potentially increase the value of science.
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Affiliation(s)
- Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Zoe Doubleday
- Future Industries Institute, University of South Australia, Adelaide, Australia
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49
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Barnett D, Barnett A, Das M, Ng Lai Oon A. P-04-16 “Menstruation, Isn't This Meant for Girls?” a Quantitative Study into Young Adult Male Understanding and Attitudes Towards Menstruation in Malaysia. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.333] [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] [Indexed: 10/24/2022]
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Affiliation(s)
- Koen B Pouwels
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laurence S J Roope
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Adrian Barnett
- Institute of Health Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, QLD, Australia
| | - David J Hunter
- Translational Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Terry M Nolan
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Philip M Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
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