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Dewidar O, Al-Zubaidi A, Bondok M, Abdelrazeq L, Huang J, Jearvis A, Barker LC, Elmestekawy N, Goghomu E, Rader T, Tufte J, Greer-Smith R, Waddington HS, Nicholls SG, Little J, Hardy BJ, Horsley T, Young T, Cuervo LG, Sharp MK, Chamberlain C, Shea B, Craig P, Lawson DO, Rizvi A, Wiysonge CS, Kredo T, Francis D, Kristjansson E, Bhutta Z, Antequera A, Melendez-Torres GJ, Pantoja T, Wang X, Jull J, Roberts JH, Funnell S, White H, Krentel A, Mahande MJ, Ramke J, Wells G, Petkovic J, Pottie K, Niba L, Feng C, Nguliefem MN, Tugwell P, Mbuagbaw L, Welch V. Reporting of equity in observational epidemiology: A methodological review. J Glob Health 2024; 14:04046. [PMID: 38491911 PMCID: PMC10903926 DOI: 10.7189/jogh.14.04046] [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] [Indexed: 03/18/2024] Open
Abstract
Background Observational studies can inform how we understand and address persisting health inequities through the collection, reporting and analysis of health equity factors. However, the extent to which the analysis and reporting of equity-relevant aspects in observational research are generally unknown. Thus, we aimed to systematically evaluate how equity-relevant observational studies reported equity considerations in the study design and analyses. Methods We searched MEDLINE for health equity-relevant observational studies from January 2020 to March 2022, resulting in 16 828 articles. We randomly selected 320 studies, ensuring a balance in focus on populations experiencing inequities, country income settings, and coronavirus disease 2019 (COVID-19) topic. We extracted information on study design and analysis methods. Results The bulk of the studies were conducted in North America (n = 95, 30%), followed by Europe and Central Asia (n = 55, 17%). Half of the studies (n = 171, 53%) addressed general health and well-being, while 49 (15%) focused on mental health conditions. Two-thirds of the studies (n = 220, 69%) were cross-sectional. Eight (3%) engaged with populations experiencing inequities, while 22 (29%) adapted recruitment methods to reach these populations. Further, 67 studies (21%) examined interaction effects primarily related to race or ethnicity (48%). Two-thirds of the studies (72%) adjusted for characteristics associated with inequities, and 18 studies (6%) used flow diagrams to depict how populations experiencing inequities progressed throughout the studies. Conclusions Despite over 80% of the equity-focused observational studies providing a rationale for a focus on health equity, reporting of study design features relevant to health equity ranged from 0-95%, with over half of the items reported by less than one-quarter of studies. This methodological study is a baseline assessment to inform the development of an equity-focussed reporting guideline for observational studies as an extension of the well-known Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guideline.
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Affiliation(s)
- Omar Dewidar
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Ali Al-Zubaidi
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Medicine, University College Cork, Cork, Ireland
| | - Mostafa Bondok
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leenah Abdelrazeq
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jimmy Huang
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Alyssa Jearvis
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Lucy C Barker
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Nour Elmestekawy
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Elizabeth Goghomu
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Tamara Rader
- Freelance health research librarian, Ottawa, Ontario, Canada
| | - Janice Tufte
- Hassanah Consulting, Seattle, Washington State, USA
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/S.T.A.R. Initiative, California, USA
| | - Hugh S Waddington
- London School of Hygiene and Tropical Medicine, London, UK
- London International Development Centre, London, UK
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Office for Patient Engagement in Research Activity (OPERA), Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Billie-Jo Hardy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada
| | - Taryn Young
- Centre for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Luis Gabriel Cuervo
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization (PAHO/WHO), Washington, DC, USA
- Doctoral Programme on Methodology of Biomedical Research and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Melissa K Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Australia
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Craig
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Centre for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Damian Francis
- School of Health and Human Performance, Georgia College, Milledgeville, Georgia, USA
| | - Elizabeth Kristjansson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - GJ Melendez-Torres
- Department of Public Health and Sports Science, University of Exeter College of Medicine and Health, Exeter, UK
| | - Tomas Pantoja
- Family Medicine Department, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Canada
| | - Janet Jull
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Janet Hatcher Roberts
- World Health Organization Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa, Canada
| | - Sarah Funnell
- Department of Family Medicine, Faculty of Health Sciences, Queen’s University, Kingston, Ontario
| | | | - Alison Krentel
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael Johnson Mahande
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Tanzania
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - George Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer Petkovic
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Pottie
- C.T. Lamont Primary Care Research Centre, Bruyère Research Institute, Ottawa, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Loveline Niba
- Department of Public Health, The University of Bamenda, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Cindy Feng
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Miriam N Nguliefem
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tugwell
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Wang X, Dewidar O, Rizvi A, Huang J, Desai P, Doyle R, Ghogomu E, Rader T, Nicholls SG, Antequera A, Krentel A, Shea B, Hardy BJ, Chamberlain C, Wiysonge CS, Feng C, Juando-Prats C, Lawson DO, Obuku EA, Kristjansson E, von Elm E, Wang H, Ellingwood H, Waddington HS, Ramke J, Jull JE, Hatcher-Roberts J, Tufte J, Little J, Mbuagbaw L, Weeks L, Niba LL, Cuervo LG, Wolfenden L, Kasonde M, Avey MT, Sharp MK, Mahande MJ, Nkangu M, Magwood O, Craig P, Tugwell P, Funnell S, Noorduyn SG, Kredo T, Horsley T, Young T, Pantoja T, Bhutta Z, Martel A, Welch VA. A scoping review establishes need for consensus guidance on reporting health equity in observational studies. J Clin Epidemiol 2023; 160:126-140. [PMID: 37330072 DOI: 10.1016/j.jclinepi.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/30/2023] [Accepted: 06/09/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To evaluate the support from the available guidance on reporting of health equity in research for our candidate items and to identify additional items for the Strengthening Reporting of Observational studies in Epidemiology-Equity extension. STUDY DESIGN AND SETTING We conducted a scoping review by searching Embase, MEDLINE, CINAHL, Cochrane Methodology Register, LILACS, and Caribbean Center on Health Sciences Information up to January 2022. We also searched reference lists and gray literature for additional resources. We included guidance and assessments (hereafter termed "resources") related to conduct and/or reporting for any type of health research with or about people experiencing health inequity. RESULTS We included 34 resources, which supported one or more candidate items or contributed to new items about health equity reporting in observational research. Each candidate item was supported by a median of six (range: 1-15) resources. In addition, 12 resources suggested 13 new items, such as "report the background of investigators". CONCLUSION Existing resources for reporting health equity in observational studies aligned with our interim checklist of candidate items. We also identified additional items that will be considered in the development of a consensus-based and evidence-based guideline for reporting health equity in observational studies.
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Affiliation(s)
- Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Omar Dewidar
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Faculty of Social Sciences, Ottawa, Ontario K1N 6N5, Canada
| | - Jimmy Huang
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada
| | - Payaam Desai
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada
| | - Rebecca Doyle
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada
| | | | - Tamara Rader
- Freelance Health Research Librarian, Ottawa, Canada
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, Canada
| | - Alba Antequera
- International Health Department, ISGlobal, Hospital Clínic - Universitat de Barcelona, 585, 08007 Barcelona, Spain
| | - Alison Krentel
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Beverley Shea
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Billie-Jo Hardy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5S, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario M5B 1T8, Canada
| | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, 3010 Victoria, Australia
| | - Charles S Wiysonge
- Centre for Evidence-based Health Care, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, 3629, South Africa; HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
| | - Cindy Feng
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Clara Juando-Prats
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5S, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario M5B 1T8, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Ekwaro A Obuku
- Africa Centre for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, Kampala 7062, Uganda; Department of Global Health Security, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala 7062, Uganda; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London WC1E 6BT, United Kingdom
| | - Elizabeth Kristjansson
- School of Psychology, University of Ottawa, Faculty of Social Sciences, Ottawa, Ontario K1N 6N5, Canada
| | - Erik von Elm
- Cochrane Switzerland, Unisanté Lausanne, Lausanne, CH 1010, Switzerland
| | - Harry Wang
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; University of Ottawa Faculty of Medicine, Ottawa, Ontario K1N 6N5, Canada
| | - Holly Ellingwood
- Department of Psychology, Department of Law, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - Hugh Sharma Waddington
- Environmental Health Group, Department of Disease Control, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; London International Development Centre, London, Ontario N5V 4T3, Canada
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; School of Optometry and Vision Science, University of Auckland, Auckland 1010, New Zealand
| | - Janet Elizabeth Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Janet Hatcher-Roberts
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | | | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Lawrence Mbuagbaw
- Department of Anesthesia, McMaster University, Hamilton, Ontario L8S 4L8, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario L8S 4L8, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario L8N 4A6, Canada; Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, VGC6+C52, Yaoundé, Cameroon; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town 7602, South Africa
| | | | - Loveline Lum Niba
- Department of Public Health, Faculty of Health Sciences, The University of Bamenda, Amphi 340, Bambili, Bamenda, Cameroon
| | | | - Luke Wolfenden
- School of medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Mwenya Kasonde
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Marc T Avey
- Canadian Council on Animal Care, Ottawa, Ontario K2P 2R3, Canada
| | - Melissa K Sharp
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin D02 YN77, Ireland
| | - Michael Johnson Mahande
- Department of Epidemiology & Biostatistics, Kilimanjaro Christian Medical University College, Kilimanjaro M8HH+MQ4, Tanzania
| | - Miriam Nkangu
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Olivia Magwood
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Peter Craig
- MRC/CSO Social and Public Health Science Unit, University of Glasgow, Glasgow G12 8QQ, UK
| | - Peter Tugwell
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Sarah Funnell
- Department of Family Medicine, Queen's University, Kingston, Ontario K7L 3N6, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Stephen G Noorduyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, 3629, South Africa
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario K1S 5N8, Canada
| | - Taryn Young
- Centre for Evidence-based Health Care, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Tomas Pantoja
- Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Zulfiqar Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada; Institute for Global Health and Development, The Aga Khan University, Karachi 74000, Pakistan
| | - Andrea Martel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5S, Canada
| | - Vivian A Welch
- Bruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada.
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Funnell S, Jull J, Mbuagbaw L, Welch V, Dewidar O, Wang X, Lesperance M, Ghogomu E, Rizvi A, Akl EA, Avey MT, Antequera A, Bhutta ZA, Chamberlain C, Craig P, Cuervo LG, Dicko A, Ellingwood H, Feng C, Francis D, Greer-Smith R, Hardy BJ, Harwood M, Hatcher-Roberts J, Horsley T, Juando-Prats C, Kasonde M, Kennedy M, Kredo T, Krentel A, Kristjansson E, Langer L, Little J, Loder E, Magwood O, Mahande MJ, Melendez-Torres GJ, Moore A, Niba LL, Nicholls SG, Nkangu MN, Lawson DO, Obuku E, Okwen P, Pantoja T, Petkovic J, Petticrew M, Pottie K, Rader T, Ramke J, Riddle A, Shamseer L, Sharp M, Shea B, Tanuseputro P, Tugwell P, Tufte J, Von Elm E, Waddington HS, Wang H, Weeks L, Wells G, White H, Wiysonge CS, Wolfenden L, Young T. Improving social justice in observational studies: protocol for the development of a global and Indigenous STROBE-equity reporting guideline. Int J Equity Health 2023; 22:55. [PMID: 36991403 PMCID: PMC10060140 DOI: 10.1186/s12939-023-01854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Addressing persistent and pervasive health inequities is a global moral imperative, which has been highlighted and magnified by the societal and health impacts of the COVID-19 pandemic. Observational studies can aid our understanding of the impact of health and structural oppression based on the intersection of gender, race, ethnicity, age and other factors, as they frequently collect this data. However, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline, does not provide guidance related to reporting of health equity. The goal of this project is to develop a STROBE-Equity reporting guideline extension. METHODS We assembled a diverse team across multiple domains, including gender, age, ethnicity, Indigenous background, disciplines, geographies, lived experience of health inequity and decision-making organizations. Using an inclusive, integrated knowledge translation approach, we will implement a five-phase plan which will include: (1) assessing the reporting of health equity in published observational studies, (2) seeking wide international feedback on items to improve reporting of health equity, (3) establishing consensus amongst knowledge users and researchers, (4) evaluating in partnership with Indigenous contributors the relevance to Indigenous peoples who have globally experienced the oppressive legacy of colonization, and (5) widely disseminating and seeking endorsement from relevant knowledge users. We will seek input from external collaborators using social media, mailing lists and other communication channels. DISCUSSION Achieving global imperatives such as the Sustainable Development Goals (e.g., SDG 10 Reduced inequalities, SDG 3 Good health and wellbeing) requires advancing health equity in research. The implementation of the STROBE-Equity guidelines will enable a better awareness and understanding of health inequities through better reporting. We will broadly disseminate the reporting guideline with tools to enable adoption and use by journal editors, authors, and funding agencies, using diverse strategies tailored to specific audiences.
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Affiliation(s)
- Sarah Funnell
- Department of Family Medicine, Queen's University, Kingston, Canada
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Vivian Welch
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | - Omar Dewidar
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Canada
| | - Miranda Lesperance
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Marc T Avey
- Canadian Council on Animal Care, Ottawa, Canada
| | - Alba Antequera
- International Health Department, ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Institute for Global Health & Development, The Aga Khan University, Karachi, Pakistan
| | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Luis Gabriel Cuervo
- Unit of Health Services and Access, Department of Health Systems and Services, Pan American Health Organization (PAHO/WHO), Washington, DC, USA
- Doctoral School, Department of Paediatrics, Obstetrics & Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alassane Dicko
- Malaria Research and Training Center, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Holly Ellingwood
- Department of Psychology, Department of Law, Carleton University, Ottawa, ON, Canada
| | - Cindy Feng
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Damian Francis
- School of Health and Human Performance, Georgia College, Milledgville, USA
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/S.T.A.R. Initiative, Los Angeles, USA
| | - Billie-Jo Hardy
- Well Living House, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Matire Harwood
- General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
| | - Janet Hatcher-Roberts
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa, Canada
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Clara Juando-Prats
- Applied Health Research Center, St. Michael's Hospital, Toronto, Canada
- Dalla School of Public Health, University of Toronto, Toronto, Canada
| | | | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Tamara Kredo
- Centre for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Alison Krentel
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Elizabeth Kristjansson
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Laurenz Langer
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Olivia Magwood
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Michael Johnson Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania
| | | | - Ainsley Moore
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Loveline Lum Niba
- Department of Public Health, Faculty of Health Sciences, The University of Bamenda, Bamenda, Cameroon
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ekwaro Obuku
- College of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Patrick Okwen
- Department of Public Health, Faculty of Health Sciences, The University of Bamenda, Bamenda, Cameroon
| | - Tomas Pantoja
- Department of Family Medicine, School of Medicine, Pontifica Universidad Católica de Chile, Santiago, Chile
| | - Jennifer Petkovic
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Kevin Pottie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Department of Family Medicine, Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Tamara Rader
- Freelance Health Research Librarian, Ottawa, Canada
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Alison Riddle
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Larissa Shamseer
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Melissa Sharp
- Health Research Board Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Bev Shea
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Peter Tanuseputro
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Medicine , University of Ottawa, Ottawa, Ontario, Canada
| | | | - Erik Von Elm
- Cochrane Switzerland, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Hugh Sharma Waddington
- London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Harry Wang
- Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, 85 Primrose, Ottawa, Ontario, Canada
- Department of Medicine , University of Ottawa, Ottawa, Ontario, Canada
| | - Laura Weeks
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada
| | - George Wells
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Charles Shey Wiysonge
- Centre for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- HIV and other Infectious Diseases Research Unit, Durban, South Africa
| | - Luke Wolfenden
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
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Hirt J, Schönenberger CM, Ewald H, Lawson DO, Papola D, Rohner R, Suter K, Lin S, Germini F, Zeng L, Shahabinezhad A, Chowdhury SR, Gao Y, Bhattacharjee A, Lima JP, Marusic A, Buljan I, Agarwal A, Guyatt GH, Briel M, Schandelmaier S. Introducing the Library of Guidance for Health Scientists (LIGHTS): A Living Database for Methods Guidance. JAMA Netw Open 2023; 6:e2253198. [PMID: 36787138 DOI: 10.1001/jamanetworkopen.2022.53198] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
IMPORTANCE Improving methodological quality is a priority in the health research community. Finding appropriate methods guidance can be challenging due to heterogeneous terminology, poor indexing in medical databases, and variation in formats. The Library of Guidance for Health Scientists (LIGHTS) is a new searchable database for methods guidance articles. OBSERVATIONS Journal articles that aim to provide guidance for performing (including planning, design, conduct, analysis, and interpretation), reporting, and assessing the quality of health-related research involving humans or human populations (ie, excluding basic and animal research) are eligible for LIGHTS. A team of health researchers, information specialists, and methodologists continuously identifies and manually indexes eligible guidance documents. The search strategy includes focused searches of specific journals, specialized databases, and suggestions from researchers. A current limitation is that a keyword-based search of MEDLINE (and other general databases) and manual screening of records were not feasible because of the large number of hits (n = 915 523). As of September 20, 2022, LIGHTS included 1246 articles (336 reporting guidelines, 80 quality assessment tools, and 830 other methods guidance articles). The LIGHTS website provides a user-oriented search interface including filters for study type, specific methodological topic, research context, guidance type, and development process of the guidance. Automated matching of alternative methodological expressions (eg, enter loss to follow-up and find articles indexed with missing data) enhances search queries. CONCLUSIONS AND RELEVANCE LIGHTS is a peer-supported initiative that is intended to increase access to and use of methods guidance relevant to health researchers, statisticians, methods consultants, methods developers, ethics boards, peer reviewers, journal editors, and funding bodies.
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Affiliation(s)
- Julian Hirt
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen
| | - Christof Manuel Schönenberger
- CLEAR (Clinical Research Empirical Assessment and Recommendations) Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Hannah Ewald
- University Medical Library, University of Basel, Basel, Switzerland
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - Ramon Rohner
- CLEAR (Clinical Research Empirical Assessment and Recommendations) Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Katja Suter
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Shanshan Lin
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Federico Germini
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Linan Zeng
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Pharmacy Department/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ali Shahabinezhad
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Saifur Rahman Chowdhury
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ya Gao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Arunima Bhattacharjee
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Swiss TPH (Tropical and Public Health Institute), University of Basel, Basel, Switzerland
| | - João Pedro Lima
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ana Marusic
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Ivan Buljan
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Matthias Briel
- CLEAR (Clinical Research Empirical Assessment and Recommendations) Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Stefan Schandelmaier
- CLEAR (Clinical Research Empirical Assessment and Recommendations) Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
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Husbands W, Lawson DO, Etowa EB, Mbuagbaw L, Baidoobonso S, Tharao W, Yaya S, Nelson LE, Aden M, Etowa J. Black Canadians' Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities. J Urban Health 2022; 99:829-841. [PMID: 36066788 PMCID: PMC9447939 DOI: 10.1007/s11524-022-00676-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 02/04/2023]
Abstract
This study explores the social determinants of Black Canadians' exposure to everyday racism, its relationship to health system access, and implications for health promotion. We used data from the A/C Study survey on HIV transmission and prevention among Black Canadians. We implemented the survey (N = 1360) in 2018-2019 in Toronto and Ottawa-two large cities that together account for 42% of Canada's Black population-among self-identified Black residents aged 15-64 years, who were born in sub-Sahara Africa or the Caribbean or had a parent who was born in those regions. Participants reported racist encounters in the preceding 12 months using the Everyday Discrimination Scale. We assessed the socio-demographic correlates of racist experiences and the impact of racism on health system access using multivariable generalised linear models. Sixty percent of participants reported experiencing racism in the preceding 12 months. Based on the adjusted odds ratios, participants were more likely to experience racism if they were older, employed, Canadian-born, had higher levels of education, self-identified as LGBTQ + and reported generally moderate access to basic needs and adequate housing; and less likely to experience racism if they lived in Ottawa, self-identified as female or reported higher levels of social capital. Visiting a healthcare provider or facility, and difficulty accessing healthcare were associated with racist experiences. Racist experiences diminished the likelihood of being tested for HIV. Racist experiences were widespread, especially among those with higher levels of social wellbeing or greater exposure to Canadian institutions. Study participants also associated racist experiences with the healthcare system.
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Affiliation(s)
- Winston Husbands
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Ontario HIV Treatment Network, Toronto, Canada
| | - Daeria O. Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Egbe B. Etowa
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Biostatistics Unit, Father Sean O Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Shamara Baidoobonso
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Wangari Tharao
- Women’s Health in Women’s Hands Community Health Centre, Toronto, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College, London, UK
| | - LaRon E. Nelson
- School of Nursing, Yale University, New Haven, USA
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
- Center for Interdisciplinary Research On AIDS (CIRA), School of Public Health, Yale University, New Haven, USA
- Yale Institute of Global Health, Yale University, New Haven, USA
| | - Muna Aden
- Women’s Health in Women’s Hands Community Health Centre, Toronto, Canada
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Mitra S, Boasquevisque DDS, Noorduyn S, Rodrigues M, Lawson DO, Thabane L, Montori V. A conversation on evidence-based medicine in the COVID-era, patient revolution, and academic career with Dr. Victor Montori. J Evid Based Med 2022; 15:187-191. [PMID: 35927962 PMCID: PMC9537952 DOI: 10.1111/jebm.12487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/21/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Souvik Mitra
- Departments of Pediatrics, Community Health & EpidemiologyDalhousie University and IWK HealthHalifaxNova ScotiaCanada
| | | | - Stephen Noorduyn
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Myanca Rodrigues
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Daeria O. Lawson
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Population Health Research InstituteMcMaster UniversityHamiltonOntarioCanada
| | - Victor Montori
- Division of Endocrinology, Diabetes, Metabolism, Nutrition, Department of Internal Medicine, Mayo ClinicRochesterMinnesota
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Lawson DO, Wang MK, Kim K, Eikelboom R, Rodrigues M, Trapsa D, Thabane L, Moher D. Lessons from the COVID-19 pandemic and recent developments on the communication of clinical trials, publishing practices, and research integrity: in conversation with Dr. David Moher. Trials 2022; 23:671. [PMID: 35978325 PMCID: PMC9383655 DOI: 10.1186/s13063-022-06624-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The torrent of research during the coronavirus (COVID-19) pandemic has exposed the persistent challenges with reporting trials, open science practices, and scholarship in academia. These real-world examples provide unique learning opportunities for research methodologists and clinical epidemiologists-in-training. Dr. David Moher, a recognized expert on the science of research reporting and one of the founders of the Consolidated Standards of Reporting Trials (CONSORT) statement, was a guest speaker for the 2021 Hooker Distinguished Visiting Professor Lecture series at McMaster University and shared his insights about these issues. MAIN TEXT This paper covers a discussion on the influence of reporting guidelines on trials and issues with the use of CONSORT as a measure of quality. Dr. Moher also addresses how the overwhelming body of COVID-19 research reflects the "publish or perish" paradigm in academia and why improvement in the reporting of trials requires policy initiatives from research institutions and funding agencies. We also discuss the rise of publication bias and other questionable reporting practices. To combat this, Dr. Moher believes open science and training initiatives led by institutions can foster research integrity, including the trustworthiness of researchers, institutions, and journals, as well as counter threats posed by predatory journals. He highlights how metrics like journal impact factor and quantity of publications also harm research integrity. Dr. Moher also discussed the importance of meta-science, the study of how research is carried out, which can help to evaluate audit and feedback systems and their effect on open science practices. CONCLUSION Dr. Moher advocates for policy to further improve the reporting of trials and health research. The COVID-19 pandemic has exposed how a lack of open science practices and flawed systems incentivizing researchers to publish can harm research integrity. There is a need for a culture shift in assessing careers and "productivity" in academia, and this requires collaborative top-down and bottom-up approaches.
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Affiliation(s)
- Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Michael K Wang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kevin Kim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Rachel Eikelboom
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Myanca Rodrigues
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Daniela Trapsa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. .,Department of Medicine, McMaster University, Hamilton, ON, Canada. .,Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. .,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Dewidar O, Rader T, Waddington H, Nicholls SG, Little J, Hardy BJ, Horsley T, Young T, Cuervo LG, Sharp MK, Chamberlain C, Shea B, Craig P, Lawson DO, Rizvi A, Wiysonge CS, Kredo T, Nguliefem MN, Ghogomu E, Francis D, Kristjansson E, Bhutta Z, Martin AA, Melendez-Torres GJ, Pantoja T, Wang X, Jull J, Roberts JH, Funnell S, White H, Krentel A, Mahande MJ, Ramke J, Wells GA, Petkovic J, Tugwell P, Pottie K, Mbuagbaw L, Welch V. Reporting of health equity considerations in equity-relevant observational studies: Protocol for a systematic assessment. F1000Res 2022. [DOI: 10.12688/f1000research.122185.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The mitigation of unfair and avoidable differences in health is an increasing global priority. Observational studies including cohort, cross-sectional and case-control studies tend to report social determinants of health which could inform evidence syntheses on health equity and social justice. However, the extent of reporting and analysis of equity in equity-relevant observational studies is unknown. Methods: We define studies which report outcomes for populations at risk of experiencing inequities as “equity-relevant”. Using a random sampling technique we will identify 320 equity-relevant observational studies published between 1 January 2020 to 27 April 2022 by searching the MEDLINE database. We will stratify sampling by 1) studies in high-income countries (HIC) and low- and middle-income countries (LMIC) according to the World Bank classification, 2) studies focused on COVID and those which are not, 3) studies focused on populations at risk of experiencing inequities and those on general populations that stratify their analyses. We will use the PROGRESS framework which stands for place of residence, race or ethnicity, occupation, gender or sex, religion, education, socioeconomic status, social capital, to identify dimensions where inequities may exist. Using a previously developed data extraction form we will pilot-test on eligible studies and revise as applicable. Conclusions: The proposed methodological assessment of reporting will allow us to systematically understand the current reporting and analysis practices for health equity in observational studies. The findings of this study will help inform the development of the equity extension for the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) reporting guidelines.
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Rizvi A, Lawson DO, Young T, Dewidar O, Nicholls S, Akl EA, Little J, Magwood O, Shamseer L, Ghogomu E, Jull JE, Rader T, Bhutta Z, Chamberlain C, Ellingwood H, Greer-Smith R, Hardy BJ, Harwood M, Kennedy M, Kredo T, Loder E, Mahande MJJ, Mbuagbaw L, Nkangu M, Okwen PM, Ramke J, Tufte J, Tugwell P, Wang X, Wiysonge CS, Welch VA. Guidance relevant to the reporting of health equity in observational research: a scoping review protocol. BMJ Open 2022; 12:e056875. [PMID: 35589369 PMCID: PMC9121499 DOI: 10.1136/bmjopen-2021-056875] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Health inequities are defined as unfair and avoidable differences in health between groups within a population. Most health research is conducted through observational studies, which are able to offer real-world insights about etiology, healthcare policy/programme effectiveness and the impacts of socioeconomic factors. However, most published reports of observational studies do not address how their findings relate to health equity. Our team seeks to develop equity-relevant reporting guidance as an extension of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. This scoping review will inform the development of candidate items for the STROBE-Equity extension. We will operationalise equity-seeking populations using the PROGRESS-Plus framework of sociodemographic factors. As part of a parallel stream of the STROBE-Equity project, the relevance of candidate guideline items to Indigenous research will be led by Indigenous coinvestigators on the team. METHODS AND ANALYSIS We will follow the Joanna Briggs Institute method for conducting scoping reviews. We will evaluate the extent to which the identified guidance supports or refutes our preliminary candidate items for reporting equity in observational studies. These candidate items were developed based on items from equity-reporting guidelines for randomised trials and systematic reviews, developed by members of this team. We will consult with our knowledge users, patients/public partners and Indigenous research steering committee to invite suggestions for relevant guidance documents and interpretation of findings. If the identified guidance suggests the need for additional candidate items, they will be developed through inductive thematic analysis. ETHICS AND DISSEMINATION We will follow a principled approach that promotes ethical codevelopment with our community partners, based on principles of cultural safety, authentic partnerships, addressing colonial structures in knowledge production and the shared ownership, interpretation, and dissemination of research. All products of this research will be published as open access.
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Affiliation(s)
- Anita Rizvi
- School of Psychology, University of Ottawa Faculty of Social Sciences, Ottawa, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Taryn Young
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Stuart Nicholls
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Magwood
- CT Lamont Primary Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences University of Ottawa, Ottawa, Ontario, Canada
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Tamara Rader
- Freelance health research librarian, (no affiliation), Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Centre for Global Child Health, SickKids Center for Global Child Health, Toronto, Ontario, Canada
- Institute for Global Health & Development, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Western Australia, Australia
| | - Holly Ellingwood
- Department of Psychology, Department of Law, Carleton University, Ottawa, Ontario, Canada
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/Strategically Targeting Appropriate Researchers (S.T.A.R.) Initiative, Apple Valley, California, USA
| | - Billie-Jo Hardy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Matire Harwood
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Elizabeth Loder
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Johnson J Mahande
- Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Miriam Nkangu
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Jacqueline Ramke
- London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, Auckland, New Zealand
| | | | - Peter Tugwell
- University of Ottawa Department of Medicine, Ottawa, Ontario, Canada
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Vivian A Welch
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Lawson DO, Mellor K, Eddy S, Lee C, Kim KH, Kim K, Mbuagbaw L, Thabane L. Pilot and Feasibility Studies in Rehabilitation Research: A Review and Educational Primer for the Physiatrist Researcher. Am J Phys Med Rehabil 2022; 101:372-383. [PMID: 34091466 DOI: 10.1097/phm.0000000000001797] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Pilot and feasibility studies are conducted early in the clinical research pathway to evaluate whether a future, definitive study can or should be done and, if so, how. Poor planning and reporting of pilot and feasibility studies can compromise subsequent research efforts. Inappropriate labeling of studies as pilots also compromises education. In this review, first, a systematic survey of the current state of pilot and feasibility studies in rehabilitation research was performed, and second, recommendations were made for improvements to their design and reporting. In a random sample of 100 studies, half (49.5%) were randomized trials. Thirty (30.0%) and three (3.0%) studies used "pilot" and "feasibility" in the study title, respectively. Only one third (34.0%) of studies provided a primary objective related to feasibility. Most studies (92.0%) stated an intent for hypothesis testing. Although many studies (70.0%) mentioned outcomes related to feasibility in the methods, a third (30.0%) reported additional outcomes in the results and discussion only or commented on feasibility anecdotally. The reporting of progression plans to a main study (21.0%) and progression criteria (4.0%) was infrequent. Based on these findings, it is recommended that researchers correctly label studies as a pilot or feasibility design based on accepted definitions, explicitly state feasibility objectives, outcomes, and criteria for determining success of feasibility, justify the sample size, and appropriately interpret and report the implications of feasibility findings for the main future study.
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Affiliation(s)
- Daeria O Lawson
- From the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (DOL, LM, LT); Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom (KM); Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom (SE); Department of Medicine, McMaster University, Hamilton, Ontario, Canada (CL, KHK, KK); and Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada (LM, LT)
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Garcia C, Rehman N, Lawson DO, Djiadeu P, Mbuagbaw L. Developing Reporting Guidelines for Studies of HIV Drug Resistance Prevalence: A Protocol for a Mixed-methods Study (Preprint). JMIR Res Protoc 2022; 11:e35969. [PMID: 35559984 PMCID: PMC9143765 DOI: 10.2196/35969] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/10/2022] [Accepted: 04/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background HIV drug resistance is a global health problem that limits the effectiveness of antiretroviral therapy. Adequate surveillance of HIV drug resistance is challenged by heterogenous and inadequate data reporting, which compromises the accuracy, interpretation, and usability of prevalence estimates. Previous research has found that the quality of reporting in studies of HIV drug resistance prevalence is low, and thus better guidance is needed to ensure complete and uniform reporting. Objective This paper contributes to the process of developing reporting guidelines for prevalence studies of HIV drug resistance by reporting the methodology used in creating a reporting item checklist and generating key insights on items that are important to report. Methods We will conduct a sequential explanatory mixed methods study among authors and users of studies of HIV drug resistance. The two-phase design will include a cross-sectional electronic survey (quantitative phase) followed by a focus group discussion (qualitative phase). Survey participants will rate the essentiality of various reporting items. This data will be analyzed using content validity ratios to determine the items that will be retained for focus group discussions. Participants in these discussions will revise the items and any additionally suggested items and settle on a complete reporting item checklist. We will also conduct a thematic analysis of the group discussions to identify emergent themes regarding the agreement process. Results As of November 2021, data collection for both phases of the study is complete. In July 2021, 51 participants had provided informed consent and completed the electronic survey. In October 2021, focus group discussions were held. Nine participants in total participated in two virtual focus group discussions. As of May 2022, data are being analyzed. Conclusions This study supports the development of a reporting checklist for studies of HIV drug resistance by achieving agreement among experts on what items should be reported in these studies. The results of this work will be refined and elaborated on by a writing committee of HIV drug resistance experts and external reviewers to develop finalized reporting guidelines. International Registered Report Identifier (IRRID) DERR1-10.2196/35969
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Affiliation(s)
- Cristian Garcia
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Nadia Rehman
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Pascal Djiadeu
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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12
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Antequera A, Lawson DO, Noorduyn SG, Dewidar O, Avey M, Bhutta ZA, Chamberlain C, Ellingwood H, Francis D, Funnell S, Ghogomu E, Greer-Smith R, Horsley T, Juando-Prats C, Jull J, Kristjansson E, Little J, Nicholls SG, Nkangu M, Petticrew M, Rada G, Rizvi A, Shamseer L, Sharp MK, Tufte J, Tugwell P, Verdugo-Paiva F, Wang H, Wang X, Mbuagbaw L, Welch V. Improving Social Justice in COVID-19 Health Research: Interim Guidelines for Reporting Health Equity in Observational Studies. Int J Environ Res Public Health 2021; 18:9357. [PMID: 34501949 PMCID: PMC8431098 DOI: 10.3390/ijerph18179357] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.
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Affiliation(s)
- Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Daeria O. Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Stephen G. Noorduyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Omar Dewidar
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Marc Avey
- Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada;
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Institute for Global Health & Development, The Aga Khan University, Karachi 74800, Pakistan
| | - Catherine Chamberlain
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia;
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA 6150, Australia
| | - Holly Ellingwood
- Department of Psychology, Faculty of Arts and Social Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada;
- Public Safety, Ottawa, ON K1A 0P8, Canada
| | - Damian Francis
- Center for Health and Social Issues, School of Health and Human Performance, Georgia College, Milledgville, GA 31061, USA;
| | - Sarah Funnell
- Department of Family Medicine, Queen’s University, Kingston, ON K7L 3G2, Canada;
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/The S.T.A.R. Initiative, Los Angeles, CA 90033, USA;
| | - Tanya Horsley
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, ON K1S 5N8, Canada
| | - Clara Juando-Prats
- Applied Health Research Center, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada;
- Dalla School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Janet Jull
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada; (J.J.); (A.R.)
| | - Elizabeth Kristjansson
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Julian Little
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Stuart G. Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
| | - Miriam Nkangu
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago 7510299, Chile; (G.R.); (F.V.-P.)
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago Región Metropolitana, Santiago 8331150, Chile
| | - Anita Rizvi
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada; (J.J.); (A.R.)
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON M5B 1T8, Canada;
| | - Melissa K. Sharp
- Health Research Board Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin DO2 H638, Ireland;
| | | | - Peter Tugwell
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago 7510299, Chile; (G.R.); (F.V.-P.)
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago Región Metropolitana, Santiago 8331150, Chile
| | - Harry Wang
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Vivian Welch
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
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13
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Zeraatkar D, Bhasin A, Morassut RE, Churchill I, Gupta A, Lawson DO, Miroshnychenko A, Sirotich E, Aryal K, Mikhail D, Khan TA, Ha V, Sievenpiper JL, Hanna SE, Beyene J, de Souza RJ. Characteristics and quality of systematic reviews and meta-analyses of observational nutritional epidemiology: a cross-sectional study. Am J Clin Nutr 2021; 113:1578-1592. [PMID: 33740039 PMCID: PMC8243916 DOI: 10.1093/ajcn/nqab002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Dietary recommendations and policies should be guided by rigorous systematic reviews. Reviews that are of poor methodological quality may be ineffective or misleading. Most of the evidence in nutrition comes from nonrandomized studies of nutritional exposures (usually referred to as nutritional epidemiology studies), but to date methodological evaluations of the quality of systematic reviews of such studies have been sparse and inconsistent. OBJECTIVES We aimed to investigate the quality of recently published systematic reviews and meta-analyses of nutritional epidemiology studies and to propose guidance addressing major limitations. METHODS We searched MEDLINE (January 2018-August 2019), EMBASE (January 2018-August 2019), and the Cochrane Database of Systematic Reviews (January 2018-February 2019) for systematic reviews of nutritional epidemiology studies. We included a random sample of 150 reviews. RESULTS Most reviews were published by authors from Asia (n = 49; 32.7%) or Europe (n = 43; 28.7%) and investigated foods or beverages (n = 60; 40.0%) and cancer morbidity and mortality (n = 54; 36%). Reviews often had important limitations: less than one-quarter (n = 30; 20.0%) reported preregistration of a protocol and almost one-third (n = 42; 28.0%) did not report a replicable search strategy. Suboptimal practices and errors in the synthesis of results were common: one-quarter of meta-analyses (n = 30; 26.1%) selected the meta-analytic model based on statistical indicators of heterogeneity and almost half of meta-analyses (n = 50; 43.5%) did not consider dose-response associations even when it was appropriate to do so. Only 16 (10.7%) reviews used an established system to evaluate the certainty of evidence. CONCLUSIONS Systematic reviews of nutritional epidemiology studies often have serious limitations. Authors can improve future reviews by involving statisticians, methodologists, and researchers with substantive knowledge in the specific area of nutrition being studied and using a rigorous and transparent system to evaluate the certainty of evidence.
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Affiliation(s)
- Dena Zeraatkar
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada,Department of Biomedical Informatics, Harvard Medical
School, Boston, MA, USA
| | - Arrti Bhasin
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Rita E Morassut
- Schulich School of Medicine and Dentistry, Western
University, London, Ontario, Canada
| | - Isabella Churchill
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Arnav Gupta
- Department of Medicine, University of Ottawa,
Ottawa, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Anna Miroshnychenko
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Emily Sirotich
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Komal Aryal
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - David Mikhail
- Faculty of Science, McMaster University,
Hamilton, Ontario, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, Department of Medicine,
Temerty Faculty of Medicine, University of Toronto,
Toronto, Ontario, Canada,3D Knowledge Synthesis and Clinical Trials Unit, Clinical
Nutrition and Risk Factor Modification Centre, Division of Endocrinology
& Metabolism, St. Michael's Hospital,
Toronto, Ontario, Canada
| | - Vanessa Ha
- School of Medicine, Queen's University,
Kingston, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Department of Medicine,
Temerty Faculty of Medicine, University of Toronto,
Toronto, Ontario, Canada,3D Knowledge Synthesis and Clinical Trials Unit, Clinical
Nutrition and Risk Factor Modification Centre, Division of Endocrinology
& Metabolism, St. Michael's Hospital,
Toronto, Ontario, Canada
| | - Steven E Hanna
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
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14
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Mokbel A, Lawson DO, Farrokhyar F. Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review. Clin Rheumatol 2021; 40:3465-3480. [PMID: 33464430 DOI: 10.1007/s10067-021-05588-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
In this scoping review, we sought to summarize the types of outcomes collected in pregnant patients with ankylosing spondylitis (AS), and to identify some methodological limitations related to pregnancy research in these patients. A comprehensive search was done to identify relevant articles in MEDLINE and Embase. We included 21 studies assessing pregnancy outcomes in AS. Most studies reported disease flare during pregnancy, and few reported improved disease activity or stable disease. Disease flare occurred in 25-80% of patients during pregnancy and in 30-100% during the postpartum. There was no increased risk of pre-eclampsia across all studies. Based on two case-control studies, there was an increased risk for prematurity and small for gestational age in AS pregnancies, pooled odds ratio (95% confidence interval) 1.99 (1.30-3.05) and 2.41 (1.22-4.77), respectively. The etiologies of cesarean section were not related to joint issues from AS but were related to other causes like pre-eclampsia and prematurity. Some key methodological issues were related to the study design, selection of study participants, disease classification, choice of control participants, and outcome measures. Based on the current literature review, some key areas for future research should evaluate the disease state at conception, effects of pharmacological treatment for AS during pregnancy, and long-term outcomes of children born to women with AS. The use of pregnancy registers and validated measurement tools in pregnancy will help to improve the state and quality of evidence in this field. Key Points • Disease flare during pregnancy in patients with ankylosing spondylitis (AS) occurred in 25-80% of the cases in the various studies, and in 30-100% of the cases during the postpartum period. • There was an increased risk for prematurity, and no increased risk of pre-eclampsia or small for gestational age. Etiologies of cesarean section were not related to the hip or sacroiliac joint affection of the disease but to other causes like pre-eclampsia and prematurity. • This study provides a comprehensive overview of issues related to research on pregnant women with ankylosing spondylitis (AS). We addressed methodological issues related to the study design, selection of study participants, disease classification, control choice, assessment of outcomes measures, and statistical analysis. • The use of pregnancy registers and validated disease activity measurement tools for pregnancy can enhance pregnancy research in women with AS.
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Affiliation(s)
- Abir Mokbel
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. .,Department of Rheumatology, Cairo University, Giza, Egypt.
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Division of Rheumatology, Toronto Western Hospital, Toronto, ON, Canada
| | - Forough Farrokhyar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Surgery, McMaster University, Hamilton, ON, Canada
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15
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Lawson DO, Puljak L, Pieper D, Schandelmaier S, Collins GS, Brignardello-Petersen R, Moher D, Tugwell P, Welch VA, Samaan Z, Thombs BD, Nørskov AK, Jakobsen JC, Allison DB, Mayo-Wilson E, Young T, Chan AW, Briel M, Guyatt GH, Thabane L, Mbuagbaw L. Reporting of methodological studies in health research: a protocol for the development of the MethodologIcal STudy reportIng Checklist (MISTIC). BMJ Open 2020; 10:e040478. [PMID: 33334836 PMCID: PMC7747548 DOI: 10.1136/bmjopen-2020-040478] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/05/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Methodological studies (ie, studies that evaluate the design, conduct, analysis or reporting of other studies in health research) address various facets of health research including, for instance, data collection techniques, differences in approaches to analyses, reporting quality, adherence to guidelines or publication bias. As a result, methodological studies can help to identify knowledge gaps in the methodology of health research and strategies for improvement in research practices. Differences in methodological study names and a lack of reporting guidance contribute to lack of comparability across studies and difficulties in identifying relevant previous methodological studies. This paper outlines the methods we will use to develop an evidence-based tool-the MethodologIcal STudy reportIng Checklist-to harmonise naming conventions and improve the reporting of methodological studies. METHODS AND ANALYSIS We will search for methodological studies in the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, MEDLINE, Web of Science, check reference lists and contact experts in the field. We will extract and summarise data on the study names, design and reporting features of the included methodological studies. Consensus on study terms and recommended reporting items will be achieved via video conference meetings with a panel of experts including researchers who have published methodological studies. ETHICS AND DISSEMINATION The consensus study has been exempt from ethics review by the Hamilton Integrated Research Ethics Board. The results of the review and the reporting guideline will be disseminated in stakeholder meetings, conferences, peer-reviewed publications, in requests to journal editors (to endorse or make the guideline a requirement for authors), and on the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and reporting guideline websites. REGISTRATION We have registered the development of the reporting guideline with the EQUATOR Network and publicly posted this project on the Open Science Framework (www.osf.io/9hgbq).
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Affiliation(s)
- Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Witten/Herdecke University, Cologne, Germany
| | - Stefan Schandelmaier
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, Faculty of Medicine and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Vivian A Welch
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Zainab Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brett D Thombs
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Anders K Nørskov
- Copenhagen Trial Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus C Jakobsen
- Copenhagen Trial Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Odense, Denmark
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Evan Mayo-Wilson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Taryn Young
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Matthias Briel
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, and Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre and Centre for Evaluation of Medicine, Saint Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, Saint Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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16
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Baldeh T, MacDonald T, Kosa SD, Lawson DO, Stalteri R, Olaiya OR, Alotaibi A, Thabane L, Mbuagbaw L. More pilot trials could plan to use qualitative data: a meta-epidemiological study. Pilot Feasibility Stud 2020; 6:164. [PMID: 33292715 PMCID: PMC7597013 DOI: 10.1186/s40814-020-00712-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 10/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Pilot trials often use quantitative data such as recruitment rate and retention rate to inform the design and feasibility of a larger trial. However, qualitative data such as patient, healthcare provider, and research staff perceptions of an intervention may also provide insights for a larger trial. Methods As part of a larger study investigating the reporting of progression criteria in pilot studies, we sought to determine how often pilot studies planned to use qualitative data to inform the design and feasibility of a larger trial and the factors associated with plans to use qualitative data. We searched for protocols of pilot studies of randomized trials in PubMed between 2013 and 2017. Results We included 227 articles. Only 92 (40.5%; 95% confidence interval [CI] 34.1–47.2) reported plans to collect qualitative data. The factors associated with collecting qualitative data were large studies (defined as sample size ≥ 60; adjusted odds ratio [aOR] 2.77; 95% CI 1.47–5.23; p = 0.002) and studies from Europe (aOR 3.86; 95% CI 1.68–8.88; p = 0.001) compared to North America and the rest of the world. Pilot trials with pharmacological interventions were less likely to plan to collect qualitative data (aOR 0.20; 95% CI 0.07–0.58; p = 0.003). Conclusions Qualitative data is not used enough in pilot trials. Large pilot trials, pilot trials from Europe, and pilot trials of non-pharmacological interventions are more likely to plan for qualitative data.
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Affiliation(s)
- Tejan Baldeh
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.
| | - Tonya MacDonald
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.,School of Midwifery, Laurentian University, Sudbury, ON, Canada
| | - Sarah Daisy Kosa
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.,Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada
| | - Rosa Stalteri
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada
| | - Oluwatobi R Olaiya
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahlam Alotaibi
- Department of Pediatrics, Princess Noura University, Riyadh, Saudi Arabia
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, ON, Canada.,Centre for Evaluation of Medicine, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Centre for the Development of Best Practices in Health, Yaounde, Cameroon
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Mbuagbaw L, Hajizadeh A, Wang A, Mertz D, Lawson DO, Smieja M, Benoit AC, Alvarez E, Puchalski Ritchie L, Rachlis B, Logie C, Husbands W, Margolese S, Zani B, Thabane L. Overview of systematic reviews on strategies to improve treatment initiation, adherence to antiretroviral therapy and retention in care for people living with HIV: part 1. BMJ Open 2020; 10:e034793. [PMID: 32967868 PMCID: PMC7513605 DOI: 10.1136/bmjopen-2019-034793] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 07/01/2020] [Accepted: 08/07/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES We sought to map the evidence and identify interventions that increase initiation of antiretroviral therapy, adherence to antiretroviral therapy and retention in care for people living with HIV at high risk for poor engagement in care. METHODS We conducted an overview of systematic reviews and sought for evidence on vulnerable populations (men who have sex with men (MSM), African, Caribbean and Black (ACB) people, sex workers (SWs), people who inject drugs (PWID) and indigenous people). We searched PubMed, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science and the Cochrane Library in November 2018. We screened, extracted data and assessed methodological quality in duplicate and present a narrative synthesis. RESULTS We identified 2420 records of which only 98 systematic reviews were eligible. Overall, 65/98 (66.3%) were at low risk of bias. Systematic reviews focused on ACB (66/98; 67.3%), MSM (32/98; 32.7%), PWID (6/98; 6.1%), SWs and prisoners (both 4/98; 4.1%). Interventions were: mixed (37/98; 37.8%), digital (22/98; 22.4%), behavioural or educational (9/98; 9.2%), peer or community based (8/98; 8.2%), health system (7/98; 7.1%), medication modification (6/98; 6.1%), economic (4/98; 4.1%), pharmacy based (3/98; 3.1%) or task-shifting (2/98; 2.0%). Most of the reviews concluded that the interventions effective (69/98; 70.4%), 17.3% (17/98) were neutral or were indeterminate 12.2% (12/98). Knowledge gaps were the types of participants included in primary studies (vulnerable populations not included), poor research quality of primary studies and poorly tailored interventions (not designed for vulnerable populations). Digital, mixed and peer/community-based interventions were reported to be effective across the continuum of care. CONCLUSIONS Interventions along the care cascade are mostly focused on adherence and do not sufficiently address all vulnerable populations.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Centre for the Develoment of Best Practices in Health, Yaounde Central Hospital, Yaounde, Cameroon
| | - Anisa Hajizadeh
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Annie Wang
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dominik Mertz
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Rheumatology, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Marek Smieja
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anita C Benoit
- Women's College Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada
| | - Lisa Puchalski Ritchie
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Beth Rachlis
- Division of Clinical Public Health, Dalla Lana School of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Carmen Logie
- Women's College Research Institute, Toronto, Ontario, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Shari Margolese
- Canadian HIV Trials Network Community Advisory Committee, Vancouver, British Columbia, Canada
| | - Babalwa Zani
- Knowledge Translation Unit, University of Cape Town Lung Institute, Rondebosch, Western Cape, South Africa
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Pediatrics and Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicine, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Mbuagbaw L, Lawson DO, Puljak L, Allison DB, Thabane L. A tutorial on methodological studies: the what, when, how and why. BMC Med Res Methodol 2020; 20:226. [PMID: 32894052 PMCID: PMC7487909 DOI: 10.1186/s12874-020-01107-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/27/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Methodological studies - studies that evaluate the design, analysis or reporting of other research-related reports - play an important role in health research. They help to highlight issues in the conduct of research with the aim of improving health research methodology, and ultimately reducing research waste. MAIN BODY We provide an overview of some of the key aspects of methodological studies such as what they are, and when, how and why they are done. We adopt a "frequently asked questions" format to facilitate reading this paper and provide multiple examples to help guide researchers interested in conducting methodological studies. Some of the topics addressed include: is it necessary to publish a study protocol? How to select relevant research reports and databases for a methodological study? What approaches to data extraction and statistical analysis should be considered when conducting a methodological study? What are potential threats to validity and is there a way to appraise the quality of methodological studies? CONCLUSION Appropriate reflection and application of basic principles of epidemiology and biostatistics are required in the design and analysis of methodological studies. This paper provides an introduction for further discussion about the conduct of methodological studies.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Biostatistics Unit/FSORC, 50 Charlton Avenue East, St Joseph's Healthcare-Hamilton, 3rd Floor Martha Wing, Room H321, Hamilton, Ontario, L8N 4A6, Canada.
- Centre for the Development of Best Practices in Health, Yaoundé, Cameroon.
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, IN, 47405, USA
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit/FSORC, 50 Charlton Avenue East, St Joseph's Healthcare-Hamilton, 3rd Floor Martha Wing, Room H321, Hamilton, Ontario, L8N 4A6, Canada
- Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, ON, Canada
- Centre for Evaluation of Medicine, St. Joseph's Healthcare-Hamilton, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
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Mbuagbaw L, Tharao W, Husbands W, Nelson LE, Aden M, Arnold K, Baidoobonso S, Dabone C, Dryden O, Etowa E, Hamid J, Jackson-Best F, Kohoun B, Lawson DO, Lofters AK, Luyombya H, Mbulaheni T, Mkandawire P, Ndungu M, Nyambi A, Obiorah S, Ongoiba F, Ongolo-Zogo C, Oraka C, Shahin R, Yaya S, Hendricks A, Gebremeskel A, Inoua H, Etowa J. A/C study protocol: a cross-sectional study of HIV epidemiology among African, Caribbean and Black people in Ontario. BMJ Open 2020; 10:e036259. [PMID: 32641329 PMCID: PMC7348322 DOI: 10.1136/bmjopen-2019-036259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION African, Caribbean and Black (ACB) communities are disproportionately infected by HIV in Ontario, Canada. They constitute only 5% of the population of Ontario yet account for 25% of new diagnoses of HIV. The aim of this study is to understand underlying factors that augment the HIV risk in ACB communities and to inform policy and practice in Ontario. METHODS AND ANALYSIS We will conduct a cross-sectional study of first-generation and second-generation ACB adults aged 15-64 in Toronto (n=1000) and Ottawa (n=500) and collect data on sociodemographic information, sexual behaviours, substance use, blood donation, access and use of health services and HIV-related care. We will use dried blood spot testing to determine the incidence and prevalence of HIV infection among ACB people, and link participant data to administrative databases to investigate health service access and use. Factors associated with key outcomes (HIV infection, testing behaviours, knowledge about HIV transmission and acquisition, HIV vulnerability, access and use of health services) will be evaluated using generalised linear mixed models, adjusted for relevant covariates. ETHICS AND DISSEMINATION This study has been reviewed and approved by the following Research Ethics Boards: Toronto Public Health, Ottawa Public Health, Laurentian University; the University of Ottawa and the University of Toronto. Our findings will be disseminated as community reports, fact sheets, digital stories, oral and poster presentations, peer-reviewed manuscripts and social media.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada
| | | | - Laron E Nelson
- School of Nursing, Yale University, West Haven, Connecticut, USA
| | - Muna Aden
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada
| | - Keresa Arnold
- African and Caribbean Council on HIV/AIDS in Ontario, Toronto, Ontario, Canada
| | - Shamara Baidoobonso
- African and Caribbean Council on HIV/AIDS in Ontario, Toronto, Ontario, Canada
| | - Charles Dabone
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - OmiSoore Dryden
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Egbe Etowa
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jemila Hamid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Bagnini Kohoun
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Aisha K Lofters
- St Michael's Hospital Centre for Urban Health Solutions, Toronto, Ontario, Canada
| | | | - Tola Mbulaheni
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Mary Ndungu
- Africans in Partnership, Toronto, Ontario, Canada
| | - Agatha Nyambi
- Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Suzanne Obiorah
- Somerset West Community Health Centre, Ottawa, Ontario, Canada
| | | | - Clémence Ongolo-Zogo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Rita Shahin
- Toronto Public Health, Toronto, Ontario, Canada
| | - Sanni Yaya
- Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Aster Gebremeskel
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Haoua Inoua
- AIDS Commitee of Ottawa, Ottawa, Ontario, Canada
| | - Josephine Etowa
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Lawson DO, Eraso M, Mbuagbaw L, Joanes M, Aves T, Leenus A, Omar A, Inman RD. Tumor Necrosis Factor Inhibitor Dose Reduction for Axial Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Arthritis Care Res (Hoboken) 2020; 73:861-872. [PMID: 32166872 DOI: 10.1002/acr.24184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/03/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The present study was undertaken to investigate the effectiveness and safety of dose reduction of tumor necrosis factor inhibitor (TNFi) therapy in the treatment of axial spondyloarthritis (SpA) compared to usual care. METHODS We searched the Cochrane Central Register of Controlled Trials, Embase, Medline, and trial registries. We screened, extracted data, and assessed risk of bias in duplicate. Data were pooled using random-effects models; subgroup analyses were performed for type of TNFi, prior TNFi exposure, and follow-up duration. Outcomes of interest were Assessment of SpondyloArthritis international Society (ASAS) response and remission criteria, disease activity, relapse, and safety. RESULTS We included 6 randomized trials with 747 participants (442 with ankylosing spondylitis and 305 with nonradiographic axial SpA). Compared to the standard dose, there were fewer events with the reduced dose for the ASAS criteria for 40% improvement (risk ratio [RR] 0.62 [95% confidence interval (95% CI) 0.49, 0.78]) and for ASAS partial remission (RR 0.17 [95% CI 0.06, 0.46]). There was a mean increase in the Bath Ankylosing Spondylitis Disease Activity Index score (mean difference [MD] 0.35 [95% CI 0.10, 0.60]) and no difference in C-reactive protein levels (MD 0.16 [95% CI -0.76, 1.07]) with the reduced dose. There were more disease flares/relapses (RR 1.73 [95% CI 1.32, 2.27]) with the reduced dose. There were no differences in infection rates (incidence rate ratio [IRR] 0.98 [95% CI 0.76, 1.25]) or injection/infusion reactions (IRR 0.71 [95% CI 0.42, 1.19]). CONCLUSION Patients with axial SpA may experience little to no clinical benefit from reduction of TNFi therapy. Maintaining the standard dose probably improves the sustained effect on disease activity and helps to prevent disease flare.
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Affiliation(s)
- Daeria O Lawson
- McMaster University, Hamilton, and Toronto Western Hospital, Toronto, Ontario, Canada
| | - Maria Eraso
- Toronto Western Hospital, Toronto, Ontario, Canada
| | - Lawrence Mbuagbaw
- McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Theresa Aves
- St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Ahmed Omar
- Toronto Western Hospital, Toronto, Ontario, Canada
| | - Robert D Inman
- Toronto Western Hospital, University of Toronto, and Toronto Western Hospital, Toronto, Ontario, Canada
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Lawson DO, Leenus A, Mbuagbaw L. Mapping the nomenclature, methodology, and reporting of studies that review methods: a pilot methodological review. Pilot Feasibility Stud 2020; 6:13. [PMID: 32699641 PMCID: PMC7003412 DOI: 10.1186/s40814-019-0544-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023] Open
Abstract
Background A relatively novel method of appraisal, methodological reviews (MRs) are used to synthesize information on the methods used in health research. There are currently no guidelines available to inform the reporting of MRs. Objectives This pilot review aimed to determine the feasibility of a full review and the need for reporting guidance for methodological reviews. Methods Search strategy: We conducted a search of PubMed, restricted to 2017 to include the most recently published studies, using different search terms often used to describe methodological reviews: "literature survey" OR "meta-epidemiologic* review" OR "meta-epidemiologic* survey" OR "methodologic* review" OR "methodologic* survey" OR "systematic survey."Data extraction: Study characteristics including country, nomenclature, number of included studies, search strategy, a priori protocol use, and sampling methods were extracted in duplicate and summarized.Outcomes: Primary feasibility outcomes were the sensitivity and specificity of the search terms (criteria for success of feasibility set at sensitivity and specificity of ≥ 70%).Analysis: The estimates are reported as a point estimate (95% confidence interval). Results Two hundred thirty-six articles were retrieved and 31 were included in the final analysis. The most accurate search term was "meta-epidemiological" (sensitivity [Sn] 48.39; 95% CI 31.97-65.16; specificity [Sp] 97.56; 94.42-98.95). The majority of studies were published by authors from Canada (n = 12, 38.7%), and Japan and USA (n = 4, 12.9% each). The median (interquartile range [IQR]) number of included studies in the MRs was 77 (13-1127). Reporting of a search strategy was done in most studies (n = 23, 74.2%). The use of a pre-published protocol (n = 7, 22.6%) or a justifiable sampling method (n = 5, 16.1%) occurred rarely. Conclusions Using the MR nomenclature identified, it is feasible to build a comprehensive search strategy and conduct a full review. Given the variation in reporting practices and nomenclature attributed to MRs, there is a need for guidance on standardized and transparent reporting of MRs. Future guideline development would likely include stakeholders from Canada, USA, and Japan.
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Affiliation(s)
- Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Alvin Leenus
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 4A6 Canada
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Mbuagbaw L, Kosa SD, Lawson DO, Stalteri R, Olaiya OR, Alotaibi A, Thabane L. The reporting of progression criteria in protocols of pilot trials designed to assess the feasibility of main trials is insufficient: a meta-epidemiological study. Pilot Feasibility Stud 2019; 5:120. [PMID: 31700654 PMCID: PMC6827233 DOI: 10.1186/s40814-019-0500-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Pilot and feasibility trials are conducted to determine feasibility or to collect information that would inform the design of a larger definitive trial. Clear progression criteria are required to determine if a definitive or main trial is feasible and how it should be designed. We sought to determine how often progression criteria are reported and the associated factors. Methods We conducted a methodological review of protocols for pilot randomised trials published in three journals that publish research protocols (BMJ Open, Trials, Pilot and Feasibility Studies), using a PubMed search (2013–2017). We extracted bibliometric information including the country in which the study was conducted, source of funding, type of intervention, use of a primary feasibility outcome, sample size reporting, and justification. We used generalised linear models to determine the factors associated with reporting progression criteria. Results Our search retrieved 276 articles, of which 49 were not eligible. We included 227 articles. Overall, 45/227 (19.8%; 95% confidence interval [CI] 14.8–25.6) reported progression criteria. Protocols published in more recent years were significantly associated with higher odds of reporting progression criteria (adjusted odds ratio [aOR] 1.40; 95% CI 1.03–1.92; p = 0.034). Pilot trials from Europe (aOR 0.19; 95% CI 0.08–0.48; p < 0.001) and the rest of the world (aOR 0.05; 95% CI 0.01–0.18; p < 0.003) compared to North America were significantly associated with lower odds of reporting progression criteria. Journal, source of funding, sample size, intervention type, and having a primary outcome related to feasibility were not significantly associated with reporting progression criteria. Conclusion Progression criteria are not often explicitly stated in protocols of pilot trials leaving room for varied interpretation of findings. The development of formal guidance for progression criteria in protocols of pilot trials is warranted.
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Affiliation(s)
- Lawrence Mbuagbaw
- 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada.,2Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, 50 Charlton Avenue East, 3rd Floor Martha Wing, Room H321, Hamilton, ON L8N 4A6 Canada.,Centre for the Development of Best Practices in Health, Yaoundé, Cameroon
| | - Sarah Daisy Kosa
- 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada.,4Toronto General Hospital, University Health Network, Toronto, ON Canada
| | - Daeria O Lawson
- 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
| | - Rosa Stalteri
- 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
| | - Oluwatobi R Olaiya
- 5Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada
| | - Ahlam Alotaibi
- 6Department of Pediatrics, McMaster University, Hamilton, ON Canada
| | - Lehana Thabane
- 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada.,2Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, 50 Charlton Avenue East, 3rd Floor Martha Wing, Room H321, Hamilton, ON L8N 4A6 Canada.,7Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, ON Canada.,8Centre for Evaluation of Medicine, St Joseph's Healthcare-Hamilton, Hamilton, ON Canada.,9Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON Canada
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Zeraatkar D, Cheung K, Milio K, Zworth M, Gupta A, Bhasin A, Bartoszko JJ, Kiflen M, Morassut RE, Noor ST, Lawson DO, Johnston BC, Bangdiwala SI, de Souza RJ. Methods for the Selection of Covariates in Nutritional Epidemiology Studies: A Meta-Epidemiological Review. Curr Dev Nutr 2019; 3:nzz104. [PMID: 31598577 PMCID: PMC6778415 DOI: 10.1093/cdn/nzz104] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/05/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Observational studies provide important information about the effects of exposures that cannot be easily studied in clinical trials, such as nutritional exposures, but are subject to confounding. Investigators adjust for confounders by entering them as covariates in analytic models. OBJECTIVE The aim of this study was to evaluate the reporting and credibility of methods for selection of covariates in nutritional epidemiology studies. METHODS We sampled 150 nutritional epidemiology studies published in 2007/2008 and 2017/2018 from the top 5 high-impact nutrition and medical journals and extracted information on methods for selection of covariates. RESULTS Most studies did not report selecting covariates a priori (94.0%) or criteria for selection of covariates (63.3%). There was general inconsistency in choice of covariates, even among studies investigating similar questions. One-third of studies did not acknowledge potential for residual confounding in their discussion. CONCLUSION Studies often do not report methods for selection of covariates, follow available guidance for selection of covariates, nor discuss potential for residual confounding.
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Affiliation(s)
- Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Kevin Cheung
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kirolos Milio
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Max Zworth
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Arnav Gupta
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Arrti Bhasin
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jessica J Bartoszko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Michel Kiflen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Rita E Morassut
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Salmi T Noor
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Bradley C Johnston
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
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Passalent L, Hawke C, Lawson DO, Omar A, Alnaqbi KA, Wallis D, Steinhart H, Silverberg M, Wolman S, Derzko-Dzulynsky L, Haroon N, Inman RD. Advancing Early Identification of Axial Spondyloarthritis: An Interobserver Comparison of Extended Role Practitioners and Rheumatologists. J Rheumatol 2019; 47:524-530. [PMID: 31043543 DOI: 10.3899/jrheum.180787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/09/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare clinical impression and confidence of extended role practitioners (ERP) with those of rheumatologists experienced in axial spondyloarthritis (axSpA) according to (1) evaluation of patients with chronic back pain assessed for axSpA; and (2) magnetic resonance imaging (MRI) recommendation for further investigation of these patients. METHODS Patients with ≥ 3 months of back pain and age of onset < 45 years were referred for axSpA evaluation. An ERP assessed consecutive patients and recorded standardized clinical information in written form. Three rheumatologists subsequently evaluated each patient based on the recorded information. Patients were classified as having axSpA or mechanical back pain based on clinical and investigative findings. Level of confidence was noted for classification and MRI indication. Agreement between assessors was evaluated using percentage agreement and κ coefficient. RESULTS Fifty-seven patients were assessed. Interobserver agreement of clinical impression for all raters was moderate (κ = 0.52). Agreement of clinical impression between ERP and rheumatologists ranged between 71.2% (κ = 0.41) and 79.7% (κ = 0.57). Agreement of clinical impression among rheumatologists ranged from 74.1% (κ = 0.49) to 79.7% (κ = 0.58). All rater agreement for MRI indication was fair (κ = 0.37). ERP agreement with rheumatologist for MRI recommendation ranged from 64.2% (κ = 0.32) to 75% (κ = 0.48). Agreement for MRI indication among rheumatologists ranged from 62.9% (κ = 0.27) to 74% (κ = 0.47). Confidence in clinical impression was similar among all practitioners. CONCLUSION ERP with specialty training in inflammatory arthritis demonstrate clinical impressions comparable with those of rheumatologists in the assessment of axSpA. Incorporation of such roles into existing models of care may assist in early detection of axSpA.
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Affiliation(s)
- Laura Passalent
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada. .,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute.
| | - Christopher Hawke
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Daeria O Lawson
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Ahmed Omar
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Khalid A Alnaqbi
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Dinny Wallis
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Hillary Steinhart
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Mark Silverberg
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Stephen Wolman
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Larissa Derzko-Dzulynsky
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Nigil Haroon
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
| | - Robert D Inman
- From the Spondylitis Program, Toronto Western Hospital; and Faculty of Medicine, University of Toronto, Krembil Research Institute, Toronto, Ontario, Canada.,L. Passalent, MHSc, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; C. Hawke, BSc Hons (PT), Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; D.O. Lawson, HBSc, Spondylitis Program, Toronto Western Hospital; A. Omar, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto; K.A. Alnaqbi, MD, Rheumatology Division, Al Ain Hospital, United Arab Emirates; D. Wallis, MD, University Hospital Southampton, Southampton, UK; H. Steinhart, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; M. Silverberg, MD, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto; S. Wolman, MD, Faculty of Medicine, University of Toronto, Toronto General Hospital, Toronto; L. Derzko-Dzulynsky, MD, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Toronto; N. Haroon, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute; R.D. Inman, MD, Spondylitis Program, Toronto Western Hospital, Faculty of Medicine, University of Toronto, Krembil Research Institute
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Mbuagbaw L, Mertz D, Lawson DO, Smieja M, Benoit AC, Alvarez E, Puchalski Ritchie L, Rachlis B, Logie C, Husbands W, Margolese S, Thabane L. Strategies to improve adherence to antiretroviral therapy and retention in care for people living with HIV in high-income countries: a protocol for an overview of systematic reviews. BMJ Open 2018; 8:e022982. [PMID: 30206089 PMCID: PMC6144485 DOI: 10.1136/bmjopen-2018-022982] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION While access to antiretroviral therapy (ART) for people living with HIV has expanded in recent years, additional efforts are required to support adherence to medication and retention in care. Interventions should be applicable in real-world settings and amenable to widespread use. The objectives of this overview are to identify effective pragmatic interventions that increase adherence to ART and retention in care for people living with HIV at high risk for suboptimal adherence and retention in high-income countries. METHODS AND ANALYSIS We will conduct an overview of systematic reviews of studies on interventions which target improved adherence to medication and retention in care among high-risk people living with HIV in high-income countries (men who have sex with men, African, Caribbean and black people, sex workers, people who inject drugs, indigenous people and other socially marginalised groups). We will search the following databases: PubMed, EMBASE (Exerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, Web of Science and the Cochrane Library. We will conduct screening, data extraction and assessment of methodological quality of the systematic reviews. Analysis will be narrative. Our findings will be interpreted in light of the certainty of the evidence, level of pragmatism, setting and population of interest. ETHICS AND DISSEMINATION Only published secondary data will be used in this study, and therefore ethics approval is not required. Our findings will be disseminated as peer-reviewed manuscripts, conference abstracts and through community activities. The findings from this overview will inform a mixed-methods study among people living with HIV and health workers in Ontario, Canada.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Dominik Mertz
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Marek Smieja
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anita C Benoit
- Women’s College Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada
| | - Lisa Puchalski Ritchie
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, Ontario, Canada
| | - Beth Rachlis
- The Ontario HIV Treatment Network, Toronto, Ontario, Canada
- Dignitas International, Toronto, Ontario, Canada
- Division of Clinical Public Health, Dalla Lana School of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Shari Margolese
- Canadian HIV Trials Network Community Advisory Committee, Toronto, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicine, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Mbuagbaw L, Morgano GP, Lawson DO, Nyambi A, Youssef M, Olaiya O, Thabane L. Subgroup analyses are seldom possible and subgroup effects are rare in Cochrane HIV systematic reviews. J Clin Epidemiol 2018; 104:143-144. [PMID: 30138701 DOI: 10.1016/j.jclinepi.2018.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 06/25/2018] [Accepted: 08/12/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 4A6, Canada; Centre for the Development of Best Practices in Health, Yaoundé, Cameroon.
| | - Gian Paolo Morgano
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Agatha Nyambi
- The Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Mark Youssef
- Bachelor of Health Sciences (Honors) Program, McMaster University, Hamilton, Ontario, Canada
| | - Oluwatobi Olaiya
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 4A6, Canada; Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, Ontario, Canada; Centre for Evaluation of Medicine, St Joseph's Healthcare, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Pan P, Lawson DO, Dudin A, Vasquez OE, Sokolowski MB, Fleming AS, McGowan PO. Both maternal care received and genotype influence stress-related phenotype in female rats. Dev Psychobiol 2018; 60:889-902. [DOI: 10.1002/dev.21770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/11/2018] [Accepted: 07/05/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Pauline Pan
- Department of Biological Sciences; University of Toronto Scarborough; Toronto Ontario Canada
- Department of Psychology; University of Toronto; Toronto Ontario Canada
- Department of Cell and Systems Biology; University of Toronto; Toronto Ontario Canada
| | - Daeria O. Lawson
- Department of Psychology; University of Toronto; Toronto Ontario Canada
| | - Aya Dudin
- Department of Psychology; University of Toronto; Toronto Ontario Canada
| | - Oscar E. Vasquez
- Department of Ecology and Evolutionary Biology; University of Toronto; Toronto Ontario Canada
| | - Marla B. Sokolowski
- Department of Ecology and Evolutionary Biology; University of Toronto; Toronto Ontario Canada
| | - Alison S. Fleming
- Department of Psychology; University of Toronto; Toronto Ontario Canada
| | - Patrick O. McGowan
- Department of Biological Sciences; University of Toronto Scarborough; Toronto Ontario Canada
- Department of Psychology; University of Toronto; Toronto Ontario Canada
- Department of Cell and Systems Biology; University of Toronto; Toronto Ontario Canada
- Department of Physiology, Faculty of Medicine; University of Toronto; Toronto Ontario Canada
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