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Cabrera M, Ryan D, Erlewyn-Lajeunesse M, Levin M, Martínez-Cañavate A, Villaizán Pérez C, Angier E, Trujillo J, Cárdenas-Rebollo JM, Reali L. Global assessment of the knowledge and confidence in managing allergic disorders among primary care pediatricians across Europe: An EAACI task force report. Pediatr Allergy Immunol 2024; 35:e14116. [PMID: 38581158 DOI: 10.1111/pai.14116] [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: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Pediatricians are often the first point of contact for children in Primary Care (PC), but still perceive gaps in their allergy knowledge. We investigated self-perceived knowledge gaps and educational needs in pediatricians across healthcare systems in Europe so that future educational initiatives may better support the delivery of allergy services in PC. METHOD A multinational survey was circulated to pediatricians who care for children and adolescents with allergy problems in PC by the EAACI Allergy Educational Needs in Primary Care Pediatricians Task Force from February to March 2023. A 5-point Likert scale was used to assess the level of agreement with questionnaire statements. Thirty surveys per country were the cut-off for inclusion and statistical analysis. RESULTS In this study, 1991 respondents were obtained from 56 countries across Europe and 210 responses were from countries with a cut-off below 30 participants per country. Primary care pediatricians (PCPs) comprised 74.4% of the respondents. The majority (65.3%) were contracted to state or district health services. 61.7% had awareness of guidelines for onward allergy referral in their countries but only 22.3% were aware of the EAACI competencies document for allied health professionals for allergy. Total sample respondents versus PCPs showed 52% and 47% of them have access to allergy investigations in their PC facility (mainly specific IgE and skin prick tests); 67.6% and 58.9% have access to immunotherapy, respectively. The main barrier to referral to a specialist was a consideration that the patient's condition could be diagnosed and treated in this PC facility, (57.8% and 63.6% respectively). The main reasons for referral were the need for hospital assessment, and partial response to first-line treatment (55.4% and 59.2%, 47% and 50.7%, respectively). Learning and assessment methods preference was fairly equally divided between Traditional methods (45.7% and 50.1% respectively) and e-learning 45.5% and 44.9%, respectively. Generalist physicians (GPs) have the poorest access to allergy investigations (32.7%, p = .000). The majority of the total sample (91.9%) assess patients with allergic pathology. 868 (43.6%) and 1117 (46.1%), received allergy training as undergraduates and postgraduates respectively [these proportions in PCPs were higher (45% and 59%), respectively]. PCPs with a special interest in allergology experienced greater exposure to allergy teaching as postgraduates. GPs received the largest amount of allergy teaching as undergraduates. Identifying allergic disease based on clinical presentation, respondents felt most confident in the management of eczema/atopic dermatitis (87.4%) and rhinitis/asthma (86.2%), and least confident in allergen immunotherapy (36.9%) and latex allergy (30.8%). CONCLUSION This study exploring the confidence of PCPs to diagnose, manage, and refer patients with allergies, demonstrated knowledge gaps and educational needs for allergy clinical practice. It detects areas in need of urgent improvement especially in latex and allergen immunotherapy. It is important to ensure the dissemination of allergy guidelines and supporting EAACI documents since the majority of PCPs lack awareness of them. This survey has enabled us to identify what the educational priorities of PCPs are and how they would like to have them met.
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Affiliation(s)
- M Cabrera
- Hospital Los Madroños, Brunete, Spain
| | - D Ryan
- The University of Edinburgh, Edinburgh, UK
| | | | - M Levin
- University of Cape Town, Cape Town, South Africa
| | | | | | - E Angier
- University of Southampton, Southampton, UK
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O'Regan PW, Dewhurst C, O'Mahony AT, O'Regan C, O'Leary V, O'Connor G, Ryan D, Maher MM, Young R. Split-bolus single-phase versus single-bolus split-phase CT acquisition protocols for staging in patients with testicular cancer: A retrospective study. Radiography (Lond) 2024; 30:628-633. [PMID: 38330895 DOI: 10.1016/j.radi.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/17/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Computed tomography (CT) imaging has become indispensable in the management of medical oncology patients. Risks associated with high cumulative effective dose (CED) are relevant in testicular cancer patients. Split-bolus protocols, whereby the contrast medium injection is divided into two, followed by combining the required phase images in a single scan acquisition has been shown to provide images of comparable image quality and less radiation dose compared to single-bolus split-phase CT for various indications. We retrospectively evaluated the performance of split-bolus and single-bolus protocols in patients having follow-up CT imaging for testicular cancer surveillance. METHODS 45 patients with testicular cancer undergoing surveillance CT imaging of the thorax, abdomen, and pelvis who underwent split-bolus and single-bolus protocols were included. Quantitative image quality analysis was conducted by placing region of interests in pre-defined anatomical sub-structures within the abdominal cavity. The signal-to-noise ratio (SNR) and radiation dose in the form of dose length product (DLP) and effective dose (ED) were recorded. RESULTS The DLP and ED for the single-bolus, split-phase acquisition was 506 ± 89 mGy cm and 7.59 ± 1.3 mSv, respectively. For the split-bolus, single-phase acquisition, 397 ± 94 mGy∗cm and 5.95 ± 1.4 mSv, respectively (p < 0.000). This represented a 21.5 % reduction in radiation dose exposure. The SNR for liver, muscle and fat for the single-bolus were 7.4, 4.7 and 8, respectively, compared to 5.5, 3.8 and 7.4 in the split-bolus protocol (p < 0.001). CONCLUSION In a testicular cancer patient cohort undergoing surveillance CT imaging, utilization of a split-bolus single-phase acquisition CT protocol enabled a significant reduction in radiation dose whilst maintaining subjective diagnostic acceptability. IMPLICATIONS FOR PRACTICE Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
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Affiliation(s)
- P W O'Regan
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - C Dewhurst
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - A T O'Mahony
- Department of Radiology, Cork University Hospital/Mercy University Hospital, Cork, Ireland.
| | - C O'Regan
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - V O'Leary
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - G O'Connor
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - D Ryan
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - M M Maher
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - R Young
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College, Cork, Ireland.
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Bhatt K, Palomares AC, Forget P, Ryan D. Importance of pain management in cancer patients and survivors. Ann Oncol 2024:S0923-7534(24)00017-6. [PMID: 38311208 DOI: 10.1016/j.annonc.2024.01.006] [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] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- K Bhatt
- University of Aberdeen, Aberdeen, UK
| | - A C Palomares
- European Pain Federation EFIC, Societal Impact of Pain Platform (SIP), Brussels, Belgium
| | - P Forget
- Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Department of Anaesthesia, NHS Grampian, Aberdeen, UK, Pain and Opioids after Surgery (PANDOS) ESAIC Research Group, Brussels, Belgium; IMAGINE UR UM 103, Montpellier University, Anesthesia Critical Care, Emergency and Pain Medicine Division, Nîmes University Hospital, Nîmes, France
| | - D Ryan
- Pain Alliance Europe PAE, Brussels, Belgium
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Sedaghat AR, Fokkens WJ, Lund VJ, Hellings PW, Kern RC, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Gevaert P, Teeling T, Alobid I, Anselmo-Lima WT, Baroody FM, Cervin A, Cohen NA, Constantinidis J, De Gabory L, Desrosiers M, Harvey RJ, Kalogjera L, Knill A, Landis BN, Meco C, Philpott CM, Ryan D, Schlosser RJ, Senior BA, Smith TL, Tomazic PV, Zhang L, Hopkins C. Consensus criteria for chronic rhinosinusitis disease control: an international Delphi Study. Rhinology 2023; 61:519-530. [PMID: 37804121 DOI: 10.4193/rhin23.335] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) disease control is a global metric of disease status for CRS. While there is broad acceptance that it is an important treatment goal, there has been inconsistency in the criteria used to define CRS control. The objective of this study was to identify and develop consensus around essential criteria for assessment of CRS disease control. METHODS Modified Delphi methodology consisting of three rounds to review a list of 24 possible CRS control criteria developed by a 12-person steering committee. The core authorship of the multidisciplinary EPOS 2020 guidelines was invited to participate. RESULTS Thirty-two individuals accepted the invitation to participate and there was no dropout of participants throughout the entire study (3 rounds). Consensus essential criteria for assessment of CRS control were: overall symptom severity, need for CRS-related systemic corticosteroids in the prior 6 months, severity of nasal obstruction, and patient-reported CRS control. Near-consensus items were: nasal endoscopy findings, severity of smell loss, overall quality of life, impairment of normal activities and severity of nasal discharge. Participants’ comments provided insights into caveats of, and disagreements related to, near-consensus items. CONCLUSIONS Overall symptom severity, use of CRS-related systemic corticosteroids, severity of nasal obstruction, and patient-reported CRS control are widely agreed upon essential criteria for assessment of CRS disease control. Consideration of near-consensus items to assess CRS control should be implemented with their intrinsic caveats in mind. These identified consensus CRS control criteria, together with evidence-based support, will provide a foundation upon which CRS control criteria with wide-spread acceptance can be developed.
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Affiliation(s)
- A R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - W J Fokkens
- Department of Otorhinolaryngology and Head and Neck Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - V J Lund
- Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, UK
| | - P W Hellings
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Belgium
| | - R C Kern
- Department of Otorhinolaryngology, Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - S Reitsma
- Department of Otorhinolaryngology and Head and Neck Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Finland and Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Finland
| | | | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - P Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - T Teeling
- Patient representative, Task Force Healthcare, WTC Den Haag, The Netherlands
| | - I Alobid
- Rhinology and Skull Base Unit, ENT Department, Hospital Clinic, Universitat de Barcelona, August Pi i Sunyer Biomedical Research Institute, CIBERES, Barcelona, Spain
| | - W T Anselmo-Lima
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, Brazil
| | - F M Baroody
- Department of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children’s Hospital, Chicago, IL, USA
| | - A Cervin
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital; Faculty of Medicine, University of Queensland, Brisbane, Australia and Department of Clinical Sciences, Lund University, Lund, Sweden
| | - N A Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L De Gabory
- Rhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU ux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, France
| | - M Desrosiers
- Department of ORL-HNS, Universitat de Montreal, Montreal, Canada
| | - R J Harvey
- Rhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, Australia
| | - L Kalogjera
- Department of Otorhinolaryngology/Head and Neck Surgery, Zagreb School of Medicine; University Hospital Center, Sestre milosrdnice,Zagreb, Croatia
| | - A Knill
- Patient representative, Sinus UK, London, UK
| | - B N Landis
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, Switzerland
| | - C Meco
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey and Department of Otorhinolaryngology, Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - C M Philpott
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK and Norfolk and Waveney ENT Service, James Paget University Hospital, Great Yarmouth and Norfolk and Norwich University Hospital, Norwich, UK
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK and International Primary Care Respiratory Group, Edinburgh, Scotland, UK
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - B A Senior
- Department of Otolaryngology - Head and Neck Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - T L Smith
- Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Oregon Health
| | - P V Tomazic
- Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria
| | - L Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China and Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China and Beijing Institute of Otolaryngology, Beijing Laboratory of Allergic Diseases, Beijing Key Laboratory of Nasal Diseases, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China and Research Unit of Diagnosis and T
| | - C Hopkins
- Department of Otolaryngology and Head Neck Surgery, Guys and St Thomas’ Hospital, London, UK
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Hellings PW, Lau S, Scadding GK, Bjermer L, Backer V, Chaker AM, Conti DM, De Corso E, Diamant Z, Djukanovic R, Fokkens W, Gevaert P, Gray CL, Han JK, Heaney LG, Hoffmann HJ, Jesenak M, Johansen P, Kumaran MS, McDonald M, Melén E, Mullol J, Reitsma S, Ryan D, Scadding G, Schmid-Grendelmeier P, Teeling T, Odemyr M, Wahn U. EUFOREA summit in Brussels 2023: inspiring the future of allergy & respiratory care. Front Allergy 2023; 4:1236977. [PMID: 37577332 PMCID: PMC10415067 DOI: 10.3389/falgy.2023.1236977] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
In March 2023, the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual Summit in Brussels with expert panel members of EUFOREA, representatives of the EUFOREA patient advisory board, and the EUFOREA board and management teams. Its aim was to define the research, educational and advocacy initiatives to be developed by EUFOREA over the next 2 years until the 10th anniversary in 2025. EUFOREA is an international non-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic allergic and respiratory diseases via research, education, and advocacy. Based on its medical scientific core competency, EUFOREA offers an evidence-supported platform to introduce innovation and education in healthcare leading to optimal patient care, bridging the gap between latest scientific evidence and daily practice. Aligned with the mission of improving health care, the expert panels of asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS) & European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), allergen immunotherapy (AIT) and paediatrics have proposed and elaborated a variety of activities that correspond to major unmet needs in the allergy and respiratory field. The current report provides a concise overview of the achievements, ambitions, and action plan of EUFOREA for the future, allowing all stakeholders in the allergy and respiratory field to be up-dated and inspired to join forces in Europe and beyond.
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Affiliation(s)
- P. W. Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - S. Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitaetsmedizin, Berlin, Germany
| | - G. K. Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, United Kingdom
- Division of Immunity and Infection, University College, London, United Kingdom
| | - L. Bjermer
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
| | - V. Backer
- Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - A. M. Chaker
- Department of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - D. M. Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - E. De Corso
- Otolaryngology Head and Neck Surgery, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - Z. Diamant
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Dept of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
| | - R. Djukanovic
- NIHR Southampton Biomedical Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - W. Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - P. Gevaert
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - C. L. Gray
- Division of Allergy, Department of Paediatrics and Child Health, University of Cape Town, Rondebosch, South Africa
- Specialist Allergist, Kidsallergy Centre, Cape Town, South Africa
| | - J. K. Han
- Department of Otolaryngology & Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, United States
| | - L. G. Heaney
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University Belfast, Belfast, United Kingdom
| | - H. J. Hoffmann
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - M. Jesenak
- Department of Pulmonology and Phthisiology, Department of Pediatrics, Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - P. Johansen
- Department of Dermatology, University of Zurich, Zurich, Switzerland
- Allergy Unit, Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - M. S. Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M. McDonald
- Mediclinic Sandton, Johannesburg, South Africa
| | - E. Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet and Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - J. Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - S. Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - D. Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
- International Primary Care Respiratory Group., Edinburgh, United Kingdom
| | - G. Scadding
- Allergy, Royal Brompton Hospital, London, United Kingdom
| | - P. Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Christine-Kühne Center for Allergy research and Education CK-CARE, Davos, Switzerland
| | - T. Teeling
- Patient Advisory Board of the European Forum for Research and Education in Allergy and Airway Diseases, Brussels, Belgium
| | - M. Odemyr
- Patient Advisory Board of the European Forum for Research and Education in Allergy and Airway Diseases, Brussels, Belgium
| | - U. Wahn
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitaetsmedizin, Berlin, Germany
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Gujar SK, Manzoor K, Wongsripuemtet J, Wang G, Ryan D, Agarwal S, Lindquist M, Caffo B, Pillai JJ, Sair HI. Identification of the Language Network from Resting-State fMRI in Patients with Brain Tumors: How Accurate Are Experts? AJNR Am J Neuroradiol 2023; 44:274-282. [PMID: 36822828 PMCID: PMC10187806 DOI: 10.3174/ajnr.a7806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/04/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND PURPOSE Resting-state fMRI helps identify neural networks in presurgical patients who may be limited in their ability to undergo task-fMRI. The purpose of this study was to determine the accuracy of identifying the language network from resting-state-fMRI independent component analysis (ICA) maps. MATERIALS AND METHODS Through retrospective analysis, patients who underwent both resting-state-fMRI and task-fMRI were compared by identifying the language network from the resting-state-fMRI data by 3 reviewers. Blinded to task-fMRI maps, these investigators independently reviewed resting-state-fMRI ICA maps to potentially identify the language network. Reviewers ranked up to 3 top choices for the candidate resting-state-fMRI language map. We evaluated associations between the probability of correct identification of the language network and some potential factors. RESULTS Patients included 29 men and 14 women with a mean age of 41 years. Reviewer 1 (with 17 years' experience) demonstrated the highest overall accuracy with 72%; reviewers 2 and 3 (with 2 and 7 years' experience, respectively) had a similar percentage of correct responses (50% and 55%). The highest accuracy used ICA50 and the top 3 choices (81%, 65%, and 60% for reviewers 1, 2, and 3, respectively). The lowest accuracy used ICA50, limiting each reviewer to the top choice (58%, 35%, and 42%). CONCLUSIONS We demonstrate variability in the accuracy of blinded identification of resting-state-fMRI language networks across reviewers with different years of experience.
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Affiliation(s)
- S K Gujar
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - K Manzoor
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - J Wongsripuemtet
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - G Wang
- Department of Biostatistics (G.W., M.L., B.C.)
| | - D Ryan
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - S Agarwal
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - M Lindquist
- Department of Biostatistics (G.W., M.L., B.C.)
| | - B Caffo
- Department of Biostatistics (G.W., M.L., B.C.)
| | - J J Pillai
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery (J.J.P.)
| | - H I Sair
- From the Division of Neuroradiology (S.K.G., K.M., J.W., D.R., S.A., J.J.P., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
- The Malone Center for Engineering in Healthcare (H.I.S.), The Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
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7
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Hellings PW, Fokkens WJ, Orlandi R, Adriaensen GF, Alobid I, Baroody FM, Bjermer L, Senior BA, Cervin A, Cohen NA, Constantinidis J, De Corso E, Desrosiers M, Diamant Z, Douglas RG, Gane S, Gevaert P, Han JK, Harvey RJ, Hopkins C, Kern RC, Landis BN, Lee JT, Lee SE, Leunig A, Lund VJ, Bernal-Sprekelsen M, Mullol J, Philpott C, Prokopakis E, Reitsma S, Ryan D, Salmi S, Scadding G, Schlosser RJ, Steinsvik A, Tomazic PV, Van Staeyen E, Van Zele T, Vanderveken O, Viskens AS, Conti D, Wagenmann M. The EUFOREA pocket guide for chronic rhinosinusitis. Rhinology 2023; 61:85-89. [PMID: 36507741 DOI: 10.4193/rhin22.344] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic rhinosinusitis (CRS) is known to affect around 5 % of the total population, with major impact on the quality of life of those severely affected (1). Despite a substantial burden on individuals, society and health economies, CRS often remains underdiagnosed, under-estimated and under-treated (2). International guidelines like the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) (3) and the International Consensus statement on Allergy and Rhinology: Rhinosinusitis 2021 (ICAR) (4) offer physicians insight into the recommended treatment options for CRS, with an overview of effective strategies and guidance of diagnosis and care throughout the disease journey of CRS.
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Affiliation(s)
- P W Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium; University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium; Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Nethe
| | - W J Fokkens
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - R Orlandi
- Rhinology and Skull Base, Department of Otorhinolaryngology, Hospital Clinic, Universidad de Barcelona, Centro Medico Teknon, Barcelona, Spain
| | - G F Adriaensen
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - I Alobid
- Rhinology and Skull Base, Department of Otorhinolaryngology, Hospital Clinic, Universidad de Barcelona, Centro Medico Teknon, Barcelona, Spain
| | - F M Baroody
- The University of Chicago Medicine, Chicago, IL, United States
| | - L Bjermer
- Dept of Respiratory Medicine and Allergology, Skane University Hospital, Lund, Sweden
| | - B A Senior
- Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Cervin
- The university of Queensland Centra for Clinical Research, Herston, Australia; Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - N A Cohen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - E De Corso
- Department of Otolaryngology Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCSS, Universita; Cattolica Sacro Cuore, Rome, Italy
| | - M Desrosiers
- Department of Otolaryngology-Head and Neck Surgery, Universita de Montreal, Montreal, Canada
| | - Z Diamant
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; Dept of Respiratory Medicine and Allergology, Skane University Hospital, Lund, Sweden; Department Clinical Pharmacy and Pharmacology, University Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R G Douglas
- Department of Surgery, The University of Auckland, New Zealand
| | - S Gane
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, London, United Kingdom
| | - P Gevaert
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
| | - J K Han
- Department of Otolaryngology and Head and Neck Surgery at Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - R J Harvey
- Rhinology and Skull Base, Applied Medical Research Center, Department of Otolaryngology and Head and Neck Surgery at Eastern Virginia Medical School, Norfolk, Virginia, USA; Faculty of medicine and heath sciences, Macquarie University, Sydney, Australia
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - R C Kern
- Department of Otolaryngology, Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - B N Landis
- Hopitaux Universitaires de Geneve, Geneve, Geneve, Switzerland
| | - J T Lee
- Brigham and Women's Hospital, Harvard Medical School, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Section of Rhinology and Skull Base Surgery, Massachusetts, USA
| | - S E Lee
- Department of Head and Neck Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - A Leunig
- Rhinology Center, Munich and ENT-Clinic, Munich, Germany
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | | | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, IDIBAPS, Universitat de Barcelona, CIBERES. Barcelona, Catalonia, Spain
| | - C Philpott
- NIHR UCLH Biomedical research Centre, London, UK; Ear Institute, University College London, London, UK
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - S Reitsma
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - D Ryan
- Usher institute, University of Edinburgh, Edinburgh, UK
| | - S Salmi
- Medicum, Haartman Institute, University of Helsinki, Helsinki, Finland; Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - G Scadding
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, London, United Kingdom
| | - R J Schlosser
- Department of Otolaryngology Head and Neck surgery, Medical University of South Carolina, Charleston, SC, USA
| | | | - P V Tomazic
- Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria
| | - E Van Staeyen
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
| | - T Van Zele
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
| | - O Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium; Multidisciplinary Sleep Disorder Center, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - A-S Viskens
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium
| | | | - M Wagenmann
- Department of Otorhinolaryngology, Universitatsklinikum Disseldorf, Dusseldorf, Germany
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8
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Harte G, Keane J, Ryan D, Collins R, Garcia C, Howlin R, Ryan S, Connolly A, Leitch E, Moynan W, Healy S, Keenan M. 321 UNMET NEEDS AFTER STROKE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.282] [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: 11/13/2022] Open
Abstract
Abstract
Background
Unmet needs, such as lack of access to rehabilitation, support and information, are experienced by a high proportion of stroke survivors after discharge from acute and rehabilitation services. The UK guidelines on stroke (2016) recommend that all patients should be offered a structured health and social care review at 6 months post-stroke. However, no such clinics exist to date in Ireland. We aimed to explore the extent of unmet needs in the catchment area of a large teaching hospital.
Methods
A random selection of patients 6-months post-stroke were contacted by telephone and unmet needs were assessed using a validated tool, Post-Stroke Checklist. Following analysis of data, the need for a pilot clinic was identified. A separate random selection of patients discharged from acute services 6 months previously were invited to attend a review clinic. Patients were assessed using an adapted version of the Greater Manchester Stroke Assessment Tool. Assessments were conducted jointly by a physiotherapist and a speech and language therapist, and appropriate onward referrals were made.
Results
Telephone clinic: 51 patients completed the checklist. The most prevalent symptoms reported were fatigue (75%), reduced participation in hobbies and activities, decline in cognition (61%) and mobility problems (59%). Review clinic: 21 patients attended. The most prevalent symptoms reported were reduced memory/concentration (71%), low mood (71%), unintentional weight loss/gain (62%), and reduced mobility (43%). Onward referrals were made for in 16/21 (76%) cases; physiotherapy (n=12), occupational therapy (n=7), speech and language therapy (n=7), clinical nutrition (n=5), social work (n=7), psychology (n=5).
Conclusion
Data from this exploratory study supports previous research indicating a high number of stroke survivors with unmet needs. This highlights the importance of establishing post-acute stroke review clinics and pathways in the Irish setting.
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Affiliation(s)
- G Harte
- Tallaght University Hospital , Dublin, Ireland
| | - J Keane
- Tallaght University Hospital , Dublin, Ireland
| | - D Ryan
- Tallaght University Hospital , Dublin, Ireland
| | - R Collins
- Tallaght University Hospital , Dublin, Ireland
| | - C Garcia
- Tallaght University Hospital , Dublin, Ireland
| | - R Howlin
- Tallaght University Hospital , Dublin, Ireland
| | - S Ryan
- Tallaght University Hospital , Dublin, Ireland
| | - A Connolly
- Tallaght University Hospital , Dublin, Ireland
| | - E Leitch
- Tallaght University Hospital , Dublin, Ireland
| | - W Moynan
- Tallaght University Hospital , Dublin, Ireland
| | - S Healy
- Tallaght University Hospital , Dublin, Ireland
| | - M Keenan
- Tallaght University Hospital , Dublin, Ireland
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9
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Leahy A, Corey G, Purtill H, O'Neill A, Devlin C, Barry L, Cummins N, Shanahan E, Shchetkovsky D, Ryan D, O'Connor M, Galvin R. 303 SCREENING INSTRUMENTS TO PREDICT ADVERSE OUTCOMES FOR UNDIFFERENTIATED OLDER ADULTS ATTENDING THE EMERGENCY DEPARTMENT: RESULTS OF SOAED PROSPECTIVE COHORT STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.266] [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: 11/14/2022] Open
Abstract
Abstract
Background
Frailty screening facilitates the stratification of older adults at most risk of adverse events for urgent assessment and subsequent intervention in the acute or community setting. We assessed the validity of the ISAR (Identification of Seniors at Risk), Rockwood Clinical Frailty Scale (CFS), PRISMA-7 and InterRAI-ED at predicting adverse outcomes at 30 days and six months among older adults presenting to the ED.
Methods
A prospective cohort study of consecutive older adults (≥65 years) who presented to the ED at a University Hospital was conducted. The ISAR, CFS, PRISMA-7 and InterRAI-ED were performed by an experienced ED research nurse. Blinded follow-up telephone interviews were completed at 30 days and six months to assess the incidence of mortality, ED re-attendance, hospital readmission, functional decline and nursing home admission. The sensitivity and specificity of the screening tools were calculated using 2×2 tables.
Results
419 patients were recruited with 49% female and a mean age of 76.9 years (SD 7.15). The prevalence of frailty varied across the screening tools (ISAR, 47% vs InterRAI-ED, 63%). At 30-days, mortality rate was 5.4%, ED re-attendance 16.9%, hospital readmission 13.6%, functional decline 47.1% and nursing home admission 7.3%. Older adults who screened positive for frailty demonstrated an increased risk of all adverse outcomes at 30 days and 6 months, regardless of frailty screening tool administered. All tools had a relatively high sensitivity but low specificity. The ISAR was the only tool which was statistically significant at predicting all outcomes at 30 days.
Conclusion
The ISAR, CFS, PRISMA-7 and InterRAI-ED demonstrated modest validity at predicting adverse outcomes at 30 days and 6 months. We would recommend the implementation of one of these frailty screening tools in Irish EDs to support clinicians in identifying older adults most likely to benefit from specialised geriatric assessment and intervention in the hospital or community setting.
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Affiliation(s)
- A Leahy
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - G Corey
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - H Purtill
- University of Limerick Department of Mathematics & Statistics, , Limerick, Ireland
| | - A O'Neill
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - C Devlin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - L Barry
- University of Limerick School of Nursing and Midwifery, Faculty of Education and Health Sciences, , Limerick, Ireland
| | - N Cummins
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - E Shanahan
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - D Shchetkovsky
- University Hospital Limerick Department of Emergency Medicine, , Limerick, Ireland
| | - D Ryan
- University Hospital Limerick Department of Emergency Medicine, , Limerick, Ireland
| | - M O'Connor
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - R Galvin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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10
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Connor AO, Hobson H, Ryan D, Collins R. 238 THE IMPACT OF COVID-19 ON ACUTE STROKE TREATMENT. Age Ageing 2022. [PMCID: PMC9620361 DOI: 10.1093/ageing/afac218.207] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Acute stroke management is time critical. Treatment options are dictated by time of symptom onset. 2019 Irish National Audit of Stroke (INAS) showed less than 50% stroke cases arrived in hospital within three hours of symptoms and national average rate of thrombolysis was 11%. The median time Door-To-Needle time (DTN) was 56 minutes, and to thrombectomy 93 and 240 minutes ‘direct to mothership’ / ‘drip and ship’ transfer to thrombectomy centre respectively. Methods Retrospective review of all stroke FAST calls on our acute stroke database in TUH from July 2019 -2021. Data was analysed pre (up until March 2020) and during COVID-19 pandemic. Results FAST protocol imaging was obtained in 78% of cases (464/594). Documented time of symptom onset to CT was 1:50:00 pre-Covid-19 and 2:26:00 during Covid (p<0.001). ED registration to CT was 28mins pre-Covid-19 and 30mins during Covid (p<0.001). The median DTN time was 41mins pre-Covid-19 (n=21), and 54mins during Covid-19 (n=37). Conclusion In contrast to INAS COVID-19 report, median DTN times and thrombolysis rates dis-improved at TUH. Trends observed probably reflect multiple factors; patient hesitation to attend ED; patient isolation from family; busier ambulance service; Infection control protocols. We observed small but significant change in door-to-CT time but a more significant increase in DTN. This may reflect time taken donning Personal Protective Equipment (PPE) or general increased ED activity. Understanding the impact of COVID-19 on acute stroke treatment metrics in addition to differences at sites may identify targets for national quality improvement in service delivery.
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Affiliation(s)
- AO Connor
- Tallaght University Hospital , Dublin, Ireland
| | - H Hobson
- Tallaght University Hospital , Dublin, Ireland
| | - D Ryan
- Tallaght University Hospital , Dublin, Ireland
| | - R Collins
- Tallaght University Hospital , Dublin, Ireland
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11
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Conneely M, Holmes A, O'Connor M, Leahy A, Gabr A, Saleh A, Okpaje B, Corey G, Barry L, Griffin A, O'Shaughnessy Í, Ryan L, Synott A, McCarthy A, Carroll I, Leahy S, Trepél D, Ryan D, Robinson K, Galvin R. 265 A PHYSIOTHERAPY-LED TRANSITION TO HOME INTERVENTION FOR OLDER ADULTS FOLLOWING EMERGENCY DEPARTMENT DISCHARGE: A PILOT FEASIBILITY RANDOMISED-CONTROLLED TRIAL. Age Ageing 2022. [PMCID: PMC9620307 DOI: 10.1093/ageing/afac218.233] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Older adults frequently attend the Emergency Department (ED) and experience high rates of adverse outcomes following ED presentation including functional decline, ED re-presentation and unplanned hospital admission. The development of effective interventions to prevent such outcomes is a key priority for research and service provision. A presentation to an ED can be viewed as an opportunity to assess those at risk of adverse outcomes and initiate a care plan in those deemed as ‘high risk'. Our aim was to evaluate the feasibility of a physiotherapy led integrated care intervention for older adults discharged from the ED (ED-PLUS). Methods Older adults presenting to the ED with undifferentiated medical complaints and discharged within 72 hours were computer randomised in a ratio of 1:1:1 to deliver usual care, Comprehensive Geriatric Assessment (CGA) in the ED, or ED-PLUS (Trial registration: NCT04983602). ED-PLUS is an evidence-based and stakeholder-informed intervention to bridge the care transition between the ED and community by initiating a CGA in the ED and implementing a six-week, multi-component, self-management programme in the patient’s own home. Feasibility (recruitment and retention rates) and acceptability of the programme were assessed quantitatively and qualitatively. Functional decline was examined post-intervention using the Barthel Index. All outcomes were assessed by a research nurse blinded to group allocation. Results 29 participants were recruited, indicating 97% of our recruitment target. 90% of participants completed the ED-PLUS intervention. All participants expressed positive feedback about the intervention. The incidence of functional decline at 6 weeks was 10% in the ED-PLUS group versus 70-89% in the usual care and CGA-only groups. Conclusion High adherence and retention rates were observed among participants and preliminary findings indicate a lower incidence of functional decline in the ED-PLUS group. Recruitment challenges existed in the context of COVID-19. Data collection is ongoing for six-month outcomes.
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Affiliation(s)
- M Conneely
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - A Holmes
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - M O'Connor
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Leahy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Gabr
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Saleh
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - B Okpaje
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - G Corey
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - L Barry
- University of Limerick School of Nursing and Midwifery, Faculty of Education and Health Sciences, , Limerick, Ireland
| | - A Griffin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - Í O'Shaughnessy
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - L Ryan
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Synott
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A McCarthy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - I Carroll
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - S Leahy
- School of Science & Computing, Atlantic Technological University, ATU Galway City Department of Sport, Exercise & Nutrition, , Old Dublin Road, Galway, Ireland
| | - D Trepél
- Trinity College Dublin Trinity Institute of Neurosciences, School of Medicine, , Ireland
| | - D Ryan
- University Hospital Limerick Limerick EM Education Research Training, Emergency Department, , Dooradoyle, Limerick, Ireland
| | - K Robinson
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - R Galvin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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12
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Dupoiron D, Brill S, Eeeltink C, Bell D, Barragán B, Petersen G, Eerdekens M, Ryan D, Rakuša M. 1571P Cancer-related neuropathic pain (CRNP) in Europe: Impact of cancer stage on diagnosis and treatment of patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1664] [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: 11/26/2022] Open
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13
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Ryan D, Holmes M, Ensaff H. Adolescents' dietary behaviour: The interplay between home and school food environments. Appetite 2022; 175:106056. [PMID: 35447162 DOI: 10.1016/j.appet.2022.106056] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 12/29/2022]
Abstract
In the UK, school food standards have looked to improve the nutritional profile of school food provision and the choices made; however, adolescents' choices tend to bias towards micronutrient poor and energy dense options. This study aimed to explore how adolescents make their school food choices, along with how they engage with their environments whilst selecting food. Seven focus group interviews took place with adolescents (n = 28; 13-14 years) in a secondary school in Northern England. Discussions with participants were audio-recorded, transcribed verbatim and then analysed using an inductive thematic approach. Six themes emerged from the data: (1) parents' and adolescents' roles in the home food environment, (2) burgeoning food autonomy, (3) school food choice factors, (4) social aspects of school food, (5) home versus school, (6) food knowledge & beliefs. Adolescents identified two distinct environments during the focus group discussions: the home and school environments. Adolescents juxtaposed the two, in terms of food provision, food choices, rules and customs surrounding food choice. This juxtaposition emerged as an indirect but important influence on adolescents' school food choices. The school and home environments both (in)directly influence adolescents' school food choices, which involve an integration of multiple, often conflicting influences. Adolescents may adopt a number of unhelpful dietary rationalisations as they try to manage and reconcile these influences. Consultation, together with consideration of relevant food choice models, is required to identify opportunities to influence adolescents' food choices at school.
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Affiliation(s)
- D Ryan
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - M Holmes
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - H Ensaff
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom.
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14
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O'Shaughnessy Í, Robinson K, O'Connor M, Conneely M, Ryan D, Steed F, Carey L, Leahy A, Shanahan E, Quinn C, Galvin R. 941 EFFECTIVENESS OF ACUTE GERIATRIC UNIT CARE AMONG HOSPITALISED OLDER ADULTS WITH ACUTE MEDICAL COMPLAINTS: A META-ANALYSIS. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Older adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid and complex conditions. This systematic review and meta-analysis aims to update and synthesise the totality of research evidence on the effectiveness of acute geriatric unit (AGU) care for older adults admitted to hospital with acute medical complaints.
Method
MEDLINE, CINAHL, CENTRAL, and Embase databases were systematically searched from 2008 to February 2021. Screening, data extraction, and quality grading were undertaken by two reviewers. Only trials with a randomised design comparing AGU care and conventional care units were included. Meta-analyses were performed in Review Manager 5.4 and the Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence for outcomes reported. The primary outcome measure was incidence of functional decline between baseline two-week prehospital admission status and discharge and at follow-up.
Results
11 trials recruiting 7,496 participants across three countries were included. AGU care was associated with a 23% reduction in functional decline at six-month follow-up (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.64–0.92; moderate certainty evidence), and significant cost savings (mean difference (MD) -538.01USD, 95% CI -571.05USD—-504.96USD; low certainty evidence). No differences were found in functional decline at hospital discharge or at three-month follow-up, length of hospital stay, the likelihood of living at home, mortality, hospital readmission, cognitive function, or patient satisfaction with the index admission.
Conclusion
AGU care improves clinical and process outcomes for older adults admitted to hospital with acute medical complaints. Future research should focus on greater inclusion of clinical and patient reported outcome measures including quality of life. Use of such measures may lead to a greater focus on patient-centered care and service provision priorities.
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Affiliation(s)
- Í O'Shaughnessy
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - K Robinson
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - M O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
- School of Medicine , Faculty of Education and Health Sciences, , Ireland
- University of Limerick , Faculty of Education and Health Sciences, , Ireland
| | - M Conneely
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - D Ryan
- School of Medicine , Faculty of Education and Health Sciences, , Ireland
- University of Limerick , Faculty of Education and Health Sciences, , Ireland
- Emergency Department, University Hospital Limerick , Ireland
| | - F Steed
- Medicine Directorate, University Hospital Limerick , Ireland
| | - L Carey
- Department of Occupational Therapy, University Hospital Limerick, Irl
| | - A Leahy
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - E Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - C Quinn
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - R Galvin
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
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15
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Leahy A, Corey G, O’Neill A, Higginbotham O, Devlin C, Barry L, Cummins N, Shanahan E, Shchetkovsky D, Ryan D, O'Connor M, Galvin R. 1081 A COMPARISON OF THE ISAR TOOL AND THE CLINICAL FRAILTY SCALE TO PREDICT MORTALITY AND ED REATTENDANCE IN A COHORT OF ED ATTENDER. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.086] [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: 11/14/2022] Open
Abstract
Abstract
Background
Frailty Screening is one method by which we can risk stratify older adults to urgent assessment in the Emergency Department. The ISAR (Identification of Seniors at Risk) and Rockwood Clinical Frailty Scale are two frailty screening tools. We assessed the validity of these tools at predicting adverse outcomes for older adults presenting to the Emergency Department.
Method
This was a prospective cohort study. Patients over 65 were recruited, baseline.
demographics were obtained and a research nurse assessed them using both the Clinical Frailty Scale and ISAR. Patients were assessed by telephone interviews at one month and six months. The outcome measures assessed were mortality, ED re-attendance, hospital readmission, functional decline and institutionalisation.
Results
419 patients were recruited. 53.3% (223) were male with a median age of 76 (IQR = 10). The median ISAR and CFS score was 2,5 respectively at baseline. The mortality rate was 5.4% and rate of ED re-attendance was 16.9% at one month. The relative risk of ED re-admission with an ISAR score >/= 2 more was 1.84 (1.12, 3.02) and CFS > 4 was 1.85 (1.08, 3.16). The ISAR tool >/= 2, had a sensitivity of 74.29 (95% CI = 62.44, 83.99) and specificity of 41.18 (95% CI = 35.90, 46.61) when used as a diagnostic tool for ED re-admission at one month. The CFS > 4 had a sensitivity of 71.43 (95% CI = 57.79, 82.70) and specificity of 45.23 (95% CI = 39.33, 51.23) for the same outcome.
Conclusion
The ISAR tool >/= 2 was the more sensitive at predicting ED reattendance at one month in comparison to the Clinical Frailty Scale. We would advocate using this tool in the ED setting to highlight those at greatest risk of adverse outcomes and those most likely to benefit from Comprehensive Geriatric Assessment.
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Affiliation(s)
- A Leahy
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- Department of Ageing and Therapeutics, University Hospital Limerick , Limerick, Ireland
| | - G Corey
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - A O’Neill
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - O Higginbotham
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - C Devlin
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - L Barry
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- School of Nursing and Midwifery , Faculty of Education and Health Sciences, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, , Limerick, Ireland
| | - N Cummins
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - E Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick , Limerick, Ireland
| | - D Shchetkovsky
- Department of Emergency Medicine, University Hospital Limerick , Limerick, Ireland
| | - D Ryan
- Department of Emergency Medicine, University Hospital Limerick , Limerick, Ireland
| | - M O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick , Limerick, Ireland
| | - R Galvin
- School of Allied Health , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
- University of Limerick , Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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16
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Corcoran R, Tian J, Chen J, Chao S, Pelka K, Baiev I, Sindurakar P, Allen J, Meyerhardt J, Enzinger A, Enzinger P, McCleary N, Klempner S, Yurgelun M, Abrams T, Clark J, Ryan D, Giannakis M, Parikh A, Hacohen N. SO-38 Clinical efficacy and single-cell analysis of combined BRAF, MEK, and PD-1 inhibition in BRAFV600E colorectal cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.436] [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: 11/01/2022] Open
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17
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Ryan D, Donnelly J. The Paeds Poll. Ir Med J 2022; 115:570. [PMID: 35532960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- D Ryan
- General Paediatrics, Children's Health Ireland (CHI) at Crumlin
| | - J Donnelly
- General Paediatrics, Children's Health Ireland (CHI) at Crumlin
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18
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Finnegan J, Mello S, Cogan N, Greene S, Ryan D, Collins R. Stroke Risk Factors, Subtype, and Outcomes in a Multi-Ethnic Stroke Population. Ir Med J 2022; 115:520. [PMID: 35279054] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aim We aim to describe differences in stroke risk factors, subtypes and outcomes in a multi-ethnic Irish Stroke population. Gaining an insight into prevalent risk factors and subtypes in ethnic groups may help target prevention efforts. Methods We retrospectively identified patients originally not of Irish ethnicity (ONIE) admitted to the acute stroke unit between 2016 and 2018 through surname recognition (N=44). Country of origin was confirmed on chart review. The presumed native Irish (PNI) patients admitted over the same time frame were used as a comparison group (N=437). Data was collected on stroke subtype, comorbidities, outcomes and socioeconomic factors. Results Patients ONIE made up 9.1% of all stroke unit admissions. Male gender was more common accounting for 33 of 44 (75%) patients ONIE and 251 of 437 (57.4%) PNI (p = 0.02). Overall ONIE were younger than PNI patients (mean age 57.5 [SD 13.0] vs 69.6yr [SD 13.2], p <0.001). Patients ONIE also recorded higher rates of intracranial haemorrhage(ICH) (N = 15 [34.1%] vs N=51 [11.7%], p <0.01). Conclusion Our study demonstrates that stroke patients ONIE have a different stroke subtype and demographic profile compared to Irish patients. Patients ONIE are more likely to be young, male with higher rates of ICH.
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Affiliation(s)
- J Finnegan
- Tallaght University Hospital, Dublin, Ireland
| | - S Mello
- Department of Age-Related Healthcare and Stroke Medicine, Tallaght University Hospital, Dublin, Ireland
| | - N Cogan
- Department of Age-Related Healthcare and Stroke Medicine, Tallaght University Hospital, Dublin, Ireland
| | - S Greene
- Department of Age-Related Healthcare and Stroke Medicine, Tallaght University Hospital, Dublin, Ireland
| | - D Ryan
- Department of Age-Related Healthcare and Stroke Medicine, Tallaght University Hospital, Dublin, Ireland
| | - R Collins
- Department of Age-Related Healthcare and Stroke Medicine, Tallaght University Hospital, Dublin, Ireland
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19
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McGarvey C, Hobson H, Greene S, Cogan N, McCabe D, McCarthy A, Murphy S, O'Dowd S, Walsh R, Coughlan T, O'Neill D, Kennelly S, Mello S, Coveney S, Ryan D, Collins R. 209 NEURO-MEDICAL COMPLICATIONS OF STROKE—TRENDS OVER THE DECADES IN AN ACUTE STROKE UNIT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.209] [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: 02/25/2023] Open
Abstract
Abstract
Background
Neuro-medical complications post-stroke are common and often serious [1]. We first described complications in our stroke cohort in 1998 and sought to assess whether the severity and the nature of neuro-medical complications may have changed over time due to changes in presentation and the processes of care [2].
Methods
Analysis of stroke service database, which captures all neuro-medical complications as part of its portal for the Irish National Audit of Stroke (INAS), was completed. The frequency of each of the 19 complications was expressed as the percentage of patients that developed each complication over a certain year and over 5 years. Historical comparison was made with dataset from 1998, which captured six complications.
Results
Data on 1,283 patients presenting over 5 years between 2015–2019 was collected. The median age of all patients was 71 years (Range 21–101). In all, 19 different post-stroke complications were recorded; 48% (n = 622) had post-stroke pain, while 23.85% (n = 306) had cognitive decline. Data on 100 patients from 1998 was compared for a number of common metrics including; 21.82% (n = 275) of patients developed an LRTI in the 2015–2019 cohort compared with 14%(n = 14) in the 1998 cohort (p = 0.09) while 16.29% (n = 209) of patients developed a swallow disorder compared to 21% (n = 21) in 1998 (p = 0.22).
Conclusion
There are high levels of neuro-medical complications in stroke patients. Twenty years has seen extensive investment in hyperacute stroke care yet post-acute care complications did not appear to reduce significantly between this time, albeit with low numbers. Direction of future funding may consider the full spectrum of stroke care.
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Affiliation(s)
- C McGarvey
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - H Hobson
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Greene
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - N Cogan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D McCabe
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - A McCarthy
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - S Murphy
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - S O'Dowd
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - R Walsh
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - T Coughlan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D O'Neill
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Kennelly
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Mello
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Coveney
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D Ryan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - R Collins
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
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20
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Synnott A, Ryan C, O'Connell P, Steed F, Reale S, Carey L, English S, Fitzgibbon K, O'Connell Á, Smalle E, Ryan D, Shchetkovsky D, McCarthy A, Moran B, Murphy H, O'Shaughnessy Í. 178 A RETROSPECTIVE EVALUATION OF PROCESS OUTCOMES OF OLDER ADULTS REFERRED TO A COMMUNITY RE-ENABLEMENT TEAM FROM THE EMERGENCY DEPARTMENT. Age Ageing 2021. [DOI: 10.1093/ageing/afab216.178] [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: 02/25/2023] Open
Abstract
Abstract
Background
Emergency Departments (ED) are complex and challenging environments to provide care to older adults. There is currently a paucity of high quality methodological research investigating the effectiveness of interventions focused on transitions of care from the ED to primary care services (Hughes et al, 2019). This study aims to evaluate the impact of a collaborative model of care between primary and secondary care services for older adults discharged home following ED index visit.
Methods
This was an observational retrospective study. Participants aged ≥65 years discharged home from the ED of a University Teaching Hospital and referred to a Multidisciplinary Community Intervention Team (MDCIT) were included. Referral pathways were via the OPTIMEND team (Cassarino et al, 2021) and MDCIT, which is a rapid access re-enablement team based in the community and compromises nursing staff, an occupational therapist, physiotherapist, therapy and healthcare assistants. Descriptive statistics were used to profile the baseline characteristics of study participants and to summarise data related to process outcomes. Ethical approval was granted for this study (020/2021).
Results
In the study period, January—December 2020, 54 patients were referred to the MDCIT. The mean age of participants was 80.1 years (SD 8.2), 57% were female, and the most common Manchester Triage System presenting complaint was ‘limb problems’. The median Patient Experience Time within the ED was 7.4 hours (IQR 13.1); 55% of participants were seen in their home within 24 hours of discharge. A mean of 10 interventions were delivered by the MDCIT. A 9.1% incidence rate of 30 day unscheduled hospital readmission was recorded.
Conclusion
Integrated care programmes have been advocated to improve the continuum of care from the ED into the community. This evaluation has demonstrated the feasibility of implementing such a model of care. However, further methodologically robust research is required to advance the evidence base and should also focus on patient outcomes.
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Affiliation(s)
- A Synnott
- Emergency Department, University Hospital Limerick , Limerick, Ireland
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - C Ryan
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - P O'Connell
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - F Steed
- Medicine Directorate, University Hospital Limerick , Limerick, Ireland
| | - S Reale
- Diagnostics Directorate, University Hospital Limerick , Limerick, Ireland
| | - L Carey
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - S English
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - K Fitzgibbon
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - Á O'Connell
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - E Smalle
- Department of Medical Social Work, University Hospital Limerick , Limerick, Ireland
| | - D Ryan
- Emergency Department, University Hospital Limerick , Limerick, Ireland
| | - D Shchetkovsky
- Emergency Department, University Hospital Limerick , Limerick, Ireland
| | - A McCarthy
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - B Moran
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - H Murphy
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - Í O'Shaughnessy
- Emergency Department, University Hospital Limerick , Limerick, Ireland
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
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21
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Doyle M, Ryan D, Mello S. 56 EFFICACY OF AN ELECTIVE PERIOD OF IN-PATIENT REHABILITATION FOR PATIENTS LIVING WITH PARKINSON’S DISEASE AND FRAILTY: A PILOT STUDY. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.56] [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: 02/25/2023] Open
Abstract
Abstract
Background
Frailty and Parkinson’s disease (PD) are more common with increasing age and are associated with syndromes such as falls, immobility, cognitive dysfunction and incontinence. PD may directly cause or co-exist with and compound frailty. A coordinated, multidisciplinary approach to care has been shown to optimize outcomes in both of these conditions. This pilot study aims to examine the short-term effects of an elective two-week in-patient rehabilitation program on frail PD patients’ function, mobility, and self-reported quality of life (QOL).
Methods
This prospective cohort study included all frail PD patients admitted for elective rehabilitation since the program’s conception. Patients included must be able to mobilize independently with or without an aid, or with assistance of one person. They also must be cognitively able to participate in rehabilitation. Patients received consultant-led Comprehensive Geriatric Assessment and attended daily physiotherapy and occupational therapy sessions. Functional outcome and health related QOL measurements were collected on admission and discharge and compared using a paired t-test. Frailty was quantified by the Clinical Frailty Index.
Results
Twelve patients completed the program (58% male). The average age was 79 (range 70–86) and average clinical frailty score was 5.6 indicating mild to moderate frailty. Performance in activities of daily living (Barthel Index: 64 vs 73, p = 0.005), overall mobility (Elderly Mobility Scale: 10.6 vs 12.9, p = 0.004), gait speed (Timed Up and Go: 35 vs 29 seconds, p = 0.05), and balance (Berg Balance Scale: 25 vs 32, p = 0.002) significantly improved from admission to discharge from the program. Health-related QOL also improved (EQ-5D: 44 vs 66, p = 0.004).
Conclusion
Early data suggests that a short elective in-patient rehabilitation program has highly significant benefits for frail PD patients on mobility, performance of activities of daily living, and QOL. Longer term follow-up is required to assess sustainability of these improvements and cost-effectiveness of this intervention.
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Affiliation(s)
- M Doyle
- Peamount Healthcare , Dublin, Ireland
| | - D Ryan
- Peamount Healthcare , Dublin, Ireland
- Tallaght University Hospital , Dublin, Ireland
| | - S Mello
- Peamount Healthcare , Dublin, Ireland
- Tallaght University Hospital , Dublin, Ireland
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22
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Leahy A, Corey G, O'Neill A, Higginbotham O, Devlin C, Barry L, Cummins N, Gabr A, Shanahan E, Shchetkovsky D, Ryan D, O'Connor M, Galvin R. 240 A COMPARISON OF THE ISAR AND THE CLINICAL FRAILTY SCALE TO PREDICT MORTALITY AND ED RE-ATTENDANCE IN OLDER ED ATTENDERS. Age Ageing 2021. [DOI: 10.1093/ageing/afab216.240] [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: 02/25/2023] Open
Abstract
Abstract
Background
Frailty Screening is one method by which we can risk stratify older adults to urgent assessment in the Emergency Department. The ISAR (Identification of Seniors at Risk) and Rockwood Clinical Frailty Scale (CFS) are two frailty screening tools. We assessed the validity of these tools at predicting adverse outcomes for older adults presenting to the Emergency Department.
Methods
This was a prospective cohort study. Patients over 65 were recruited, baseline demographics were obtained and a research nurse assessed them using both the CFS and ISAR. Patients were assessed by telephone interviews at one month and six months. The outcome measures assessed were mortality, ED re-attendance, hospital readmission, functional decline and institutionalisation.
Results
419 patients were recruited. 53.3% (223) were male with a median age of 76 (IQR = 10). At baseline, the median ISAR was 2 and CFS was 5. The mortality rate was 5.4% and the rate of ED re-attendance was 16.9% at one month. The relative risk of ED re-admission with an ISAR score ≥ 2 was 1.84 (1.12, 3.02) and CFS > 4 was 1.85 (1.08, 3.16). The ISAR tool ≥2 had a sensitivity of 74% (95% CI = 62.44, 83.99) and specificity of 41% (95% CI = 35.90, 46.61) when used as a diagnostic tool for ED re-admission at one month. The CFS > 4 had a sensitivity of 71% (95% CI = 57.79, 82.70) and specificity of 45% (95% CI = 39.33, 51.23) for ED re-attendance.
Conclusion
The ISAR tool ≥2 was more sensitive at predicting ED reattendance at one month in comparison to the CFS. We advocate to use this tool in the ED setting to highlight those at greatest risk of adverse outcomes and those most likely to benefit from Comprehensive Geriatric Assessment.
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Affiliation(s)
- A Leahy
- Department of Therapeutics and Ageing, University Hospital Limerick , Limerick, Ireland
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - G Corey
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - A O'Neill
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - O Higginbotham
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - C Devlin
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - L Barry
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - N Cummins
- School of Allied Health, University of Limerick , Limerick, Ireland
| | - A Gabr
- Department of Therapeutics and Ageing, University Hospital Limerick , Limerick, Ireland
| | - E Shanahan
- Department of Therapeutics and Ageing, University Hospital Limerick , Limerick, Ireland
| | | | - D Ryan
- Department of Emergency Medicine , Limerick, Ireland
| | - M O'Connor
- Department of Therapeutics and Ageing, University Hospital Limerick , Limerick, Ireland
| | - R Galvin
- School of Allied Health , HRI, , Limerick, Ireland
- University of Limerick , HRI, , Limerick, Ireland
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23
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Bradley P, Ryan D, Craig C, Booton R, Crosbie P, Balata H. P61.02 The Use of PLCOm2012 vs PLCOm2012noRace Risk Prediction Models in a UK Lung Cancer Screening Programme. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.637] [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: 11/26/2022]
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24
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Onishi-Seebacher M, Erikson G, Sawitzki Z, Ryan D, Greve G, Lübbert M, Jenuwein T. Repeat to gene expression ratios in leukemic blast cells can stratify risk prediction in acute myeloid leukemia. BMC Med Genomics 2021; 14:166. [PMID: 34174884 PMCID: PMC8234671 DOI: 10.1186/s12920-021-01003-z] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 06/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Repeat elements constitute a large proportion of the human genome and recent evidence indicates that repeat element expression has functional roles in both physiological and pathological states. Specifically for cancer, transcription of endogenous retrotransposons is often suppressed to attenuate an anti-tumor immune response, whereas aberrant expression of heterochromatin-derived satellite RNA has been identified as a tumor driver. These insights demonstrate separate functions for the dysregulation of distinct repeat subclasses in either the attenuation or progression of human solid tumors. For hematopoietic malignancies, such as Acute Myeloid Leukemia (AML), only very few studies on the expression/dysregulation of repeat elements were done. METHODS To study the expression of repeat elements in AML, we performed total-RNA sequencing of healthy CD34 + cells and of leukemic blast cells from primary AML patient material. We also developed an integrative bioinformatic approach that can quantify the expression of repeat transcripts from all repeat subclasses (SINE/ALU, LINE, ERV and satellites) in relation to the expression of gene and other non-repeat transcripts (i.e. R/G ratio). This novel approach can be used as an instructive signature for repeat element expression and has been extended to the analysis of poly(A)-RNA sequencing datasets from Blueprint and TCGA consortia that together comprise 120 AML patient samples. RESULTS We identified that repeat element expression is generally down-regulated during hematopoietic differentiation and that relative changes in repeat to gene expression can stratify risk prediction of AML patients and correlate with overall survival probabilities. A high R/G ratio identifies AML patient subgroups with a favorable prognosis, whereas a low R/G ratio is prevalent in AML patient subgroups with a poor prognosis. CONCLUSIONS We developed an integrative bioinformatic approach that defines a general model for the analysis of repeat element dysregulation in physiological and pathological development. We find that changes in repeat to gene expression (i.e. R/G ratios) correlate with hematopoietic differentiation and can sub-stratify AML patients into low-risk and high-risk subgroups. Thus, the definition of a R/G ratio can serve as a valuable biomarker for AML and could also provide insights into differential patient response to epigenetic drug treatment.
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Affiliation(s)
- M Onishi-Seebacher
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
- Novartis Institute for Biomedical Research (NIBR), Basel, Switzerland
| | - G Erikson
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
| | - Z Sawitzki
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
- Faculty of Biology, International Max Planck Research School for Molecular and Cellular Biology (IMPRS-MCB) and University of Freiburg, Freiburg, Germany
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - D Ryan
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
| | - G Greve
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Lübbert
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Freiburg, Germany
| | - T Jenuwein
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany.
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25
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Joyce DP, Ryan D, Kavanagh DO, Traynor O, Tierney S. Impact of COVID-19 on operative experience of junior surgical trainees. Br J Surg 2021; 108:e33-e34. [PMID: 33640935 PMCID: PMC7799345 DOI: 10.1093/bjs/znaa079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/13/2020] [Indexed: 12/02/2022]
Affiliation(s)
- D P Joyce
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Ryan
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D O Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - O Traynor
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S Tierney
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
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26
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Ryan D, Pérez-Accino J, Gonçalves R, Czopowicz M, Bertolani C, Tabar MD, Puig J, Ros C, Suñol A. Clinical findings, neurological manifestations and survival of dogs with insulinoma: 116 cases (2009-2020). J Small Anim Pract 2021; 62:531-539. [PMID: 33724496 DOI: 10.1111/jsap.13318] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/23/2020] [Accepted: 01/25/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To review the clinical findings and outcome in dogs diagnosed with insulinoma, and to assess which factors are predictors of overall survival. Additionally, to describe the neurological manifestations of this population and their correlation with survival. MATERIALS AND METHODS Retrospective multicentric study of canine insulinoma cases (2009 to 2020). Signalment, clinical history, neurological examination, diagnostic findings, treatment and outcome were obtained from clinical records. Univariate and multivariate analyses were used to compare the overall survival. RESULTS One hundred and sixteen cases were included. Median duration of clinical signs before presentation was 1.5 months. The most common presenting clinical signs were weakness (59.5%), epileptic seizures (33.6%) and changes in consciousness or behaviour (27.6%). Three dogs were suspected to have paroxysmal dyskinesia. Thirty-two dogs had an abnormal neurological examination, most commonly showing obtundation (28.1%), decreased withdrawal reflexes (21.9%) and absent menace response (18.8%). Overall survival for dogs undergoing surgery (20 months) was significantly longer than in medically treated (8 months; adjusted hazard ratio: 0.33; 95% confidence interval: 0.18, 0.59). Presence of metastases was the only other variable associated with prognosis (adjusted hazard ratio 1.72; 95% confidence interval: 1.02, 2.91). CLINICAL SIGNIFICANCE Clinical signs of canine insulinoma are vague and non-specific. Weakness, epileptic seizures and changes in mentation or behaviour were the most commonly reported. Obtunded mentation and forebrain neurolocalisation were the main neurological manifestations. Dogs undergoing surgery had a longer overall survival compared to medically treated cases, and dogs with metastasis had a shorter overall survival regardless of treatment modality. Abnormalities in the neurological examination did not correlate with prognosis.
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Affiliation(s)
- D Ryan
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, EH25 9RG, UK
| | - J Pérez-Accino
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, EH25 9RG, UK
| | - R Gonçalves
- Small Animal Teaching Hospital, University of Liverpool, Leahurst, Neston, CH64 7TE, UK
| | - M Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, 02-776, Poland
| | - C Bertolani
- Internal Medicine Service, Hospital Veterinari Canis Mallorca, Palma, 07010, Spain
| | - M D Tabar
- Internal Medicine Service, Hospital Veterinario San Vincente, Alicante, 03690, Spain
| | - J Puig
- Internal Medicine Service, Ars Veterinaria, Barcelona, 08034, Spain
| | - C Ros
- Hospital Veterinario UCV, Universidad Católica de Valencia, Valencia, 46018, Spain
| | - A Suñol
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, EH25 9RG, UK
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27
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Tieges Z, MacLullich AMJ, Anand A, Cassaroni M, O'Connor M, Ryan D, Saller T, Arora R, Chang Y, Agarwal K, Taffet G, Quinn T, Shenkin S, Galvin R. 33 Diagnostic Test Accuracy of the 4AT for Delirium Detection: Systematic Review and Meta-Analysis. Age Ageing 2021. [DOI: 10.1093/ageing/afab029.12] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT; www.the4AT.com) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection.
Methods
We searched the following electronic databases through Ovid: MEDLINE, Embase, and PsycINFO. Additional databases were searched: CINAHL (EBSCOhost), clinicaltrials.gov and Cochrane Central Register of Controlled Trials from 2011 (4AT publication) until 21 December 2019. Inclusion criteria: older adults (≥65) across any setting of care except critical care; validation study of the 4AT against a delirium reference standard (standard diagnostic criteria or validated tool). Two reviewers independently screened abstracts and papers and performed the data extraction. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model.
Results
17 studies (n = 3,701 observations) were included. Various settings including acute medicine, surgery, stroke wards and the emergency department were represented. The overall prevalence of delirium was 24.2% (95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity was 0.88 (95% CI 0.82–0.92). The methodological quality of studies was mostly good.
Conclusions
The 4AT is now supported by a substantial evidence base comparable to other well-studied tools such as the Confusion Assessment Method (CAM). The strong pooled sensitivity and specificity findings for the 4AT in this meta-analysis along with its brevity and lack of need for specific training provide support for its use as an effective assessment tool for delirium.
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Affiliation(s)
- Z Tieges
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - A M J MacLullich
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - A Anand
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - M Cassaroni
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - M O'Connor
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - D Ryan
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - T Saller
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - R Arora
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - Y Chang
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - K Agarwal
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - G Taffet
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - T Quinn
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - S Shenkin
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - R Galvin
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
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28
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Hogan P, Enright H, Ryan D, O'Neill D. 56 Ageism in Myelodysplastic Syndrome. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.17] [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: 11/13/2022] Open
Abstract
Abstract
Background
Myelodysplastic Syndromes (MDS) are a group of haematological disorders which are common in older people and can be amenable to treatment. Ageism has previously been identified in studies of treatment for conditions affecting older people.
Objectives
To assess for the presence of ageism in studies of treatment for MDS.
Design
A review of the Cochrane Library of Systematic Reviews.
Setting
Desk-based.
Methods
Systematic reviews were analysed to determine: use of age as an exclusion criteria in randomized-control trials (RCTs); the comparison of ages of patients in RCTs to that of the median age of patients with MDS; exclusion of patients from RCTs on the basis of dementia or other conditions associated with ageing.
Results
17 reviews were identified, 2 of which were suitable for analysis. The two remaining systematic reviews reported data on 13 RCTs—of which 2 did not report age. The median age of all patients was 68. Three RCTs used a maximum age limit for therapy—one of which was lower than the median age of diagnosis of MDS. More recent studies tended to include older patients. No studies excluded patients on the basis of cognitive status.
Conclusion
There was some evidence of ageism identified in studies of treatment for MDS. There was limited data available in the Cochrane database of Systematic Reviews, which may itself be suggestive of ageism in such reviews.
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Affiliation(s)
- P Hogan
- Dept. Age-Related Healthcare, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - H Enright
- Dept. Haematology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - D Ryan
- Dept. Age-Related Healthcare, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - D O'Neill
- Dept. Age-Related Healthcare, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
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29
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Hellings PW, Scadding G, Bachert C, Bjermer L, Canonica GW, Cardell LO, Carney AS, Constantinidis J, Deneyer L, Diamant Z, Durham S, Gevaert P, Harvey R, Hopkins C, Kjeldsen A, Klimek L, Lund VJ, Price D, Rimmer J, Ryan D, Roberts G, Sahlstrand-Johnson P, Salmi S, Samji M, Scadding G, Smith P, Steinsvik A, Wagenmann M, Seys S, Wahn U, Fokkens WJ. EUFOREA treatment algorithm for allergic rhinitis. Rhinology 2021; 58:626-628. [PMID: 32991658 DOI: 10.4193/rhin20.246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P W Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium; University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium; Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, The Netherlands
| | - G Scadding
- RNENT Hospital, Huntley Street, London, UK
| | - C Bachert
- Upper Airways Research Laboratory, Dept of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Division of ENT diseases, CLINTEC, Karolinska Institute, University of Stockholm, Sweden;Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital, Guangzhou, China
| | - L Bjermer
- Dept of Respiratory Medicine and Allergology, Skane Uni- versity Hospital, Lund, Sweden
| | - G W Canonica
- Personalized Medicine Asthma and Allergy Clinic, Humanitas University and Research Hospital, Milan, Italy, and SANI-Severe Asthma Network Italy
| | - L O Cardell
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A S Carney
- Ear, Nose, and Throat (ENT) Department, Flinders Univer- sity, Bedford Park, South Australia, Australia
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L Deneyer
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Z Diamant
- Dept of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden; Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Dept Clin Pharm and Pharmacol, Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
| | - S Durham
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London; MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - P Gevaert
- Upper Airways Research Laboratory, Dept of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - R Harvey
- Rhinology and Skull Base, Applied medical research center, University of New South Wales, Sydney, Australia; Faculty of medicine and heath sciences, Macquarie University, Sydney, Australia
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - A Kjeldsen
- Department of Otorhinolaryngology Head and Neck surgery, Odense University Hospital, Denmark; University of Southern Denmark, Odense, Denmark
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany; Mainz University Allergy Center, Mainz, Germany
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - D Price
- Optimum Patient Care, Cambridge, UK; Observational and Pragmatic Research Institute, Singapore
| | - J Rimmer
- Monash Health, Monash University, Melbourne, Australia
| | - D Ryan
- Usher institute, University of Edinburgh, Edinburgh, UK
| | - G Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, United Kingdom;NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; University of Southampton, Southampton, United Kingdom
| | - P Sahlstrand-Johnson
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Skane University Hospital, Malmoo, Sweden
| | - S Salmi
- Helsinki University Hospital, Helsinki, Finland
| | - M Samji
- Imperial College London, London, UK
| | - G Scadding
- Royal Brompton and Ha- refield NHS Trust, London, UK
| | - P Smith
- Clinical Medicine, Griffith University, Southport, QLD, Australia
| | - A Steinsvik
- Department of Otorhinolaryngo- logy, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - M Wagenmann
- Department of Otorhinolaryngology, Universitatsklinikum Dusseldorf, Dusseldorf, Germany
| | - S Seys
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - U Wahn
- Klinik fur Padiatrie m.S. Pneumologie und Immunologie, Charite, Berlin, Germany
| | - W J Fokkens
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, The Netherlands
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30
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Bédard A, Basagaña X, Anto JM, Garcia-Aymerich J, Devillier P, Arnavielhe S, Bedbrook A, Onorato GL, Czarlewski W, Murray R, Almeida R, Fonseca JA, Correia da Sousa J, Costa E, Morais-Almeida M, Todo-Bom A, Cecchi L, De Feo G, Illario M, Menditto E, Monti R, Stellato C, Ventura MT, Annesi-Maesano I, Bosse I, Fontaine JF, Pham-Thi N, Thibaudon M, Schmid-Grendelmeier P, Spertini F, Chavannes NH, Fokkens WJ, Reitsma S, Dubakiene R, Emuzyte R, Kvedariene V, Valiulis A, Kuna P, Samolinski B, Klimek L, Mösges R, Pfaar O, Shamai S, Roller-Wirnsberger RE, Tomazic PV, Ryan D, Sheikh A, Haahtela T, Toppila-Salmi S, Valovirta E, Cardona V, Mullol J, Valero A, Makris M, Papadopoulos NG, Prokopakis EP, Psarros F, Bachert C, Hellings PW, Pugin B, Bindslev-Jensen C, Eller E, Kull I, Melén E, Wickman M, De Vries G, van Eerd M, Agache I, Ansotegui IJ, Bosnic-Anticevich S, Cruz AA, Casale T, Ivancevich JC, Larenas-Linnemann DE, Sofiev M, Wallace D, Waserman S, Yorgancioglu A, Laune D, Bousquet J. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study. Clin Transl Allergy 2020; 10:62. [PMID: 33298191 PMCID: PMC7726888 DOI: 10.1186/s13601-020-00342-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/25/2020] [Indexed: 02/02/2023] Open
Abstract
Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information including the phenotypic characteristics of the users. Methods The Allergy Diary–MASK-air–mobile phone app, freely available via Google Play and App, was used to collect the data of daily visual analogue scales (VASs) for overall allergic symptoms and medication use. Fluticasone Furoate (FF), Mometasone Furoate (MF), Azelastine Fluticasone Proprionate combination (MPAzeFlu) and eight oral H1-antihistamines were studied. Phenotypic characteristics were recorded at entry. The ARIA severity score was derived from entry data. This was an a priori planned analysis. Results 9037 users filled in 70,286 days of VAS in 2016, 2017 and 2018. The ARIA severity score was lower outside than during the pollen season. Severity was similar for all treatment groups during the pollen season, and lower in the MPAzeFlu group outside the pollen season. Days with MPAzeFlu had lower VAS levels and a higher frequency of monotherapy than the other treatments during the season. Outside the season, days with MPAzeFlu also had a higher frequency of monotherapy. The number of reported days was significantly higher with MPAzeFlu during and outside the season than with MF, FF or oral H1-antihistamines. Conclusions This study shows that the overall efficacy of treatments is similar during and outside the pollen season and indicates that medications are similarly effective during the year.
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Affiliation(s)
- A Bédard
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - X Basagaña
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - J M Anto
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - J Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - P Devillier
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | | | | | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France
| | - R Murray
- Research fellow, OPC, and Director, Cambridge, UK.,Medscript, Paraparaumu, New Zealand
| | - R Almeida
- Faculdade de Medicina da Universidade do Porto, Lda Porto, Portugal
| | - J A Fonseca
- Faculdade de Medicina da Universidade do Porto, Lda Porto, Portugal.,MEDIDA, Lda, Porto, Portugal
| | - J Correia da Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - E Costa
- Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.,UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | | | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - G De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - M Illario
- Division for Health Innovation, Campania Region, Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - E Menditto
- CIRFF, Federico II University, Naples, Italy
| | - R Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino, Mauriziano Hospital, Turin, Italy
| | - C Stellato
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M T Ventura
- Medical School Saint Antoine, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université, Paris, France
| | - I Annesi-Maesano
- Medical School Saint Antoine, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université, Paris, France
| | - I Bosse
- Allergist La Rochelle, La Rochelle, France
| | | | - N Pham-Thi
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - M Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - F Spertini
- Service Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - R Dubakiene
- Clinic of Chest Diseases, Immunology and Allergology, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- Department of Pathology, Faculty of Medicine and Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Institute of Clinical Medicine, Vilnius, Lithuania
| | - A Valiulis
- Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, Department of Public Health, and Institute of Health Sciences, Vilnius, Lithuania.,European Academy of Paediatrics, EAP/UEMS-SP), Brussels, Belgium
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - R Mösges
- Medical Faculty, CRI-Clinical Research International-Ltd, Institute of Medical Statistics, and Computational Biology, University of Cologne, Hamburg, Germany
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - S Shamai
- Medical Faculty, CRI-Clinical Research International-Ltd, Institute of Medical Statistics, and Computational Biology, University of Cologne, Hamburg, Germany
| | | | - P V Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - D Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - A Sheikh
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - E Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Terveystalo Allergy Clinic, Turku, Finland
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, ARADyAL Research Network, Barcelona, Spain
| | - J Mullol
- Rhinology Unit, & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - A Valero
- Pneumology and Allergy Department CIBERES and Clinical, & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Makris
- Allergy Unit "D Kalogeromitros", 2nd Dpt of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - N G Papadopoulos
- Division of Infection, & Respiratory Medicine, Royal Manchester Children's Hospital Immunity, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou," University of Athens, Athens, Greece
| | - E P Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - F Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - C Bachert
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium.,Sun Yat-sen University, International Airway Research Center, Guangzou, China.,Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - P W Hellings
- Academic Medical Center, Univ of Amsterdam, Dept of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, The Netherlands.,European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - C Bindslev-Jensen
- Odense University Hospital, Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - E Eller
- Odense University Hospital, Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - I Kull
- Thermofisher Scientific, Uppsala, Sweden
| | - E Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sach´s Children and Youth Hospital, Södersjukhuset, Sweden
| | - M Wickman
- Sachs' Children and Youth Hospital, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - G De Vries
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - M van Eerd
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - I Agache
- Peercode BV, Geldermalsen, The Netherlands
| | | | - S Bosnic-Anticevich
- Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain.,Woolcock Institute of Medical Research, University of Sydney, Woolcock Emphysema Centre, Sydney Local Health District, Glebe, NSW, Australia
| | - A A Cruz
- Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil.,WHO GARD Planning Group, Salvador, Brazil
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FLA, USA
| | - J C Ivancevich
- Clinica Santa Isabel, Servicio de Alergia e Immunologia, Buenos Aires, Argentina
| | - D E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - M Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - D Wallace
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | - S Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - A Yorgancioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - D Laune
- KYomed INNOV, Montpellier, France
| | - J Bousquet
- CHU de Montpellier, Montpellier, France. .,University Hospital, Montpellier, France. .,INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France. .,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny Le Bretonneux, France. .,Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. .,Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany.
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Hellings PW, Scadding G, Bachert C, Bjermer L, Canonica GW, Cardell LO, Carney AS, Constantinidis J, Deneyer L, Diamant Z, Durham S, Gevaert P, Harvey R, Hopkins C, Kjeldsen A, Klimek L, Lund VJ, Price D, Rimmer J, Ryan D, Roberts G, Sahlstrand-Johnson P, Salmi S, Samji M, Scadding G, Smith P, Steinsvik A, Wagenmann M, Seys S, Wahn U, Fokkens WJ. EUFOREA treatment algorithm for allergic rhinitis. Rhinology 2020; 58:618-622. [PMID: 32991658 DOI: 10.4193/rhin20.376] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P W Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium; University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium; Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, The Netherlands
| | - G Scadding
- RNENT Hospital, Huntley Street, London, UK
| | - C Bachert
- Upper Airways Research Laboratory, Dept of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Division of ENT diseases, CLINTEC, Karolinska Institute, University of Stockholm, Sweden;Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital, Guangzhou, China
| | - L Bjermer
- Dept of Respiratory Medicine and Allergology, Skane Uni- versity Hospital, Lund, Sweden
| | - G W Canonica
- Personalized Medicine Asthma and Allergy Clinic, Humanitas University and Research Hospital, Milan, Italy, and SANI-Severe Asthma Network Italy
| | - L O Cardell
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A S Carney
- Ear, Nose, and Throat (ENT) Department, Flinders Univer- sity, Bedford Park, South Australia, Australia
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L Deneyer
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Z Diamant
- Dept of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden; Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Dept Clin Pharm and Pharmacol, Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
| | - S Durham
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London; MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - P Gevaert
- Upper Airways Research Laboratory, Dept of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - R Harvey
- Rhinology and Skull Base, Applied medical research center, University of New South Wales, Sydney, Australia; Faculty of medicine and heath sciences, Macquarie University, Sydney, Australia
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - A Kjeldsen
- Department of Otorhinolaryngology Head and Neck surgery, Odense University Hospital, Denmark; University of Southern Denmark, Odense, Denmark
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany; Mainz University Allergy Center, Mainz, Germany
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - D Price
- Optimum Patient Care, Cambridge, UK; Observational and Pragmatic Research Institute, Singapore
| | - J Rimmer
- Monash Health, Monash University, Melbourne, Australia
| | - D Ryan
- Usher institute, University of Edinburgh, Edinburgh, UK
| | - G Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, United Kingdom;NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; University of Southampton, Southampton, United Kingdom
| | - P Sahlstrand-Johnson
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Skane University Hospital, Malmoo, Sweden
| | - S Salmi
- Helsinki University Hospital, Helsinki, Finland
| | - M Samji
- Imperial College London, London, UK
| | - G Scadding
- Royal Brompton and Ha- refield NHS Trust, London, UK
| | - P Smith
- Clinical Medicine, Griffith University, Southport, QLD, Australia
| | - A Steinsvik
- Department of Otorhinolaryngo- logy, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - M Wagenmann
- Department of Otorhinolaryngology, Universitatsklinikum Dusseldorf, Dusseldorf, Germany
| | - S Seys
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - U Wahn
- Klinik fur Padiatrie m.S. Pneumologie und Immunologie, Charite, Berlin, Germany
| | - W J Fokkens
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, The Netherlands
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Hennessy M, Ryan D, Clarke S, Higgins C, Logan M, O’Brien E, Morgan R. Optimal Timing of CT Scanning in the Rapid Access Lung Cancer Clinic. Ir Med J 2020; 113:121. [PMID: 32924372] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aims To investigate whether a ‘CT first’ approach to Rapid Access Lung Cancer Clinic (RALC) review could be feasible in an Irish context. Methods A retrospective review of our institution’s Lung Cancer Database was performed. All RALC first attendances from 2012-2018 were identified. Timing of CT was assessed as well as CT imaging findings. Results Total first attendances in this period were 2372, of whom 91% had CT thorax as part of their evaluation. 866 patients (37%) were diagnosed with lung cancer, all had an abnormal CT. 1290 patients (54%) underwent CT but did not have lung cancer after clinical work up. 34% of patients diagnosed with Lung Cancer had their CT scan post RALC. Time to diagnosis was longer in those who had post RALC CT (34.5 versus 21 days) Conclusion CT scanning plays a vital role in the RALC pathway. Initial delays in obtaining CT can result in delayed time to diagnosis. These findings warrant close consideration when devising future national lung cancer policy.
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Affiliation(s)
- M Hennessy
- Dept of Medical Oncology, Beaumont Hospital, Dublin
| | - D Ryan
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - S Clarke
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - C Higgins
- Cancer Data Department, Beaumont Hospital, Dublin
| | - M Logan
- Dept of Radiology, Beaumont Hospital, Dublin
| | - E O’Brien
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - R Morgan
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
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Corcoran R, Giannakis M, Allen J, Chen J, Pelka K, Chao S, Meyerhardt J, Enzinger A, Enzinger P, McCleary N, Yugelun M, Abrams T, Kanter K, Van Seventer E, Bradford W, Fetter I, Siravegna G, Tian J, Clark J, Ryan D, Hacohen N, Parikh A. SO-26 Clinical efficacy of combined BRAF, MEK, and PD-1 inhibition in BRAFV600E colorectal cancer patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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Lee MS, Ryoo BY, Hsu CH, Numata K, Stein S, Verret W, Hack SP, Spahn J, Liu B, Abdullah H, Wang Y, He AR, Lee KH, Bang YJ, Bendell J, Chao Y, Chen JS, Chung HC, Davis SL, Dev A, Gane E, George B, He AR, Hochster H, Hsu CH, Ikeda M, Lee J, Lee M, Mahipal A, Manji G, Morimoto M, Numata K, Pishvaian M, Qin S, Ryan D, Ryoo BY, Sasahira N, Stein S, Strickler J, Tebbutt N. Atezolizumab with or without bevacizumab in unresectable hepatocellular carcinoma (GO30140): an open-label, multicentre, phase 1b study. Lancet Oncol 2020. [DOI: 10.1016/s1470-2045(20)30156-x 10.1016/s1470-2045(20)30156-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Gough C, Ryan D. Non-Invasive Ventilation for Chronic Obstructive Pulmonary Disease (COPD) in Ireland: How Far Have We Really Come? Ir Med J 2020; 113:75. [PMID: 32603570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- C Gough
- Department of Respiratory Medicine, Beaumont Hospital, Dublin
| | - D Ryan
- Department of Respiratory Medicine, Beaumont Hospital, Dublin
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Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Alobid I, Terezinha Anselmo-Lima W, Bachert C, Baroody F, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Desrosiers M, Diamant Z, Douglas RG, Gevaert PH, Hafner A, Harvey RJ, Joos GF, Kalogjera L, Knill A, Kocks JH, Landis BN, Limpens J, Lebeer S, Lourenco O, Meco C, Matricardi PM, O'Mahony L, Philpott CM, Ryan D, Schlosser R, Senior B, Smith TL, Teeling T, Tomazic PV, Wang DY, Wang D, Zhang L, Agius AM, Ahlstrom-Emanuelsson C, Alabri R, Albu S, Alhabash S, Aleksic A, Aloulah M, Al-Qudah M, Alsaleh S, Baban MA, Baudoin T, Balvers T, Battaglia P, Bedoya JD, Beule A, Bofares KM, Braverman I, Brozek-Madry E, Richard B, Callejas C, Carrie S, Caulley L, Chussi D, de Corso E, Coste A, El Hadi U, Elfarouk A, Eloy PH, Farrokhi S, Felisati G, Ferrari MD, Fishchuk R, Grayson W, Goncalves PM, Grdinic B, Grgic V, Hamizan AW, Heinichen JV, Husain S, Ping TI, Ivaska J, Jakimovska F, Jovancevic L, Kakande E, Kamel R, Karpischenko S, Kariyawasam HH, Kawauchi H, Kjeldsen A, Klimek L, Krzeski A, Kopacheva Barsova G, Kim SW, Lal D, Letort JJ, Lopatin A, Mahdjoubi A, Mesbahi A, Netkovski J, Nyenbue Tshipukane D, Obando-Valverde A, Okano M, Onerci M, Ong YK, Orlandi R, Otori N, Ouennoughy K, Ozkan M, Peric A, Plzak J, Prokopakis E, Prepageran N, Psaltis A, Pugin B, Raftopulos M, Rombaux P, Riechelmann H, Sahtout S, Sarafoleanu CC, Searyoh K, Rhee CS, Shi J, Shkoukani M, Shukuryan AK, Sicak M, Smyth D, Sindvongs K, Soklic Kosak T, Stjarne P, Sutikno B, Steinsvag S, Tantilipikorn P, Thanaviratananich S, Tran T, Urbancic J, Valiulius A, Vasquez de Aparicio C, Vicheva D, Virkkula PM, Vicente G, Voegels R, Wagenmann MM, Wardani RS, Welge-Lussen A, Witterick I, Wright E, Zabolotniy D, Zsolt B, Zwetsloot CP. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020; 58:1-464. [PMID: 32077450 DOI: 10.4193/rhin20.600] [Citation(s) in RCA: 521] [Impact Index Per Article: 130.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.
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Affiliation(s)
- W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - P W Hellings
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Belgium.,Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium
| | - R Kern
- Department of Otorhinolaryngology - Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | | | - I Alobid
- Rhinology and Skull Base Unit, ENT Department, Hospital Clinic de Barcelona, Universidad de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - W Terezinha Anselmo-Lima
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, Brazil
| | - C Bachert
- Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium.,Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden
| | - F Baroody
- Department of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children's Hospital, Chicago, IL, USA
| | - C von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Hospital, Copenhagen, Denmark
| | - A Cervin
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - N Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L De Gabory
- Rhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU de Bordeaux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, France
| | - M Desrosiers
- Department of ORL-HNS, Universite de Montreal, Montreal, Canada
| | - Z Diamant
- Dept of Respiratory Medicine and Allergology, Skane University in Lund, Sweden.,Research Director Respiratory and Allergy, at QPS-Netherlands, Groningen, Netherlands.,Affiliate to Charles University, Dept of Respiratory Diseases, in Prague, Czech Republic
| | - R G Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - P H Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - A Hafner
- University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - R J Harvey
- Rhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, Australia
| | - G F Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - L Kalogjera
- ENT Department, Zagreb School of Medicine.,University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - A Knill
- Patient representative, Opuscomms, London, UK
| | - J H Kocks
- Department of Inhalation Medicine, Observational Pragmatic Research Institute, Singapore
| | - B N Landis
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, Switzerland
| | - J Limpens
- Medical Information Specialist, Medical Library, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Lebeer
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - O Lourenco
- FCS - UBI Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
| | - C Meco
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey.,Department of Otorhinolaryngology, Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - P M Matricardi
- Department of Pediatric Pneumology and Immunology, Charite - Universitatsmedizin Berlin, Berlin, Germany
| | - L O'Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | - C M Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.,ENT Department, James Paget University Hospital, Great Yarmouth, UK
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Optimum Patient Care, Cambridgeshire, UK
| | - R Schlosser
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
| | - B Senior
- UNC Otorhinolaryngology / Head and Neck Surgery, Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery and Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - T L Smith
- Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - T Teeling
- Patient representative, Task Force Healthcare, WTC Den Haag, The Netherlands
| | - P V Tomazic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - D Y Wang
- Department of Otorhinolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - D Wang
- Rhinology Division, ENT Department.,Eye and ENT Hospital, Fudan University, Shanghai, China
| | - L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China
| | - A M Agius
- Department of Medicine and Surgery in the University of Malta
| | | | - R Alabri
- ENT Division, Surgery Department, College of Medicine and Health and Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Albu
- Department of Otorhinolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - A Aleksic
- ENT Department, University Clinical Centre, University of Banja Luka, Bosnia and Herzegovina
| | - M Aloulah
- ENT Department, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Al-Qudah
- Department of Otorhinolaryngology, Jordan University of Science and Technology, Irbid, Jordan
| | - S Alsaleh
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M A Baban
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Sulaimani, Sulaimayniha, Iraq
| | - T Baudoin
- Dept. of ORL-HNS Sisters of Mercy University Medical Center, School of Medicine University of Zagreb, Croatia
| | - T Balvers
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - P Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - J D Bedoya
- Department of Otorhinolaryngology, Universidad de Antioquia, Medellin, Colombia
| | - A Beule
- Department of Otorhinolaryngology, University Clinic of Munster, Germany
| | - K M Bofares
- Department of Otorhinolaryngology, Omar Al-Moukhtar University, Albyeda, Libya
| | - I Braverman
- Department of Otorhinolaryngology - Head and Neck Surgery, Hillel Yaffe Medical Center, Israel
| | - E Brozek-Madry
- Department of Otorhinolaryngology, Medical University of Warsaw, Poland
| | - B Richard
- Department of ENT, Makerere University, Kampala, Uganda
| | - C Callejas
- Department of Otorhinolaryngology, Pontificia Catholic University, Santiago, Chile
| | - S Carrie
- Department of Otorhinolaryngology, Head and Neck Surgery, Newcastle University, United Kingdom
| | - L Caulley
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - D Chussi
- Department of Otorhinolaryngology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - E de Corso
- Department of Otorhinolaryngology , La Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - A Coste
- ORL et Chirurgie Cervico-Faciale, Universite Paris-Est Creteil (UPEC), France
| | - U El Hadi
- Department of Otorhinolaryngology, American University of Beirut, Lebanon
| | - A Elfarouk
- Department of Otorhinolaryngology, Cairo University, Egypt
| | - P H Eloy
- Department of ENT, CHU UCL Namur, Yvoir, Belgium
| | - S Farrokhi
- Department of Immunology and Allergy, The Persian Gulf Tropical Medicine Research Center.,The Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - G Felisati
- Department of Head and Neck, University of Milan, Italy
| | - M D Ferrari
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - R Fishchuk
- Department of ENT- Organs Microsurgery, Central city clinical hospital of lvano-Frankivsk city council, Ivano-Frankivsk, Ukraine
| | - W Grayson
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Alabama Birmingham, USA
| | - P M Goncalves
- ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - B Grdinic
- ENT Department, General Hospital, Pula, Pula, Croatia
| | - V Grgic
- ENT Department, Zagreb School of Medicine.,University Hospital center 'Sestre milosrdnice', Zagreb, Croatia
| | - A W Hamizan
- Department of Otorhinolaryngology, University Kebangsaan, Kuala Lumpur, Malasyia
| | - J V Heinichen
- Department of ENT of Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, Paraguay
| | - S Husain
- Department of Otorhinolaryngology, Head and Neck Surgery, National University of Malaysia, Kuala Lumpur, Malaysia
| | - T I Ping
- Department ORLHNS, University Malaysia Sarawak, Kuching, Malaysia
| | - J Ivaska
- Clinic of Ear, Nose, Throat and Eye diseases, Vilnius University, Lithuania
| | - F Jakimovska
- ENT Department of Medical Faculty, St Cyril and Methodius University of Skopje, North Macedonia
| | - L Jovancevic
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - E Kakande
- Department of ENT Surgery, Mulago National Referral Hospital Kampala, Uganda
| | - R Kamel
- Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Egypt
| | - S Karpischenko
- ENT Department, Director of Saint Petersburg Research Institute of Ear, Throat , Nose and Speech.,Professor and Chairman of First Pavlov State Medical University, Saint Petersburg, Russia
| | - H H Kariyawasam
- Department of Allergy and Clinical Immunology, Royal National ENT Hospital, London, England
| | - H Kawauchi
- 96. Department of Otorhinolaryngology, Shimane University, Matsue, Shimane, Japan
| | - A Kjeldsen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Southern Denmark, Odense, Denmark
| | - L Klimek
- Center of Rhinology and Allergology, Wiesbaden, Hesse, Germany
| | - A Krzeski
- Department of Otorhinolaryngology, Warsaw Medical University, Warsaw, Poland
| | - G Kopacheva Barsova
- Department of Otorhinolaryngology, University If Medicine, st. Ciril and Methodius, Skopje
| | - S W Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, Kyung Hee University, Seoul, South Korea
| | - D Lal
- Department of Otorhinolaryngology, Head and Neck Surgery, Mayo Clinic in Arizona, Phoenix, Arizona, USA
| | - J J Letort
- Department of Otorhinolaryngology, Pontifica Catholic University of Ecuador, Quito, Ecuador
| | - A Lopatin
- Department of Otorhinolaryngology, Policlinic No.1- Senior ENT Consultant and Surgeon.,President of Russian Rhinologic Society, Moscow, Russia
| | | | - A Mesbahi
- Department of Facial Surgery, Khodadoust Hospital, Ordibehesht Hospital, Shiraz, Iran
| | - J Netkovski
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Cyril and Methodius, Skopje, Republic of North Macedonia
| | - D Nyenbue Tshipukane
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - A Obando-Valverde
- Department of Otorhinolaryngology and Surgery, Hospital Mexico, University of Costa Rica, San Jose, Costa Rica
| | - M Okano
- Department of Otorhinolaryngology, International University of Health and Welfare, Narita , Japan
| | - M Onerci
- Department of Otorhinolaryngology, Hacettepe, Ankara, Turkey
| | - Y K Ong
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Singapore, National University Hospital, Singapore
| | - R Orlandi
- Department of Otorhinolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - N Otori
- Department of Otorhinolaryngology at The Jikei University School of Medicine,Tokyo, Japan
| | - K Ouennoughy
- Department of Otorhinolaryngology-Head and Neck Surgery, Saad Dahleb Blida 1, Blida, Algeria
| | - M Ozkan
- Department of Otorhinolaryngology, University of Health Sciences, Ankara City Hospital, Turkey
| | - A Peric
- Department of Otorhinolaryngology, Military Medical Academy, Faculty of Medicine, University of Defense, Belgrade, Serbia
| | - J Plzak
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - N Prepageran
- Department of ENT, University Malaya, Kuala Lumpur, Malaysia
| | - A Psaltis
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - B Pugin
- Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - M Raftopulos
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Royal Australian College of Surgeons, Trainee Representative (Australia)
| | - P Rombaux
- Department of Otorhinolaryngology, University of Louvain, Brussels, Belgium
| | - H Riechelmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ulm, Baden-Wurttemberg, Germany
| | - S Sahtout
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - C-C Sarafoleanu
- ENT and H NS Department, Santa Maria Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K Searyoh
- Surgery Ear, Nose and Throat Unit, School of Medicine and Dentistry, University of Ghana, Korle-Bu Teaching Hospital, Accra, Ghana
| | - C-S Rhee
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul, Seoul National University, Seoul, Korea
| | - J Shi
- Department of Rhinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - M Shkoukani
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - A K Shukuryan
- Department of Otorhinolaryngology, Yerevan State Medical University, Yerevan, Armenia
| | - M Sicak
- Department of Otorhinolaryngology, Head and Neck Surgery, Central Military Hospital, Slovakia, Slovak Health University Bratislava and Catholic University, Ruzom berok, Slovakia
| | - D Smyth
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal College of Surgeons in Ireland and University College Cork, Waterford, Ireland
| | - K Sindvongs
- Department of Otorhinolaryngology, Chulalongkorn University, Bangkok, Thailand
| | - T Soklic Kosak
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - P Stjarne
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - B Sutikno
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Airlangga, Surabaya, Indonesia
| | - S Steinsvag
- Department of ORL, University of Bergen, Norway
| | - P Tantilipikorn
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Thanaviratananich
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - T Tran
- Department of ENT Hospital of Ho Chi Minh city, Faculty of medicine of Ho Chi Minh city Vietnam National University, Vietnam
| | - J Urbancic
- Department of Otorhinolaryngology and cervicofacial surgery, UMC Ljubljana, University of Ljubljana, Medical Faculty, Ljubljana, Slovenia
| | - A Valiulius
- Department of Children's diseases, Vilnius University Medical Faculty, Institute of Clinical Medicine, Vilnius, Lithuania
| | - C Vasquez de Aparicio
- Department of Paediatric Surgery, National Hospital Benjamin Bloom, National University of El Salvador, San Salvador, El Salvador
| | - D Vicheva
- Department of Otorhinolaryngology, Medical University Plovdiv, Bulgaria
| | - P M Virkkula
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki, University Hospital, Helsinki, Finland
| | - G Vicente
- Department of Otolaryngology, St. Luke's Medical Centre, Quezon City, The Philippines
| | - R Voegels
- Department of Otorhinolaryngology, University of Sao Paulo, Sau Paulo, Brazil
| | - M M Wagenmann
- Department of Otorhinolaryngology, Dusseldorf University Hospital, Dusseldorf, German
| | - R S Wardani
- Department of Otorhinolaryngology Head and Neck Surgery, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - A Welge-Lussen
- Department of Otorhinolaryngology, University Hospital Basel, University Basel, Switzerland
| | - I Witterick
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - E Wright
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - D Zabolotniy
- State Institution of O.S. Kolomiychenko Institute of Othorhnilarungology of National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | - B Zsolt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
| | - C P Zwetsloot
- Department of Neurology, Dijklander Ziekenhuis, Purmerend, The Netherlandsn
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Mauri G, Kanter K, Fish M, Horick N, Allen J, Blaszkowsky L, Clark J, Ryan D, Nipp R, Giantonio B, Goyal L, Dubois J, Murphy J, Roeland E, Weekes C, Wo J, Hong T, Zhu A, Van Seventer E, Corcoran R, Parikh A. PARP-ness in metastatic colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Parikh A, Kanter K, Mojtahed A, Schneider J, Van Seventer E, Fish M, Allen J, Blaszkowsky L, Wo J, Clark J, Giantonio B, Goyal L, Hong T, Nipp R, Roeland E, Weekes C, Zhu A, Ryan D, Fetter I, Horick N, Corcoran R. Serial circulating tumor DNA (ctDNA) monitoring to predict response to treatment in metastatic gastrointestinal cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Parikh A, Clark J, Wo J, Yeap B, Allen J, Blaszkowsky L, Ryan D, Giantonio B, Weekes C, Zhu A, Van Seventer E, Ly L, Matlack L, Foreman B, Drapek L, Ting D, Corcoran R, Hong T. Proof of concept of the abscopal effect in MSS GI cancers: A phase 2 study of ipilimumab and nivolumab with radiation in metastatic pancreatic and colorectal adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fokkens W, Desrosiers M, Harvey R, Hopkins C, Mullol J, Philpott C, Alobid I, Anselmo-Lima W, Bachert C, Baroody F, Bernal-Sprekelsen M, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Douglas R, Gevaert P, Hafner A, Hellings P, Joos G, Kalogjera L, Kern R, Knill A, Kocks J, Landis B, Limpens J, Lebeer S, Lourenco O, Matricardi P, Meco C, O'Mahony L, Reitsma S, Ryan D, Schlosser R, Senior B, Teeling T, Tomazic P, Toppila-Salmi S, Wang D, Wang D, Zhang L, Lund V. EPOS2020: development strategy and goals for the latest European Position Paper on Rhinosinusitis. Rhinology 2019; 57:162-168. [DOI: 10.4193/rhin19.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bousquet J, Bedbrook A, Czarlewski W, Onorato GL, Arnavielhe S, Laune D, Mathieu-Dupas E, Fonseca J, Costa E, Lourenço O, Morais-Almeida M, Todo-Bom A, Illario M, Menditto E, Canonica GW, Cecchi L, Monti R, Napoli L, Ventura MT, De Feo G, Fokkens WJ, Chavannes NH, Reitsma S, Cruz AA, da Silva J, Serpa FS, Larenas-Linnemann D, Fuentes Perez JM, Huerta-Villalobos YR, Rivero-Yeverino D, Rodriguez-Zagal E, Valiulis A, Dubakiene R, Emuzyte R, Kvedariene V, Annesi-Maesano I, Blain H, Bonniaud P, Bosse I, Dauvilliers Y, Devillier P, Fontaine JF, Pépin JL, Pham-Thi N, Portejoie F, Picard R, Roche N, Rolland C, Schmidt-Grendelmeier P, Kuna P, Samolinski B, Anto JM, Cardona V, Mullol J, Pinnock H, Ryan D, Sheikh A, Walker S, Williams S, Becker S, Klimek L, Pfaar O, Bergmann KC, Mösges R, Zuberbier T, Roller-Wirnsberger RE, Tomazic PV, Haahtela T, Salimäki J, Toppila-Salmi S, Valovirta E, Vasankari T, Gemicioğlu B, Yorgancioglu A, Papadopoulos NG, Prokopakis EP, Tsiligianni IG, Bosnic-Anticevich S, O'Hehir R, Ivancevich JC, Neffen H, Zernotti ME, Kull I, Melén E, Wickman M, Bachert C, Hellings PW, Brusselle G, Palkonen S, Bindslev-Jensen C, Eller E, Waserman S, Boulet LP, Bouchard J, Chu DK, Schünemann HJ, Sova M, De Vries G, van Eerd M, Agache I, Ansotegui IJ, Bewick M, Casale T, Dykewick M, Ebisawa M, Murray R, Naclerio R, Okamoto Y, Wallace DV. Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma. Clin Transl Allergy 2019; 9:16. [PMID: 30911372 PMCID: PMC6413444 DOI: 10.1186/s13601-019-0252-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/04/2019] [Indexed: 01/02/2023] Open
Abstract
Aims Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases. Methods MASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients. Stakeholders Include patients, health care professionals (pharmacists and physicians), authorities, patient’s associations, private and public sectors. Results MASK is deployed in 23 countries and 17 languages. 26,000 users have registered. EU grants (2018) MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour). Lessons learnt (i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.
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Affiliation(s)
- J Bousquet
- 1MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny Le Bretonneux, France.,Euforea, Brussels, Belgium.,4Humboldt-Universität zu Berlin, Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - A Bedbrook
- 1MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France
| | - G L Onorato
- 1MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | | | - D Laune
- KYomed INNOV, Montpellier, France
| | | | - J Fonseca
- Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, Medida, Lda Porto, Portugal
| | - E Costa
- 8UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto (Porto4Ageing), Porto, Portugal
| | - O Lourenço
- 9Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - A Todo-Bom
- 11Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - E Menditto
- 13CIRFF, Federico II University, Naples, Italy
| | - G W Canonica
- 14Personalized Medicine Clinic Asthma and Allergy, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - R Monti
- 16Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Turin, Italy
| | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - M T Ventura
- 18Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - G De Feo
- 19Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centre (AMC), Amsterdam, The Netherlands
| | - N H Chavannes
- 21Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centre (AMC), Amsterdam, The Netherlands
| | - A A Cruz
- 22ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória da Conquista, Brazil
| | - J da Silva
- WHO GARD Planning Group, Salvador, Brazil
| | - F S Serpa
- 24Department of Internal Medicine and Allergic Clinic of Professor Polydoro Ernani de Sao, Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.,25Asthma Reference Center, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitória, Esperito Santo Brazil
| | - D Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, Mexico City, Mexico
| | - J M Fuentes Perez
- 27Hospital General Regional 1 "Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico
| | - Y R Huerta-Villalobos
- 27Hospital General Regional 1 "Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico
| | | | | | - A Valiulis
- 29Clinic of Children's Diseases, and Institute of Health Sciences Department of Public Health, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - R Dubakiene
- 31Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - R Emuzyte
- 32Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- 33Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - I Annesi-Maesano
- 34Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université, Medical School Saint Antoine, Paris, France
| | - H Blain
- 35Department of Geriatrics, Montpellier University Hospital, Montpellier, France.,36EA 2991, Euromov, University Montpellier, Montpellier, France
| | | | - I Bosse
- Allergist, La Rochelle, France
| | - Y Dauvilliers
- 39Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France.,Inserm U1061, Montpellier, France
| | - P Devillier
- 41UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - J L Pépin
- 43Laboratoire HP2, Grenoble, INSERM, U1042, Université Grenoble Alpes, Grenoble, France.,44CHU de Grenoble, Grenoble, France
| | - N Pham-Thi
- 45Allergy Department, Pasteur Institute, Paris, France
| | - F Portejoie
- 1MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - R Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - N Roche
- 47Pneumologie et Soins Intensifs Respiratoires, Hôpitaux Universitaires Paris, Centre Hôpital Cochin, Paris, France
| | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - P Schmidt-Grendelmeier
- 49Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - P Kuna
- 50Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- 51Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - J M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,53IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,54CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,55Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Cardona
- 56Allergy Section, Department of Internal Medicine, Hospital Vall 'dHebron & ARADyAL Research Network, Barcelona, Spain
| | - J Mullol
- 57Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,58Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - H Pinnock
- 59Asthma UK Centre for Applied Research, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - D Ryan
- 60Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, UK
| | - A Sheikh
- 61The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - S Walker
- 62Asthma UK, Mansell Street, London, UK
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland, UK
| | - S Becker
- 64Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - O Pfaar
- 66Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Marburg, Germany
| | - K C Bergmann
- 67Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | - R Mösges
- 69Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - T Zuberbier
- 67Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | - P V Tomazic
- 72Department of ENT, Medical University of Graz, Graz, Austria
| | - T Haahtela
- 73Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - J Salimäki
- Association of Finnish Pharmacies, Helsinki, Finland
| | - S Toppila-Salmi
- 73Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - E Valovirta
- 75Department of Lung Diseases and Clinical Immunology, Terveystalo Allergy Clinic, University of Turku, Turku, Finland
| | - T Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - B Gemicioğlu
- 77Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istambul, Turkey
| | - A Yorgancioglu
- 78Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - N G Papadopoulos
- 79Division of Infection, Immunity and Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,80Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - E P Prokopakis
- 81Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - I G Tsiligianni
- 61The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.,82Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - S Bosnic-Anticevich
- 83University of Sydney and Woolcock Emphysema Centre and Local Health District, Woolcock Institute of Medical Research, Glebe, NSW Australia
| | - R O'Hehir
- 84Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia.,85Department of Immunology, Monash University, Melbourne, VIC Australia
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - H Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina Center for Allergy and Immunology, Santa Fe, Argentina
| | - M E Zernotti
- 88Universidad Católica de Córdoba, Córdoba, Argentina
| | - I Kull
- 89Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,90Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melén
- 90Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- 91Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - C Bachert
- 92Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium
| | - P W Hellings
- Euforea, Brussels, Belgium.,93Department of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium.,94Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands
| | - G Brusselle
- 95Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - S Palkonen
- 96EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - S Waserman
- 98Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - L P Boulet
- 99Quebec Heart and Lung Institute, Laval University, Québec City, QC Canada
| | - J Bouchard
- Clinical Medecine, Laval's University, Quebec City, Canada
| | - D K Chu
- Medecine Department, Hôpital de la Malbaie, Quebec, Canada
| | - H J Schünemann
- Medecine Department, Hôpital de la Malbaie, Quebec, Canada
| | - M Sova
- 102Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - G De Vries
- 103Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Peercode BV, Geldermalsen, The Netherlands
| | - M van Eerd
- 103Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Peercode BV, Geldermalsen, The Netherlands
| | - I Agache
- 105Faculty of Medicine, Transylvania University, Brasov, Romania
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - T Casale
- 108Division of Allergy/Immunology, University of South Florida, Tampa, USA
| | - M Dykewick
- 109Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - M Ebisawa
- 110Clinical Reserch Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - R Murray
- Medical Communications Consultant, MedScript Ltd (Ireland & New Zealand), Dundalk, Ireland.,Honorary Research Fellow, OPC, Cambridge, UK
| | - R Naclerio
- 113Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Y Okamoto
- 114Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - D V Wallace
- 115Nova Southeastern University, Fort Lauderdale, FL USA
| | | |
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43
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Bousquet J, Arnavielhe S, Bedbrook A, Bewick M, Laune D, Mathieu-Dupas E, Murray R, Onorato GL, Pépin JL, Picard R, Portejoie F, Costa E, Fonseca J, Lourenço O, Morais-Almeida M, Todo-Bom A, Cruz AA, da Silva J, Serpa FS, Illario M, Menditto E, Cecchi L, Monti R, Napoli L, Ventura MT, De Feo G, Larenas-Linnemann D, Fuentes Perez M, Huerta Villabolos YR, Rivero-Yeverino D, Rodriguez-Zagal E, Amat F, Annesi-Maesano I, Bosse I, Demoly P, Devillier P, Fontaine JF, Just J, Kuna TP, Samolinski B, Valiulis A, Emuzyte R, Kvedariene V, Ryan D, Sheikh A, Schmidt-Grendelmeier P, Klimek L, Pfaar O, Bergmann KC, Mösges R, Zuberbier T, Roller-Wirnsberger RE, Tomazic P, Fokkens WJ, Chavannes NH, Reitsma S, Anto JM, Cardona V, Dedeu T, Mullol J, Haahtela T, Salimäki J, Toppila-Salmi S, Valovirta E, Gemicioğlu B, Yorgancioglu A, Papadopoulos N, Prokopakis EP, Bosnic-Anticevich S, O'Hehir R, Ivancevich JC, Neffen H, Zernotti E, Kull I, Melen E, Wickman M, Bachert C, Hellings P, Palkonen S, Bindslev-Jensen C, Eller E, Waserman S, Sova M, De Vries G, van Eerd M, Agache I, Casale T, Dykewickz M, Naclerio RN, Okamoto Y, Wallace DV. MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence. Clin Transl Allergy 2018; 8:45. [PMID: 30386555 PMCID: PMC6201545 DOI: 10.1186/s13601-018-0227-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/07/2018] [Indexed: 12/11/2022] Open
Abstract
mHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly affect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients largely use over-the-counter medications dispensed in pharmacies. Shared decision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), the Phase 3 ARIA initiative, is based on the freely available MASK app (the Allergy Diary, Android and iOS platforms). MASK is available in 16 languages and deployed in 23 countries. The present paper provides an overview of the methods used in MASK and the key results obtained to date. These include a novel phenotypic characterization of the patients, confirmation of the impact of allergic rhinitis on work productivity and treatment patterns in real life. Most patients appear to self-medicate, are often non-adherent and do not follow guidelines. Moreover, the Allergy Diary is able to distinguish between AR medications. The potential usefulness of MASK will be further explored by POLLAR (Impact of Air Pollution on Asthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium
| | | | - A Bedbrook
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - D Laune
- KYomed-INNOV, Montpellier, France
| | | | - R Murray
- MedScript Ltd, Dundalk, Co Louth Ireland
| | - G L Onorato
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - J L Pépin
- 7Laboratoire HP2, Grenoble, INSERM, U1042, Université Grenoble Alpes, Grenoble, France.,8CHU de Grenoble, Grenoble, France
| | - R Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - F Portejoie
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - E Costa
- 10UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto (Porto4Ageing), Porto, Portugal
| | - J Fonseca
- 11Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Medida, Lda, Porto, Portugal
| | - O Lourenço
- 13Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - A Todo-Bom
- 15Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A A Cruz
- 16ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória da Conquista, Brazil.,WHO GARD Planning Group, Salvador, Brazil
| | - J da Silva
- 18Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - F S Serpa
- 19Asthma Reference Center, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitória, Esperito Santo Brazil
| | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - E Menditto
- 21CIRFF, Federico II University, Naples, Italy
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - R Monti
- 23Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - M T Ventura
- 25Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - G De Feo
- 26Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - D Larenas-Linnemann
- 27Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico
| | | | | | | | | | - F Amat
- 31Allergology Department, Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP), Paris, France.,32UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, Equipe EPAR, 75013 Paris, France
| | - I Annesi-Maesano
- 33Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France
| | | | - P Demoly
- 35Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P Devillier
- 36UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - J Just
- 31Allergology Department, Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP), Paris, France.,32UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, Equipe EPAR, 75013 Paris, France
| | - T P Kuna
- 38Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- 39Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - A Valiulis
- 40Clinic of Children's Diseases, and Institute of Health Sciences Department of Public Health, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - R Emuzyte
- 42Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- 43Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK.,45Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School, Edinburgh, UK
| | - A Sheikh
- 46Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - P Schmidt-Grendelmeier
- 47Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany.,49Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,49Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - K C Bergmann
- 50Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | - R Mösges
- 52Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - T Zuberbier
- 50Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | | | - P Tomazic
- 55Department of ENT, Medical University of Graz, Graz, Austria
| | - W J Fokkens
- 56Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - N H Chavannes
- 57Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - S Reitsma
- 56Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,59IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,60CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,61Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Cardona
- 62Allergy Section, Department of Internal Medicine, Hospital Vall 'dHebron & ARADyAL Research Network, Barcelona, Spain
| | - T Dedeu
- 63AQuAS, Barcelona, Spain.,EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - J Mullol
- 65Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,66Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - T Haahtela
- 67Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J Salimäki
- Association of Finnish Pharmacists, Helsinki, Finland
| | - S Toppila-Salmi
- 67Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - E Valovirta
- 69Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.,Terveystalo Allergy Clinic, Turku, Finland
| | - B Gemicioğlu
- 71Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - A Yorgancioglu
- 72Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.,GARD Executive Committee, Manisa, Turkey
| | - N Papadopoulos
- 74Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,75Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, 11527 Athens, Greece
| | - E P Prokopakis
- 76Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - R O'Hehir
- 78Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia.,79Department of Immunology, Monash University, Melbourne, VIC Australia
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - H Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina Center for Allergy and Immunology, Santa Fe, Argentina
| | - E Zernotti
- 82Universidad Católica de Córdoba, Córdoba, Argentina
| | - I Kull
- 83Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - E Melen
- 84Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,85Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- 86Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - C Bachert
- 87Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - P Hellings
- Euforea, Brussels, Belgium.,88Department of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium.,89Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Palkonen
- 90EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - S Waserman
- 92Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - M Sova
- 93University Hospital Olomouc, Olomouc, Czech Republic
| | - G De Vries
- Peercode BV, Geldermalsen, The Netherlands
| | - M van Eerd
- Peercode BV, Geldermalsen, The Netherlands
| | - I Agache
- 95Faculty of Medicine, Transylvania University, Brasov, Romania
| | - T Casale
- 96Division of Allergy/Immunology, University of South Florida, Tampa, USA
| | - M Dykewickz
- 97Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - R N Naclerio
- 98Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Y Okamoto
- 99Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - D V Wallace
- 100Nova Southeastern University, Fort Lauderdale, Florida USA
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Seys SF, Bousquet J, Bachert C, Fokkens WJ, Agache I, Bernal-Sprekelsen M, Callebaut I, Cardel LO, Carrie S, Castelnuovo P, Cathcart R, Constantinidis J, Cools L, Cornet M, Clement G, de Sousa JC, Cox T, Doulaptsi M, Gevaert P, Hopkins C, Hox V, Hummel T, Hosemann W, Jacobs R, Jorissen M, Landis BN, Leunig A, Lund VJ, Mullol J, Onerci M, Palkonen S, Proano I, Prokopakis E, Ryan D, Riechelmann H, Saevels J, Segboer C, Speleman K, Steinsvik EA, Surda P, Tomazic PV, Vanderveken O, Van Gerven L, Van Zele T, Verhaeghe B, Vierstraete K, Vlaminck S, Wilkinson J, Williams S, Pugin B, Hellings PW. mySinusitisCoach: patient empowerment in chronic rhinosinusitis using mobile technology. Rhinology 2018; 56:209-215. [PMID: 29466477 DOI: 10.4193/rhin17.253] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mobile health technology is emerging to take a prominent position in the management of chronic diseases. These technologies aim at enhancing patient empowerment via education and self-management. To date, of all the different apps available for patients with sinus disease, none were developed by medical experts dealing with chronic rhinosinusitis (CRS). The European Forum for Research and Education in Allergy and Airway diseases (EUFOREA) has undertaken a multi-stakeholder approach for designing, developing and implementing a tool to support CRS patients in monitoring their symptoms and to provide patients with a digital support platform containing reliable medical information about their disease and treatment options. mySinusitisCoach has been developed by medical experts dealing with CRS in close collaboration with patients, primary care physicians and community pharmacists, meeting the needs of both patients and health care providers. From a research perspective, the generation of real life data will help to validate clinical studies, patient stratification and improve understanding of the socio-economic impact of CRS, thereby paving the way for better treatment strategies.
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Affiliation(s)
- S F Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - J Bousquet
- Department of Respiratory Disease, University Hospital Arnaud de Villeneuve, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - M Bernal-Sprekelsen
- Department of Otorhinolaryngology, Hospital Clinic Universitari, Barcelona, Spain
| | - I Callebaut
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - L O Cardel
- Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - S Carrie
- ENT Department, Freeman Hospital, Newcastle upon Tyne, UK
| | - P Castelnuovo
- ENT Department, Ospedale Di Circolo E Fondazione Macchi, Varese, Italy
| | - R Cathcart
- ENT Department, Cumberland Infirmary, Carlisle, Cumbria, UK
| | - J Constantinidis
- 2nd Academic ENT department, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - L Cools
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - M Cornet
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - G Clement
- ENT Department, AZ Damiaan, Oostende, Belgium
| | - J C de Sousa
- Community Health, Life and Health Sciences Research Institute, School of Health Sciences, Univerity of Minho, Portugal
| | - T Cox
- ENT Department, Jessa hospital, Hasselt, Belgium
| | - M Doulaptsi
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - P Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - C Hopkins
- ENT Department, Guys and St Thomas NHS Foundation Trust, London, United Kingdom
| | - V Hox
- Departement dOtorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - T Hummel
- Smell and Taste Clinic, ENT Department, Technische Universitat Dresden, Dresden, Germany
| | - W Hosemann
- ENT Department, University of Greifswald, Germany
| | - R Jacobs
- Department of Otorhinolaryngology, Head and Neck Surgery, General Hospital Sint-Blasius, Dendermonde, Belgium
| | - M Jorissen
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - B N Landis
- Unite de Rhinologie-Olfactologie, Service dOto-Rhino-Laryngologie et de Chirurgie cervico-faciale, Hopitaux Universitaires de Geneve, Geneve, Suisse
| | - A Leunig
- ENT Department, Ludwig Maximilians University Munich, Germany
| | - V J Lund
- UCL and Honorary Consultant ENT Surgeon, UCLH, UK
| | - J Mullol
- IDIBAPS, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - M Onerci
- ENT Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
| | - I Proano
- European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
| | - E Prokopakis
- ENT Department, Jessa hospital, Hasselt, Belgium
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - H Riechelmann
- Universitatsklinik fur Hals- Nasen- Ohrenheilkunde Innsbruck, Austria
| | - J Saevels
- Association of Pharmacists in Belgium, Brussels, Belgium
| | - C Segboer
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Speleman
- ENT Department, AZ Sint-Jan, Bruges, Belgium
| | - E A Steinsvik
- Department of Otorhinolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - P Surda
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - P V Tomazic
- Department of General ORL, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - O Vanderveken
- ENT Department, University Hospital of Antwerp, Wilrijk, Belgium
| | - L Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - T Van Zele
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - B Verhaeghe
- ENT Department, Sint-Jozefskliniek, Izegem, Belgium
| | | | - S Vlaminck
- ENT Department, AZ Sint-Jan, Bruges, Belgium
| | - J Wilkinson
- Pharmaceutical Group of the European Union, Brussels, Belgium
| | - S Williams
- International Primary Care Respiratory Group, Aberdeen, UK
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - P W Hellings
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
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McHale C, Fitzhenry D, Coughlan T, Ryan D, O’Neill D, Collins R, McElwaine P, Sheridan L, Tobin F, McMahon A, Kennelly S. 276Early Features of Cognitive Decline - What Precipitates Referral for Memory Assessment? Age Ageing 2018. [DOI: 10.1093/ageing/afy140.199] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- C McHale
- Tallaght Hospital, Dublin, Ireland
| | | | - T Coughlan
- Tallaght Hospital, Dublin, Ireland
- Trinity College, Dublin, Ireland
| | - D Ryan
- Tallaght Hospital, Dublin, Ireland
- Trinity College, Dublin, Ireland
| | - D O’Neill
- Trinity College, Dublin, Ireland
- Tallaght Hospital, Dublin, Ireland
| | - R Collins
- Tallaght Hospital, Dublin, Ireland
- Trinity College, Dublin, Ireland
| | - P McElwaine
- Tallaght Hospital, Dublin, Ireland
- Trinity College, Dublin, Ireland
| | | | - F Tobin
- Tallaght Hospital, Dublin, Ireland
| | - A McMahon
- Integrated Care Team, Dublin, Ireland
| | - S Kennelly
- Tallaght Hospital, Dublin, Ireland
- Trinity College, Dublin, Ireland
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Bousquet J, Devillier P, Arnavielhe S, Bedbrook A, Alexis-Alexandre G, van Eerd M, Murray R, Canonica GW, Illario M, Menditto E, Passalacqua G, Stellato C, Triggiani M, Carreiro-Martins P, Fonseca J, Morais Almeida M, Nogueira-Silva L, Pereira AM, Todo Bom A, Bosse I, Caimmi D, Demoly P, Fontaine JF, Just J, Onorato GL, Kowalski ML, Kuna P, Samolinski B, Anto JM, Mullol J, Valero A, Tomazic PV, Bergmann KC, Keil T, Klimek L, Mösges R, Shamai S, Zuberbier T, Murphy E, McDowall P, Price D, Ryan D, Sheikh A, Chavannes NH, Fokkens WJ, Kvedariene V, Valiulis A, Bachert C, Hellings PW, Kull I, Melen E, Wickman M, Bindslev-Jensen C, Eller E, Haahtela T, Papadopoulos NG, Annesi-Maesano I, Bewick M, Bosnic-Anticevich S, Cruz AA, De Vries G, Gemicioglu B, Larenas-Linnemann D, Laune D, Mathieu-Dupas E, O'Hehir RE, Pfaar O, Portejoie F, Siroux V, Spranger O, Valovirta E, VandenPlas O, Yorgancioglu A. Treatment of allergic rhinitis using mobile technology with real-world data: The MASK observational pilot study. Allergy 2018; 73:1763-1774. [PMID: 29336067 DOI: 10.1111/all.13406] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Large observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect "real-world" everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real-life treatment of allergic rhinitis (AR) using mobile technology. METHODS A mobile phone app (Allergy Diary, freely available in Google Play and Apple App stores) collects the data of daily visual analog scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular, and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries. RESULTS A total of 2871 users filled in 17 091 days of VAS in 2015 and 2016. Medications were reported for 9634 days. The assessment of days appeared to be more informative than the course of the treatment as, in real life, patients do not necessarily use treatment on a daily basis; rather, they appear to increase treatment use with the loss of symptom control. The Allergy Diary allowed differentiation between treatments within or between classes (intranasal corticosteroid use containing medications and oral H1-antihistamines). The control of days differed between no [best control], single, or multiple treatments (worst control). CONCLUSIONS This study confirms the usefulness of the Allergy Diary in accessing and assessing everyday use and practice in AR. This pilot observational study uses a very simple assessment (VAS) on a mobile phone, shows novel findings, and generates new hypotheses.
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Affiliation(s)
- J. Bousquet
- Contre les MAladies Chroniques Pour un VIeillissement Actif en France; European Innovation Partnership on Active and Healthy Ageing Reference Site; MACVIA-France; Montpellier France
- INSERM U 1168; VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches; Université Versailles St-Quentin-en-Yvelines, UMR-S168; Villejuif, Montigny le Bretonneux France
- Euforea; Brussels Belgium
| | - P. Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220; Pôle des Maladies Respiratoires; Hôpital Foch; Suresnes - Université Versailles Saint-Quentin; Versailles France
| | | | - A. Bedbrook
- Contre les MAladies Chroniques Pour un VIeillissement Actif en France; European Innovation Partnership on Active and Healthy Ageing Reference Site; MACVIA-France; Montpellier France
| | | | | | - R. Murray
- Medical Communications Consultant; MedScript Ltd; Dundalk Ireland
| | - G. W. Canonica
- Allergy and Respiratory Diseases; Department of Internal Medicine; IRCCS San Martino-IST-University of Genoa; Genoa Italy
| | - M. Illario
- Division for Health Innovation; Campania Region and Federico II University Hospital Naples (R&D and DISMET); Naples Italy
| | - E. Menditto
- Center of Pharmacoeconomics; CIRFF; University of Naples Federico II; Naples Italy
| | - G. Passalacqua
- Allergy and Respiratory Diseases; Department of Internal Medicine; IRCCS San Martino-IST-University of Genoa; Genoa Italy
| | - C. Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”; University of Salerno; Salerno Italy
| | - M. Triggiani
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”; University of Salerno; Salerno Italy
| | - P. Carreiro-Martins
- Servicio de Imunoalergologia; EPE - Nova Medical School; Respiratory Research Group; CEDOC; Centro Hospitalar de Lisboa Central; Lisbon Portugal
| | - J. Fonseca
- Faculdade de Medicina; Center for Health Technology and Services Research-CINTESIS; Universidade do Porto; Porto Portugal
- Allergy Unit; CUF Porto Instituto & Hospital; Porto Portugal
| | - M. Morais Almeida
- Rhinology Unit & Smell Clinic; ENT Department; Hospital Clinic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES; University of Barcelona; Barcelona Spain
| | - L. Nogueira-Silva
- Department of Internal Medicine; Center for Health Technology and Services Research-CINTESIS; Centro Hospitalar Sao Joao; Porto Portugal
| | - A. M. Pereira
- Allergy Unit; CUF Porto Instituto & Hospital; Porto Portugal
- Immunoallergy Department; CUF-Descobertas Hospital; Lisbon Portugal
- Health Information and Decision Sciences Department; Faculty of Medicine of the University of Porto; Porto Portugal
| | - A. Todo Bom
- Imunoalergologia; Centro Hospitalar Universitario de Coimbra; Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | | | - D. Caimmi
- CHU de Montpellier; UPMC, Paris 06; UMR-S 1136, IPLESP, Equipe EPAR; Sorbonne Universités; Paris France
| | - P. Demoly
- CHU de Montpellier; UPMC, Paris 06; UMR-S 1136, IPLESP, Equipe EPAR; Sorbonne Universités; Paris France
| | | | - J. Just
- Allergology Department; Centre de l'Asthme et des Allergies; Hôpital d'Enfants Armand-Trousseau - INSERM; UMRS 1136, UPMC Univ Paris 06 - Institut Pierre Louis d'Epidémiologie et de Santé Publique; Equipe EPAR; Sorbonne Universités; Paris France
| | - G. L. Onorato
- Contre les MAladies Chroniques Pour un VIeillissement Actif en France; European Innovation Partnership on Active and Healthy Ageing Reference Site; MACVIA-France; Montpellier France
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Medical University of Lodz; Lodz Poland
- HARC; Lodz Poland
| | - P. Kuna
- Division of Internal Medicine; Asthma and Allergy; Barlicki University Hospital; Medical University of Lodz; Lodz Poland
| | - B. Samolinski
- Department of Prevention of Environmental Hazards and Allergology; Medical University of Warsaw; Warsaw Poland
| | - J. M. Anto
- ISGLoBAL; Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- IMIM (Hospital del Mar Research Institute); Barcelona Spain
- CIBER Epidemiologıa y Salud Publica (CIBERESP); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | - J. Mullol
- Rhinology Unit & Smell Clinic; ENT Department; Hospital Clinic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES; University of Barcelona; Barcelona Spain
| | - A. Valero
- Pneumology and Allergy Department Hospital Clınic; Clinical & Experimental Respiratory Immunoallergy; IDIBAPS, CIBERES; University of Barcelona; Barcelona Spain
| | - P. V. Tomazic
- Department of ENT; Medical University of Graz; Graz Austria
| | - K. C. Bergmann
- Comprehensive Allergy-Centre-Charité; Department of Dermatology and Allergy; Global Allergy and Asthma European Network (GA LEN); Charité Universitatsmedizin Berlin; Berlin Germany
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité-Universitatsmedizin; Berlin Germany
- Institute for Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - R. Mösges
- Institute of Medical Statistics and Computational Biology; Medical Faculty; University of Cologne; Cologne Germany
- CRI-Clinical Research International-Ltd; Hamburg Germany
| | - S. Shamai
- Institute of Medical Statistics and Computational Biology; Medical Faculty; University of Cologne; Cologne Germany
- CRI-Clinical Research International-Ltd; Hamburg Germany
| | - T. Zuberbier
- Comprehensive Allergy-Centre-Charité; Department of Dermatology and Allergy; Global Allergy and Asthma European Network (GA LEN); Charité Universitatsmedizin Berlin; Berlin Germany
| | - E. Murphy
- Newcastle OHS; The Newcastle upon Tyne NHS Foundation Hospitals Trust; Newcastle upon Tyne UK
| | - P. McDowall
- Newcastle OHS; The Newcastle upon Tyne NHS Foundation Hospitals Trust; Newcastle upon Tyne UK
| | - D. Price
- Observational and Pragmatic Research Institute; Singapore City Singapore
- Optimum Patient Care; Cambridge UK
- Academic Centre of Primary Care; University of Aberdeen; Aberdeen UK
| | - D. Ryan
- Allergy and Respiratory Research Group; Usher Institute of Population Health Sciences and Informatics; University of Edinburgh; Edinburgh UK
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Centre of Medical Informatics; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
| | - N. H. Chavannes
- Department of Public Health and Primary Care; Leiden University Medical Center; Leiden The Netherlands
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
| | - V. Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology; Vilnius University; Vilnius Lithuania
| | - A. Valiulis
- Vilnius University Clinic of Children's Diseases and Public Health Institute; Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP); Brussels Belgium
| | - C. Bachert
- ENT Department; Upper Airways Research Laboratory; Ghent University Hospital; Ghent Belgium
| | - P. W. Hellings
- Euforea; Brussels Belgium
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - I. Kull
- Department of Clinical Science and Education; Sodersjukhuset; Karolinska Institutet; Stockholm Sweden
| | - E. Melen
- Department of Clinical Science and Education; Sodersjukhuset; Karolinska Institutet; Stockholm Sweden
| | - M. Wickman
- Sodersjukhuset; Sachs' Children and Youth Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - E. Eller
- Department of Dermatology and Allergy Centre; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
| | - N. G. Papadopoulos
- Center for Pediatrics and Child Health; Institute of Human Development; Royal Manchester Children's Hospital; University of Manchester; Manchester UK
- Allergy Department; 2nd Pediatric Clinic; Athens General Children's Hospital “P&A Kyriakou”; University of Athens; Athens Greece
| | - I. Annesi-Maesano
- EPAR U707 INSERM; Paris France
- EPAR UMR-S UPMC; Paris VI; Paris France
| | | | - S. Bosnic-Anticevich
- Woolcock Institute of Medical Research; University of Sydney; Sydney NSW Australia
- Sydney Local Health District; Glebe NSW Australia
| | - A. A. Cruz
- ProAR-Nucleo de Excelencia em Asma; Federal University of Bahia; Salvador Brazil
- GARD Executive Committee; Salvador Brazil
| | | | - B. Gemicioglu
- Department of Pulmonary Diseases; Cerrahpasa Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - D. Larenas-Linnemann
- Center of Excellence in Asthma and Allergy; Hospital Médica Sur; Mexico City Mexico
| | | | | | - R. E. O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine; Alfred Hospital and Central Clinical School; Monash University; Melbourne Vic. Australia
- Department of Immunology; Monash University; Melbourne Vic. Australia
| | - O. Pfaar
- Center for Rhinology and Allergology; Wiesbaden Germany
- Departent of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannhein; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - F. Portejoie
- Contre les MAladies Chroniques Pour un VIeillissement Actif en France; European Innovation Partnership on Active and Healthy Ageing Reference Site; MACVIA-France; Montpellier France
| | - V. Siroux
- INSERM; Universite Grenoble Alpes; IAB; U 1209; Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health; Université Joseph Fourier; Grenoble France
| | - O. Spranger
- Global Allergy and Asthma Platform GAAPP; Vienna Austria
| | - E. Valovirta
- Department of Lung Diseases and Clinical Allergology; Terveystalo; Allergy Clinic; University of Turku; Turku Finland
| | - O. VandenPlas
- Department of Chest Medicine; Centre Hospitalier Universitaire UCL Namur; Université Catholique de Louvain; Yvoir Belgium
| | - A. Yorgancioglu
- Department of Pulmonology; Celal Bayar University; Manisa Turkey
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Skypala IJ, de Jong NW, Angier E, Gardner J, Kull I, Ryan D, Venter C, Vlieg-Boerstra BJ, Grimshaw K. Promoting and achieving excellence in the delivery of Integrated Allergy Care: the European Academy of Allergy & Clinical Immunology competencies for allied health professionals working in allergy. Clin Transl Allergy 2018; 8:31. [PMID: 30151118 PMCID: PMC6102852 DOI: 10.1186/s13601-018-0218-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/14/2018] [Indexed: 12/27/2022] Open
Abstract
The multi-disciplinary team approach is an effective model for patient care. Allied health professionals (AHPs) are an important part of such teams, bringing specific knowledge and skills related to the target patient population. The AHPs most often involved in allergy care are nurses and dietitians. Nurses are often involved in the care of patients with all types of allergy and also with asthma, whilst allergy-specialist dietitians provide vital nutritional and dietary support for the diagnosis and management of food allergy. There are many other AHPs who have a role to play in allergy care, including physiotherapists, psychologists, pharmacists and speech therapists, and their involvement is likely to develop as allergy care becomes more rooted in the community. With the development of multi-professional teams comes the requirement for disease-specific knowledge and skill sets, with all allergy team members required to have baseline knowledge and competency of the condition being managed. Whilst some competencies for AHPs practising in other disease states have been published, none are available for allergic disease against which AHPs can be benchmarked. The European Academy of Allergy & Clinical Immunology (EAACI) recognised this need, and supported the establishment of a Task Force to develop allergy-focussed competencies for AHPs. The varied skills, expertise and professional background of the Task Force members enabled the creation of a set of allergy competencies relevant to all AHPs working in allergy. It is recognised that the training and allergy expertise of AHPs, and their role within the allergy setting, will vary considerably depending on the country. However, it is important for patient care, that all AHP involved in allergy services have access to training, of a sufficiently high enough level to be aspirational and enable the continued growth and development of a wide range of allergy services, given the increasing need. The EAACI competencies will provide an important benchmark for allergy knowledge and skills against which education and training can be designed and health care professionals can subsequently be measured. However, more importantly, the EAACI AHP allergy competencies will enable the development and reach of specialist allergy services, with allergy-specialist AHPs undertaking key roles, especially in the community care setting.
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Affiliation(s)
- I J Skypala
- 1Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP UK.,2Imperial College, London, UK
| | | | - E Angier
- 4University of Southampton, Southampton, UK
| | - J Gardner
- 5Great North Children's Hospital, Newcastle, UK.,6Newcastle University, Newcastle, UK
| | - I Kull
- 7Karolinska Institutet, Stockholm, Sweden.,8Sachs Children's Hospital, Stockholm, Sweden
| | - D Ryan
- 9Usher Institute, University of Edinburgh, Edinburgh, UK
| | - C Venter
- 10Denver School of Medicine, Colorado Children's Hospital, University of Colorado, Denver, USA
| | | | - K Grimshaw
- 4University of Southampton, Southampton, UK.,12Southampton Children's Hospital, Southampton, UK
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Bousquet J, Devillier P, Anto JM, Bewick M, Haahtela T, Arnavielhe S, Bedbrook A, Murray R, van Eerd M, Fonseca JA, Morais Almeida M, Todo Bom A, Menditto E, Passalacqua G, Stellato C, Triggiani M, Ventura MT, Vezzani G, Annesi-Maesano I, Bourret R, Bosse I, Caimmi D, Cartier C, Demoly P, Just J, Portejoie F, Siroux V, Viart F, Bergmann KC, Keil T, Klimek L, Mösges R, Pfaar O, Shamai S, Zuberbier T, Mullol J, Valero A, Spranger O, Tomazic PV, Kowalski ML, Kuna P, Kupczyk M, Raciborski F, Samolinski B, Toppila-Salmi SK, Valovirta E, Cruz AA, Sarquis-Serpa F, da Silva J, Stelmach R, Larenas-Linnemann D, Rodriguez Gonzalez M, Burguete Cabañas MT, Kvedariene V, Valiulis A, Chavannes NH, Fokkens WJ, Ryan D, Sheikh A, Bachert C, Hellings PW, VandenPlas O, Ballardini N, Kull I, Melén E, Westman M, Wickman M, Bindslev-Jensen C, Eller E, Bosnic-Anticevich S, O'Hehir RE, Agache I, Bieber T, Casale T, Gemicioğlu B, Ivancevich JC, De Vries G, Sorensen M, Yorgancioglu A, Laune D. Daily allergic multimorbidity in rhinitis using mobile technology: A novel concept of the MASK study. Allergy 2018; 73:1622-1631. [PMID: 29569295 DOI: 10.1111/all.13448] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Multimorbidity in allergic airway diseases is well known, but no data exist about the daily dynamics of symptoms and their impact on work. To better understand this, we aimed to assess the presence and control of daily allergic multimorbidity (asthma, conjunctivitis, rhinitis) and its impact on work productivity using a mobile technology, the Allergy Diary. METHODS We undertook a 1-year prospective observational study in which 4 210 users and 32 585 days were monitored in 19 countries. Five visual analogue scales (VAS) assessed the daily burden of the disease (i.e., global evaluation, nose, eyes, asthma and work). Visual analogue scale levels <20/100 were categorized as "Low" burden and VAS levels ≥50/100 as "High" burden. RESULTS Visual analogue scales global measured levels assessing the global control of the allergic disease were significantly associated with allergic multimorbidity. Eight hypothesis-driven patterns were defined based on "Low" and "High" VAS levels. There were <0.2% days of Rhinitis Low and Asthma High or Conjunctivitis High patterns. There were 5.9% days with a Rhinitis High-Asthma Low pattern. There were 1.7% days with a Rhinitis High-Asthma High-Conjunctivitis Low pattern. A novel Rhinitis High-Asthma High-Conjunctivitis High pattern was identified in 2.9% days and had the greatest impact on uncontrolled VAS global measured and impaired work productivity. Work productivity was significantly correlated with VAS global measured levels. CONCLUSIONS In a novel approach examining daily symptoms with mobile technology, we found considerable intra-individual variability of allergic multimorbidity including a previously unrecognized extreme pattern of uncontrolled multimorbidity.
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Affiliation(s)
- J. Bousquet
- MACVIA-France; Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
- INSERM U 1168; VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches; Villejuif France
- UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; Montigny le Bretonneux France
- Euforea; Brussels Belgium
- Charité; Berlin Germany
| | - P. Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220; Pôle des Maladies Respiratoires; Hôpital Foch; Suresnes Université Versailles Saint-Quentin; Suresnes France
| | - J. M. Anto
- ISGloBAL; Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- IMIM (Hospital del Mar Research Institute); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
- Universitat Pompeu Fabra (UPF); Barcelona Spain
| | | | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
| | | | - A. Bedbrook
- MACVIA-France; Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
| | | | | | - J. A. Fonseca
- Faculdade de Medicina; Center for Health Technology and Services Research- CINTESIS; MEDIDA, Lda; Universidade do Porto; Porto Portugal
| | - M. Morais Almeida
- Allergy and Clinical Immunology Department; Hospital CUF-Descobertas; Lisboa Portugal
| | - A. Todo Bom
- Imunoalergologia; Faculty of Medicine; Centro Hospitalar Universitário de Coimbra; University of Coimbra; Coimbra Portugal
| | - E. Menditto
- CIRFF; Center of Pharmacoeconomics; University of Naples Federico II; Naples Italy
| | - G. Passalacqua
- Allergy and Respiratory Diseases; Ospedale Policlinico San Martino; University of Genoa; Genoa Italy
| | - C. Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”; University of Salerno; Salerno Italy
| | - M. Triggiani
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”; University of Salerno; Salerno Italy
| | - M. T. Ventura
- Unit of Geriatric Immunoallergology; University of Bari Medical School; Bari Italy
| | - G. Vezzani
- Pulmonary Unit; Department of Medical Specialties; Arcispedale SMaria Nuova/IRCCS; AUSL di Reggio Emilia; Reggio Emilia Italy
| | - I. Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases; Department Institute Pierre Louis of Epidemiology and Public Health; INSERM; Medical School Saint Antoine; UPMC Sorbonne Universités; Paris France
| | | | | | - D. Caimmi
- CHRU de Montpellier; UMR-S 1136; IPLESP; Equipe EPAR; UPMC Paris 06; Sorbonne Universités; Paris France
| | - C. Cartier
- ASA - Advanced Solutions Accelerator; Clapiers France
| | - P. Demoly
- CHRU de Montpellier; UMR-S 1136; IPLESP; Equipe EPAR; UPMC Paris 06; Sorbonne Universités; Paris France
| | - J. Just
- Allergology Department; Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP); Paris France
- UMR_S 1136; Institut Pierre Louis d'Epidémiologie et de Santé Publique; Equipe EPAR; UPMC Univ Paris 06; Sorbonne Universités; Paris France
| | - F. Portejoie
- MACVIA-France; Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
| | - V. Siroux
- INSERM; IAB, U 1209; Team of Environmental Epidemiology applied to Reproduction and Respiratory Health; Université Grenoble Alpes; Université Joseph Fourier; Grenoble France
| | - F. Viart
- ASA - Advanced Solutions Accelerator; Clapiers France
| | - K. C. Bergmann
- Department of Dermatology and Allergy; Comprehensive Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Global Allergy and Asthma European Network (GA LEN); Berlin Germany
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
- Institute for Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology, Head and Neck Surgery; Medical Faculty Mannheim; Universitätsmedizin Mannheim; Heidelberg University; Mannheim Germany
| | - R. Mösges
- CRI-Clinical Research International-Ltd; Hamburg Germany
| | - O. Pfaar
- Center for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology, Head and Neck Surgery; Medical Faculty Mannheim; Universitätsmedizin Mannheim; Heidelberg University; Mannheim Germany
| | - S. Shamai
- CRI-Clinical Research International-Ltd; Hamburg Germany
- Medical Faculty; Institute of Medical Statistics, and Computational Biology; University of Cologne; Cologne Germany
| | - T. Zuberbier
- Department of Dermatology and Allergy; Comprehensive Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Global Allergy and Asthma European Network (GA LEN); Berlin Germany
| | - J. Mullol
- Rhinology Unit & Smell Clínic; ENT Department; Hospital Clinic; University of Barcelona; Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy; IDIBAPS; CIBERES; University of Barcelona; Barcelona Spain
| | - A. Valero
- Rhinology Unit & Smell Clínic; ENT Department; Hospital Clinic; University of Barcelona; Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy; IDIBAPS; CIBERES; University of Barcelona; Barcelona Spain
| | - O. Spranger
- Global Allergy and Asthma Platform GAAPP; Vienna Austria
| | - P. V. Tomazic
- Department of ENT; Medical University of Graz; Graz Austria
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; HARC; Medical University of Lodz; Lodz Poland
| | - P. Kuna
- Division of Internal Medicine, Asthma and Allergy; Barlicki University Hospital; Medical University of Lodz; Lodz Poland
| | - M. Kupczyk
- Division of Internal Medicine, Asthma and Allergy; Barlicki University Hospital; Medical University of Lodz; Lodz Poland
| | - F. Raciborski
- Department of Prevention of Envinronmental Hazards and Allergology; Medical University of Warsaw; Warsaw Poland
| | - B. Samolinski
- Department of Prevention of Envinronmental Hazards and Allergology; Medical University of Warsaw; Warsaw Poland
| | | | - E. Valovirta
- Department of Lung Diseases and Clinical Immunology; University of Turku; Turku Finland
- Terveystalo Allergy Clinic; Turku Finland
| | - A. A. Cruz
- ProAR - Nucleo de Excelencia em Asma; Federal University of Bahia; Salvador Brasil
- GARD Executive Committee; Salvador Brazil
| | - F. Sarquis-Serpa
- Asthma Reference Center; Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria; Esperito Santo Brazil
| | - J. da Silva
- Nucleo de Alergia; Hospital Universitario Polydoro Ernani de Sao Thiago; Federal University of Santa Catarina (HU-UFSC); Florioanopolis Brazil
| | - R. Stelmach
- Pulmonary Division; Heart Institute (InCor); Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo; Sao Paulo Brazil
| | - D. Larenas-Linnemann
- Center of Excellence in Asthma and Allergy; Hospital Médica Sur; México City Mexico
| | - M. Rodriguez Gonzalez
- Pediatric Allergy and Clinical Immunology; Hospital Angeles Pedregal; Mexico City Mexico
| | | | - V. Kvedariene
- Departement of Pathology, Forensic Medicine and Pharmacology; Faculty of Medicine; Clinic of Infecious, Chest Diseases, Dermatology and Allergology; Institute of Biomedical Sciences; Vilnius University; Vilnius Lithuania
- Clinic of Infecious, Chest Diseases, Dermatology and Allergology; Institute of Clinical Medicine; Vilnius Lithuania
| | - A. Valiulis
- Department of Public Health; Clinic of Children's Diseases; Institute of Health Sciences; Vilnius University Institute of Clinical Medicine; Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP); Brussels Belgium
| | - N. H. Chavannes
- Department of Public Health and Primary Care; Leiden University Medical Center; Leiden The Netherlands
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
| | - D. Ryan
- Allergy and Respiratory Research Group; Usher Institute of Population Health Sciences and Informatics; University of Edinburgh; Edinburgh UK
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Centre of Medical Informatics; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
| | - C. Bachert
- ENT Department; Upper Airways Research Laboratory; Ghent University Hospital; Ghent Belgium
| | - P. W. Hellings
- Department of Otorhinolaryngology; University Hospitals Leuven; Leuven Belgium
- Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- Euforea; Brussels Belgium
| | - O. VandenPlas
- Department of Chest Medicine; Centre Hospitalier Universitaire UCL Namur; Université Catholique de Louvain; Yvoir Belgium
| | - N. Ballardini
- Centre for Clinical Research Sörmland; Uppsala University; Eskilstuna Sweden
| | - I. Kull
- Allergy and Respiratory Research Group; Usher Institute of Population Health Sciences and Informatics; University of Edinburgh; Edinburgh UK
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
| | - E. Melén
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - M. Westman
- Department of Medicine Solna; Immunology and Allergy Unit; Karolinska Institutet; Stockholm Sweden
- Department of ENT Diseases; Karolinska University Hospital; Stockholm Sweden
| | - M. Wickman
- Centre for Clinical Research Sörmland; Uppsala University; Eskilstuna Sweden
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - E. Eller
- Department of Dermatology and Allergy Centre; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - S. Bosnic-Anticevich
- Woolcock Institute of Medical Research; Sydney Local Health District; University of Sydney; Glebe NSW Australia
| | - R. E. O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine; Alfred Hospital and Central Clinical School; Monash University; Melbourne Vic. Australia
- Department of Immunology; Monash University; Melbourne Vic. Australia
| | - I. Agache
- Transylvania University; Brasov Romania
| | - T. Bieber
- Department of Dermatology and Allergy; Rheinische Friedrich-Wilhelms-University Bonn; Bonn Germany
| | - T. Casale
- Division of Allergy/Immunology; University of South Florida; Tampa FL USA
| | - B. Gemicioğlu
- Department of Pulmonary Diseases; Cerrahpasa Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - J. C. Ivancevich
- Servicio de Alergia e Immunologia; Clinica Santa Isabel; Buenos Aires Argentina
| | | | - M. Sorensen
- Department of Paediatric and Adolescent Medicine; University Hospital of North Norway; Tromsø Norway
- Department of Clinical Medicine; Paediatric Research Group; Faculty of Health Sciences; UiT The Arctic University of Norway; Tromsø Norway
| | - A. Yorgancioglu
- Department of Pulmonology; Celal Bayar University; Manisa Turkey
- GARD Executive Committee; Manisa Turkey
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Samreth D, Arnavielhe S, Ingenrieth F, Bedbrook A, Onorato GL, Murray R, Almeida R, Mizani MA, Fonseca J, Costa E, Malva J, Morais-Almeida M, Pereira AM, Todo-Bom A, Menditto E, Stellato C, Ventura MT, Larenas-Linnemann D, Fuentes-Pérez JM, Huerta-Villalobos YR, Cruz AA, Stelmach R, da Silva J, Emuzyte R, Kvedariene V, Valiulis A, Annesi-Maesano I, Bosse I, Demoly P, Devillier P, Fontaine JF, Kuna P, Samolinski B, Klimek L, Mösges R, Pfaar O, Shamai S, Bewick M, Ryan D, Sheikh A, Anto JM, Cardona V, Mullol J, Valero A, Chavannes NH, Fokkens WJ, Reitsma S, Roller-Wirnsberger RE, Tomazic PV, Haahtela T, Toppila-Salmi S, Valovirta E, Makris M, Papadopoulos NG, Prokopakis EP, Psarros F, Gemicioğlu B, Yorgancioglu A, Bindslev-Jensen C, Eller E, Kull I, Wickman M, Bachert C, Hellings PW, Pugin B, Bosnic-Anticevich S, O'Hehir RE, Kolek V, Sova M, Wehner K, De Vries G, van Eerd M, Laune D, Wittmann J, Bousquet J, Poncelet P. Geolocation with respect to personal privacy for the Allergy Diary app - a MASK study. World Allergy Organ J 2018; 11:15. [PMID: 30061979 PMCID: PMC6048852 DOI: 10.1186/s40413-018-0194-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/19/2018] [Indexed: 12/25/2022] Open
Abstract
Background Collecting data on the localization of users is a key issue for the MASK (Mobile Airways Sentinel networK: the Allergy Diary) App. Data anonymization is a method of sanitization for privacy. The European Commission's Article 29 Working Party stated that geolocation information is personal data.To assess geolocation using the MASK method and to compare two anonymization methods in the MASK database to find an optimal privacy method. Methods Geolocation was studied for all people who used the Allergy Diary App from December 2015 to November 2017 and who reported medical outcomes. Two different anonymization methods have been evaluated: Noise addition (randomization) and k-anonymity (generalization). Results Ninety-three thousand one hundred and sixteen days of VAS were collected from 8535 users and 54,500 (58.5%) were geolocalized, corresponding to 5428 users. Noise addition was found to be less accurate than k-anonymity using MASK data to protect the users' life privacy. Discussion k-anonymity is an acceptable method for the anonymization of MASK data and results can be used for other databases.
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Affiliation(s)
| | | | - F Ingenrieth
- Selbstregulierung Informationswirtschaft eV, Berlin, Germany
| | - A Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - G L Onorato
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - R Murray
- MedScript Ltd, Dundalk, Co Louth, Ireland
| | - R Almeida
- 5Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto; and Medina, Lda, Porto, Portugal
| | - M A Mizani
- 6Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - J Fonseca
- 5Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto; and Medina, Lda, Porto, Portugal
| | - E Costa
- 7UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - J Malva
- 8Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, Ageing@Coimbra EIP-AHA Reference Site, University of Coimbra, Coimbra, Portugal
| | | | - A M Pereira
- 10Allergy Unit, CUF-Porto Hospital and Institute; Center for Research in Health Technologies and information systems CINTESIS, Universidade do Porto, Porto, Portugal
| | - A Todo-Bom
- 11Imunoalergologia Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - E Menditto
- 12CIRFF, Federico II University, Naples, Italy
| | - C Stellato
- 13Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - M T Ventura
- 14Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - D Larenas-Linnemann
- 15Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico
| | | | | | - A A Cruz
- 17ProAR - Nucleo de Excelencia em Asma, Brasil and WHO GARD Planning Group, Federal University of Bahia, Salvador, Brazil
| | - R Stelmach
- 18Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - J da Silva
- 19Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, SC Brazil
| | - R Emuzyte
- 20Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- 21Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Valiulis
- 22Clinic of Children's Diseases, and Institute of Health Sciences, Department of Public Health, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - I Annesi-Maesano
- 24Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, Medical School Saint Antoine, INSERM and Sorbonne Université, Paris, France
| | - I Bosse
- Allergist, La Rochelle, France
| | - P Demoly
- 26Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P Devillier
- 27UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - P Kuna
- 29Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- 30Samolinski. Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - R Mösges
- 32Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International Ltd, Hamburg, Germany
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,34Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - S Shamai
- 32Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International Ltd, Hamburg, Germany
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK.,37Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School, Edinburgh, UK
| | - A Sheikh
- 6Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - J M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,39IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,40CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,41Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Cardona
- 42S Allergologia, S Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - J Mullol
- 43Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - A Valero
- 44Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - N H Chavannes
- 45Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W J Fokkens
- 46Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
| | - S Reitsma
- 46Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
| | | | - P V Tomazic
- 48Department of ENT, Medical University of Graz, Graz, Austria
| | - T Haahtela
- 49Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Toppila-Salmi
- 49Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - E Valovirta
- 50Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo allergy clinic, Turku, Finland
| | - M Makris
- 51Division of Infection, Immunity 1 Respiratory Medicine, University of Manchester, Manchester, UK.,52Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - N G Papadopoulos
- 51Division of Infection, Immunity 1 Respiratory Medicine, University of Manchester, Manchester, UK.,52Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - E P Prokopakis
- 53Department of Otorhinolaryngology University of Crete School of Medicine, Heraklion, Greece
| | - F Psarros
- Allergy Department Athens Naval Hospital, Athens, Greece
| | - B Gemicioğlu
- 55Department of Pulmonary Diseases, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - A Yorgancioglu
- 56Department of Pulmonary Diseases, Faculty of Medicine, Turkey and GARD Executive Committee, Celal Bayar University, Manisa, Turkey
| | - C Bindslev-Jensen
- 57Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - E Eller
- 57Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - I Kull
- 58Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- 59Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - C Bachert
- 60Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - P W Hellings
- 61Department of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, Belgium.,62Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands.,Euforea, Brussels, Belgium
| | | | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - R E O'Hehir
- 65Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria Australia.,66Department of Immunology, Monash University, Melbourne, Victoria Australia
| | - V Kolek
- 67Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - M Sova
- 67Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - K Wehner
- 68Fachbereich Biologie, Technische Universität, Darmstadt, Germany
| | - G De Vries
- Peercode BV, Geldermalsen, The Netherlands
| | - M van Eerd
- Peercode BV, Geldermalsen, The Netherlands
| | | | - J Wittmann
- Selbstregulierung Informationswirtschaft eV, Berlin, Germany
| | - J Bousquet
- Euforea, Brussels, Belgium.,70INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, France.,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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