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Dewidar O, McHale G, Al Zubaidi A, Bondok M, Abdelrazeq L, Huang J, Jearvis A, Aliyeva K, Alghamyan A, Jahel F, Greer-Smith R, Tufte J, Barker LC, Elmestekawy N, Sharp MK, Horsley T, Prats CJ, Jull J, Wolfenden L, Cuervo LG, Hardy BJ, Roberts JH, Ghogomu E, Obuku E, Owusu-Addo E, Nicholls SG, Mbuagbaw L, Funnell S, Shea B, Rizvi A, Tugwell P, Bhutta Z, Welch V, Melendez-Torres GJ. Motivations for investigating health inequities in observational epidemiology: a content analysis of 320 studies. J Clin Epidemiol 2024; 168:111283. [PMID: 38369078 DOI: 10.1016/j.jclinepi.2024.111283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To enhance equity in clinical and epidemiological research, it is crucial to understand researcher motivations for conducting equity-relevant studies. Therefore, we evaluated author motivations in a randomly selected sample of equity-relevant observational studies published during the COVID-19 pandemic. STUDY DESIGN AND SETTING We searched MEDLINE for studies from 2020 to 2022, resulting in 16,828 references. We randomly selected 320 studies purposefully sampled across income setting (high vs low-middle-income), COVID-19 topic (vs non-COVID-19), and focus on populations experiencing inequities. Of those, 206 explicitly mentioned motivations which we analyzed thematically. We used discourse analysis to investigate the reasons behind emerging motivations. RESULTS We identified the following motivations: (1) examining health disparities, (2) tackling social determinants to improve access, and (3) addressing knowledge gaps in health equity. Discourse analysis showed motivations stem from commitments to social justice and recognizing the importance of highlighting it in research. Other discourses included aspiring to improve health-care efficiency, wanting to understand cause-effect relationships, and seeking to contribute to an equitable evidence base. CONCLUSION Understanding researchers' motivations for assessing health equity can aid in developing guidance that tailors to their needs. We will consider these motivations in developing and sharing equity guidance to better meet researchers' needs.
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Affiliation(s)
- Omar Dewidar
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Bruyère Research Institute, University of Ottawa, Ottawa, Canada.
| | - Georgia McHale
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Ali Al Zubaidi
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Medicine, University College Cork, Cork, Ireland
| | - Mostafa Bondok
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Leenah Abdelrazeq
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Department of Health Sciences, Carelton University, Ottawa, Canada
| | - Jimmy Huang
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Alyssa Jearvis
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Khadija Aliyeva
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Amjad Alghamyan
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Fatima Jahel
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | | | | | - Lucy C Barker
- Department of Psychiatry, University of Toronto, Toronto, Canada; Women's College Hospital, Toronto, Canada
| | - Nour Elmestekawy
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Melissa K Sharp
- Department of General Practice, Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Clara Juandro Prats
- Applied Health Research Center, St. Michael's Hospital, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Luke Wolfenden
- Cochrane Public Health, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia
| | - Luis Gabriel Cuervo
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization (PAHO/WHO), Washington, DC, USA; Department of Paediatrics, Obstetrics & Gynaecology, and Preventive Medicine, Doctoral School, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Billie-Jo Hardy
- Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Hatchet Roberts
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa, Canada
| | | | - Ekwaro Obuku
- Africa Centre for Systematic Reviews & Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sarah Funnell
- Department of Family Medicine, Queen's University, Kingston, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bev Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada; Centre for Excellence in Women and Child Health and Institute of Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Clyne B, Sharp MK, O' Neill M, Pollock D, Lynch R, Amog K, Ryan M, Smith SM, Mahtani K, Booth A, Godfrey C, Munn Z, Tricco AC. An international modified Delphi process supported updating the web-based "right review" tool. J Clin Epidemiol 2024; 170:111333. [PMID: 38522755 DOI: 10.1016/j.jclinepi.2024.111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES The proliferation of evidence synthesis methods makes it challenging for reviewers to select the ''right'' method. This study aimed to update the Right Review tool (a web-based decision support tool that guides users through a series of questions for recommending evidence synthesis methods) and establish a common set of questions for the synthesis of both quantitative and qualitative studies (https://rightreview.knowledgetranslation.net/). STUDY DESIGN AND SETTING A 2-round modified international electronic modified Delphi was conducted (2022) with researchers, health-care providers, patients, and policy makers. Panel members rated the importance/clarity of the Right Review tool's guiding questions, evidence synthesis type definitions and tool output. High agreement was defined as at least 70% agreement. Any items not reaching high agreement after round 2 were discussed by the international Project Steering Group. RESULTS Twenty-four experts from 9 countries completed round 1, with 12 completing round 2. Of the 46 items presented in round 1, 21 reached high agreement. Twenty-seven items were presented in round 2, with 8 reaching high agreement. The Project Steering Group discussed items not reaching high agreement, including 8 guiding questions, 9 review definitions (predominantly related to qualitative synthesis), and 2 output items. Three items were removed entirely and the remaining 16 revised and edited and/or combined with existing items. The final tool comprises 42 items; 9 guiding questions, 25 evidence synthesis definitions and approaches, and 8 tool outputs. CONCLUSION The freely accessible Right Review tool supports choosing an appropriate review method. The design and clarity of this tool was enhanced by harnessing the Delphi technique to shape ongoing development. The updated tool is expected to be available in Quarter 1, 2025.
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Affiliation(s)
- Barbara Clyne
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Melissa K Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Danielle Pollock
- Health Evidence Synthesis, Recommendations and Impact, School of Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, Australia
| | | | - Krystle Amog
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mairin Ryan
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Susan M Smith
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Kamal Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andrew Booth
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK; University of Limerick, Limerick, Ireland
| | - Christina Godfrey
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Zachary Munn
- Health Evidence Synthesis, Recommendations and Impact, School of Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, Australia
| | - Andrea C Tricco
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen's University, Kingston, Ontario, Canada; Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Epidemiology Division and Institute for Health, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Hansford HJ, Richards GC, Page MJ, Sharp MK, Lee H, Cashin AG. Reporting health and medical research. BMJ Evid Based Med 2024:bmjebm-2023-112563. [PMID: 38453420 DOI: 10.1136/bmjebm-2023-112563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Harrison J Hansford
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Georgia C Richards
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Melissa K Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Hopin Lee
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- IQVIA, London, UK
| | - Aidan G Cashin
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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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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5
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Nguyen VT, Sharp MK, Superchi C, Baron G, Glonti K, Blanco D, Olsen M, Vo Tat TT, Olarte Parra C, Névéol A, Hren D, Ravaud P, Boutron I. Biomedical doctoral students' research practices when facing dilemmas: two vignette-based randomized control trials. Sci Rep 2023; 13:16371. [PMID: 37773192 PMCID: PMC10541422 DOI: 10.1038/s41598-023-42121-1] [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: 02/25/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023] Open
Abstract
Our aim was to describe the research practices of doctoral students facing a dilemma to research integrity and to assess the impact of inappropriate research environments, i.e. exposure to (a) a post-doctoral researcher who committed a Detrimental Research Practice (DRP) in a similar situation and (b) a supervisor who did not oppose the DRP. We conducted two 2-arm, parallel-group randomized controlled trials. We created 10 vignettes describing a realistic dilemma with two alternative courses of action (good practice versus DRP). 630 PhD students were randomized through an online system to a vignette (a) with (n = 151) or without (n = 164) exposure to a post-doctoral researcher; (b) with (n = 155) or without (n = 160) exposure to a supervisor. The primary outcome was a score from - 5 to + 5, where positive scores indicated the choice of DRP and negative scores indicated good practice. Overall, 37% of unexposed participants chose to commit DRP with important variation across vignettes (minimum 10%; maximum 66%). The mean difference [95%CI] was 0.17 [- 0.65 to 0.99;], p = 0.65 when exposed to the post-doctoral researcher, and 0.79 [- 0.38; 1.94], p = 0.16, when exposed to the supervisor. In conclusion, we did not find evidence of an impact of postdoctoral researchers and supervisors on student research practices.Trial registration: NCT04263805, NCT04263506 (registration date 11 February 2020).
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Affiliation(s)
- V T Nguyen
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - M K Sharp
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
- Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - C Superchi
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Statistics and Operations Research Department, Barcelona-Tech, UPC, Barcelona, Spain
| | - G Baron
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France
| | - K Glonti
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
| | - D Blanco
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Physiotherapy, Universitat Internacional de Catalunya, Barcelona, Spain
| | - M Olsen
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T T Vo Tat
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, Philadelphia, USA
| | - C Olarte Parra
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | | | - D Hren
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
| | - P Ravaud
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France
| | - I Boutron
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France.
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France.
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, 1 place du Parvis Notre-Dame, Cedex 4, 75089, Paris, France.
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6
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Hansford HJ, Cashin AG, Jones MD, Swanson SA, Islam N, Dahabreh IJ, Dickerman BA, Egger M, Garcia-Albeniz X, Golub RM, Lodi S, Moreno-Betancur M, Pearson SA, Schneeweiss S, Sterne J, Sharp MK, Stuart EA, Hernan MA, Lee H, McAuley JH. Development of the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) guideline. BMJ Open 2023; 13:e074626. [PMID: 37699620 PMCID: PMC10503363 DOI: 10.1136/bmjopen-2023-074626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Observational studies are increasingly used to inform health decision-making when randomised trials are not feasible, ethical or timely. The target trial approach provides a framework to help minimise common biases in observational studies that aim to estimate the causal effect of interventions. Incomplete reporting of studies using the target trial framework limits the ability for clinicians, researchers, patients and other decision-makers to appraise, synthesise and interpret findings to inform clinical and public health practice and policy. This paper describes the methods that we will use to develop the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) reporting guideline. METHODS/DESIGN The TARGET reporting guideline will be developed in five stages following recommended guidance. The first stage will identify target trial reporting practices by systematically reviewing published studies that explicitly emulated a target trial. The second stage will identify and refine items to be considered for inclusion in the TARGET guideline by consulting content experts using sequential online surveys. The third stage will prioritise and consolidate key items to be included in the TARGET guideline at an in-person consensus meeting of TARGET investigators. The fourth stage will produce and pilot-test both the TARGET guideline and explanation and elaboration document with relevant stakeholders. The fifth stage will disseminate the TARGET guideline and resources via journals, conferences and courses. ETHICS AND DISSEMINATION Ethical approval for the survey has been attained (HC220536). The TARGET guideline will be disseminated widely in partnership with stakeholders to maximise adoption and improve reporting of these studies.
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Affiliation(s)
- Harrison J Hansford
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Aidan G Cashin
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Matthew D Jones
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Sonja A Swanson
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nazrul Islam
- Oxford Population Health, Big Data Institute, University of Oxford, Oxford, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Issa J Dahabreh
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Barbra A Dickerman
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Matthias Egger
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Xavier Garcia-Albeniz
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- RTI Health Solutions Barcelona, Barcelona, Catalunya, Spain
| | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara Lodi
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Margarita Moreno-Betancur
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sallie-Anne Pearson
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan Sterne
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Health Data Research UK South-West, Bristol, UK
| | - Melissa K Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Miguel A Hernan
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hopin Lee
- University of Exeter Medical School, Exeter, UK
- EMEA Methods and Evidence Generation, IQVIA London, London, UK
| | - James H McAuley
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
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7
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Hansford HJ, Cashin AG, Jones MD, Swanson SA, Islam N, Douglas SRG, Rizzo RRN, Devonshire JJ, Williams SA, Dahabreh IJ, Dickerman BA, Egger M, Garcia-Albeniz X, Golub RM, Lodi S, Moreno-Betancur M, Pearson SA, Schneeweiss S, Sterne JAC, Sharp MK, Stuart EA, Hernán MA, Lee H, McAuley JH. Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review. JAMA Netw Open 2023; 6:e2336023. [PMID: 37755828 PMCID: PMC10534275 DOI: 10.1001/jamanetworkopen.2023.36023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023] Open
Abstract
Importance Observational (nonexperimental) studies that aim to emulate a randomized trial (ie, the target trial) are increasingly informing medical and policy decision-making, but it is unclear how these studies are reported in the literature. Consistent reporting is essential for quality appraisal, evidence synthesis, and translation of evidence to policy and practice. Objective To assess the reporting of observational studies that explicitly aimed to emulate a target trial. Evidence Review We searched Medline, Embase, PsycINFO, and Web of Science for observational studies published between March 2012 and October 2022 that explicitly aimed to emulate a target trial of a health or medical intervention. Two reviewers double-screened and -extracted data on study characteristics, key predefined components of the target trial protocol and its emulation (eligibility criteria, treatment strategies, treatment assignment, outcome[s], follow-up, causal contrast[s], and analysis plan), and other items related to the target trial emulation. Findings A total of 200 studies that explicitly aimed to emulate a target trial were included. These studies included 26 subfields of medicine, and 168 (84%) were published from January 2020 to October 2022. The aim to emulate a target trial was explicit in 70 study titles (35%). Forty-three studies (22%) reported use of a published reporting guideline (eg, Strengthening the Reporting of Observational Studies in Epidemiology). Eighty-five studies (43%) did not describe all key items of how the target trial was emulated and 113 (57%) did not describe the protocol of the target trial and its emulation. Conclusion and Relevance In this systematic review of 200 studies that explicitly aimed to emulate a target trial, reporting of how the target trial was emulated was inconsistent. A reporting guideline for studies explicitly aiming to emulate a target trial may improve the reporting of the target trial protocols and other aspects of these emulation attempts.
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Affiliation(s)
- Harrison J. Hansford
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Aidan G. Cashin
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Matthew D. Jones
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Sonja A. Swanson
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nazrul Islam
- Oxford Population Health, Big Data Institute, University of Oxford, Oxford, United Kingdom
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Susan R. G. Douglas
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Rodrigo R. N. Rizzo
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Jack J. Devonshire
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Sam A. Williams
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Issa J. Dahabreh
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Barbra A. Dickerman
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Xabier Garcia-Albeniz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- RTI Health Solutions, Barcelona, Spain
| | - Robert M. Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sara Lodi
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Margarita Moreno-Betancur
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Sallie-Anne Pearson
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology, Department of Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jonathan A. C. Sterne
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, Bristol, United Kingdom
- Health Data Research UK South-West, Bristol, United Kingdom
| | - Melissa K. Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Elizabeth A. Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Miguel A. Hernán
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hopin Lee
- University of Exeter Medical School, Exeter, United Kingdom
| | - James H. McAuley
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
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8
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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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9
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Schlussel MM, Sharp MK, de Beyer JA, Kirtley S, Logullo P, Dhiman P, MacCarthy A, Koroleva A, Speich B, Bullock GS, Moher D, Collins GS. Reporting guidelines used varying methodology to develop recommendations. J Clin Epidemiol 2023; 159:246-256. [PMID: 36965598 DOI: 10.1016/j.jclinepi.2023.03.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 01/30/2023] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND AND OBJECTIVES We investigated the developing methods of reporting guidelines in the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network's database. METHODS In October 2018, we screened all records and excluded those not describing reporting guidelines from further investigation. Twelve researchers performed duplicate data extraction on bibliometrics, scope, development methods, presentation, and dissemination of all publications. Descriptive statistics were used to summarize the findings. RESULTS Of the 405 screened records, 262 described a reporting guidelines development. The number of reporting guidelines increased over the past 3 decades, from 5 in the 1990s and 63 in the 2000s to 157 in the 2010s. Development groups included 2-151 people. Literature appraisal was performed during the development of 56% of the reporting guidelines; 33% used surveys to gather external opinion on items to report; and 42% piloted or sought external feedback on their recommendations. Examples of good reporting for all reporting items were presented in 30% of the reporting guidelines. Eighteen percent of the reviewed publications included some level of spin. CONCLUSION Reporting guidelines have been developed with varying methodology. Reporting guideline developers should use existing guidance and take an evidence-based approach, rather than base their recommendations on expert opinion of limited groups of individuals.
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Affiliation(s)
- Michael M Schlussel
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK.
| | - 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
| | - Jennifer A de Beyer
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Shona Kirtley
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Patricia Logullo
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Paula Dhiman
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK; National Institute for Health Research, Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Angela MacCarthy
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Benjamin Speich
- CLEAR Methos Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Garrett S Bullock
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK; National Institute for Health Research, Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
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10
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Chong MC, Sharp MK, Smith SM, O'Neill M, Ryan M, Lynch R, Mahtani KR, Clyne B. Strong recommendations from low certainty evidence: a cross-sectional analysis of a suite of national guidelines. BMC Med Res Methodol 2023; 23:68. [PMID: 36966277 PMCID: PMC10039768 DOI: 10.1186/s12874-023-01895-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/18/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Clinical guidelines should be based on a thorough evaluation of the evidence and generally include a rating of the quality of evidence and assign a strength to recommendations. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance warns against making strong recommendations when the certainty of the evidence is low or very low, but has identified five paradigmatic situations (e.g. life-threatening situations) where this may be justified. AIMS AND OBJECTIVES We aimed to characterize the strength of recommendations and certainty of the evidence in Irish National Clinical Guidelines using the GRADE approach. METHODS All National Clinical Guidelines from the National Clinical Effectiveness Committee (NCEC) website using the GRADE approach (fully or partially) were included. All recommendations and their corresponding certainty of the evidence, strength of recommendations and justifications were extracted. Authors classified instances of strong recommendations with low certainty evidence (referred to as discordant recommendations) into one of the five paradigmatic situations. Descriptive statistics were calculated. RESULTS From the 29 NCEC Clinical Guidelines available at the time of analysis, we identified 8 guidelines using GRADE with a total of 240 recommendations; 38 recommendations did not use the GRADE approach and were excluded. Half of the included guidelines focused on emergency situations. In the final dataset of 202 recommendations, 151 (74.7%) were classified as strong and 51 (25.3%) as conditional. Of the 151 strong recommendations, 55 (36.4%) were supported by high or moderate certainty evidence and 96 (63.6%) by low or very low certainty evidence and were considered discordant. Of these 96 discordant recommendations, 55 (73.7%) were consistent with one of the five paradigmatic situations. However, none were specifically described as such within the guidelines. CONCLUSIONS The proportion of discordant recommendations identified in this analysis was higher than some previous international studies (range of all strong recommendations being discordant 30-50%), but similar to other guidelines focused on emergency situations. The majority of discordant recommendations could be mapped to one of the five situations, but no National Clinical Guideline explicitly referenced this. Guideline developers require further guidance to enable greater transparency in the reporting of the reasons for discordant recommendations.
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Affiliation(s)
- Ming Chuen Chong
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Dublin 2, Ireland
| | - Melissa K Sharp
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Dublin 2, Ireland
| | - Susan M Smith
- Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin, Dublin 2, Ireland
| | - Michelle O'Neill
- Health Information and Quality Authority, George's Court, George's Lane, Dublin, Dublin 7, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority, George's Court, George's Lane, Dublin, Dublin 7, Ireland
| | - Rosarie Lynch
- Department of Health, Clinical Effectiveness and Antimicrobial Resistance Unit, National Patient Safety Office, Dublin, Ireland
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Barbara Clyne
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Dublin 2, Ireland.
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11
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Sharp MK, Forde Z, McGeown C, O’Murchu E, Smith SM, O’Neill M, Ryan M, Clyne B. Irish Media Coverage of COVID-19 Evidence-Based Research Reports From One National Agency. Int J Health Policy Manag 2022; 11:2464-2475. [PMID: 35042323 PMCID: PMC9818095 DOI: 10.34172/ijhpm.2021.169] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/11/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND How research findings are presented through domestic news can influence behaviour and risk perceptions, particularly during emergencies such as the coronavirus disease 2019 (COVID-19) pandemic. Monitoring media communications to track misinformation and find information gaps is an important component of emergency risk communication. Therefore, this study investigated the traditional media coverage of nine selected COVID-19 evidence-based research reports and associated press releases (PRs) published during the initial phases of the pandemic (April to July 2020) by one national agency. METHODS NVivo was used for summative content analysis. 'Key messages' from each research report were proposed and 488 broadcast, print, and online media sources were coded at the phrase level. Manifest content was coded and counted to locate patterns in the data (what and how many) while latent content was analysed to further investigate these patterns (why and how). This included the coding of the presence of political and public health actors in coverage. RESULTS Coverage largely did not misrepresent the results of the reports, however, selective reporting and the variability in the use of quotes from governmental and public health stakeholders changed and contextualised results in different manners than perhaps originally intended in the PR. Reports received varying levels of media attention. Coverage focused on more 'human-interest' stories (eg, spread of COVID-19 by children and excess mortality) as opposed to more technical reports (eg, focusing on viral load, antibodies, testing, etc). CONCLUSION Our findings provide a case-study of European media coverage of evidence reports produced by a national agency. Results highlighted several strengths and weaknesses of current communication efforts.
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Affiliation(s)
- Melissa K. Sharp
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Zoë Forde
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Cordelia McGeown
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Eamon O’Murchu
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Susan M. Smith
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Michelle O’Neill
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity
Health Sciences, Dublin 8, Ireland
| | - Barbara Clyne
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
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Sharp MK, Baki DABA, Quigley J, Tyner B, Devane D, Mahtani KR, Smith SM, O'Neill M, Ryan M, Clyne B. The effectiveness and acceptability of evidence synthesis summary formats for clinical guideline development groups: a mixed-methods systematic review. Implement Sci 2022; 17:74. [PMID: 36303142 PMCID: PMC9615384 DOI: 10.1186/s13012-022-01243-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Clinical guideline development often involves a rigorous synthesis of evidence involving multidisciplinary stakeholders with different priorities and knowledge of evidence synthesis; this makes communicating findings complex. Summary formats are typically used to communicate the results of evidence syntheses; however, there is little consensus on which formats are most effective and acceptable for different stakeholders. METHODS This mixed-methods systematic review (MMSR) aimed to evaluate the effectiveness and acceptability (e.g. preferences and attitudes and preferences towards) of evidence synthesis summary formats for GDG members. We followed the PRISMA 2020 guideline and Joanna Briggs Institute Manual for Evidence Synthesis for MMSRs. We searched six databases (inception to April 20, 2021) for randomised controlled trials (RCTs), RCTs with a qualitative component, and qualitative studies. Screening, data extraction, and quality appraisal were performed in duplicate. Qualitative findings were synthesised using meta-aggregation, and quantitative findings are described narratively. RESULTS We identified 17,240 citations and screened 54 full-text articles, resulting in 22 eligible articles (20 unique studies): 4 articles reported the results of 5 RCTs, one of which also had a qualitative component. The other 18 articles discussed the results of 16 qualitative studies. Therefore, we had 5 trials and 17 qualitative studies to extract data from. Studies were geographically heterogeneous and included a variety of stakeholders and summary formats. All 5 RCTs assessed knowledge or understanding with 3 reporting improvement with newer formats. The qualitative analysis identified 6 categories of recommendations: 'presenting information', 'tailoring information' for end users, 'trust in producers and summary', 'knowledge required' to understand findings, 'quality of evidence', and properly 'contextualising information'. Across these categories, the synthesis resulted in 126 recommendations for practice. Nine recommendations were supported by both quantitative and qualitative evidence and 116 by only qualitative. A majority focused on how to present information (n = 64) and tailor content for different end users (n = 24). CONCLUSIONS This MMSR provides guidance on how to improve evidence summary structure and layout. This can be used by synthesis producers to better communicate to GDGs. Study findings will inform the co-creation of evidence summary format prototypes based on GDG member's needs. Trial registration The protocol for this project was previously published, and the project was preregistered on Open Science Framework (Clyne and Sharp, Evidence synthesis and translation of findings for national clinical guideline development: addressing the needs and preferences of guideline development groups, 2021; Sharp and Clyne, Evidence synthesis summary formats for decision-makers and Clinical Guideline Development Groups: A mixed-methods systematic review protocol, 2021).
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Affiliation(s)
- Melissa K Sharp
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland.
| | | | - Joan Quigley
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Barrie Tyner
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, NUI Galway, Galway, Ireland
- Evidence Synthesis Ireland & Cochrane, Galway, Ireland
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Susan M Smith
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland
- Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Michelle O'Neill
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, James Street, Dublin 8, Ireland
| | - Barbara Clyne
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
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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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Sharp MK, Tyner B, Awang Baki DAB, Farrell C, Devane D, Mahtani KR, Smith SM, O'Neill M, Ryan M, Clyne B. Evidence synthesis summary formats for clinical guideline development group members: a mixed-methods systematic review protocol. HRB Open Res 2022; 4:76. [PMID: 36071877 PMCID: PMC9433911 DOI: 10.12688/hrbopenres.13325.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: Evidence syntheses, often in the form of systematic reviews, are essential for clinical guideline development and informing changes to health policies. However, clinical guideline development groups (CGDG) are multidisciplinary, and participants such as policymakers, healthcare professionals and patient representatives can face obstacles when trying to understand and use evidence synthesis findings. Summary formats to communicate the results of evidence syntheses have become increasingly common, but it is currently unclear which format is most effective for different stakeholders. This mixed-methods systematic review (MMSR) evaluates the effectiveness and acceptability of different evidence synthesis summary formats for CGDG members. Methods: This protocol follows guidance from the Joanna Briggs Institute on MMSRs and is reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA)-P guideline. A comprehensive search of six databases will be performed with no language restrictions. Primary outcomes are those relating to the effectiveness and preferences for and attitudes towards the different summary formats. We will include qualitative research and randomised controlled trials. Two reviewers will perform title, abstract, and full-text screening. Independent double-extraction of study characteristics and critical appraisal items will be undertaken using a standardised form. We will use a convergent segregated approach to analyse quantitative and qualitative data separately; results will then be integrated. Discussion: The results of this systematic review will provide an overview of the effectiveness and acceptability of different summary formats for evidence synthesis findings. These findings can be helpful for those in or communicating to guideline development groups. The results can also inform the development and pilot-testing of summary formats for evidence summaries.
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Affiliation(s)
- Melissa K. Sharp
- Health Research Board Centre for Primary Care Research, Department of General Practice,, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Barrie Tyner
- Health Information and Quality Authority, Dublin, Ireland
| | | | - Cormac Farrell
- Health Information and Quality Authority, Dublin, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, NUI Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
| | - Kamal R. Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Susan M. Smith
- Health Research Board Centre for Primary Care Research, Department of General Practice,, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Máirín Ryan
- Health Information and Quality Authority, Dublin, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - Barbara Clyne
- Health Research Board Centre for Primary Care Research, Department of General Practice,, Royal College of Surgeons in Ireland, Dublin, Ireland
- Health Information and Quality Authority, Dublin, Ireland
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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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Sharp MK, Tyner B, Awang Baki DAB, Farrell C, Devane D, Mahtani KR, Smith SM, O'Neill M, Ryan M, Clyne B. Evidence synthesis summary formats for clinical guideline development group members: a mixed-methods systematic review protocol. HRB Open Res 2021; 4:76. [DOI: 10.12688/hrbopenres.13325.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction: Evidence syntheses, often in the form of systematic reviews, are essential for clinical guideline development and informing changes to health policies. However, clinical guideline development groups (CGDG) are multidisciplinary, and participants such as policymakers, healthcare professionals and patient representatives can face obstacles when trying to understand and use evidence synthesis findings. Summary formats to communicate the results of evidence syntheses have become increasingly common, but it is currently unclear which format is most effective for different stakeholders. This mixed-methods systematic review (MMSR) evaluates the effectiveness and acceptability of different evidence synthesis summary formats for CGDG members. Methods: This protocol follows guidance from the Joanna Briggs Institute on MMSRs and is reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA)-P guideline. A comprehensive search of six databases will be performed with no language restrictions. Primary outcomes are those relating to the effectiveness and preferences for and attitudes towards the different summary formats. We will include qualitative research and randomised controlled trials. Two reviewers will perform title, abstract, and full-text screening. Independent double-extraction of study characteristics and critical appraisal items will be undertaken using a standardised form. We will use a convergent segregated approach to analyse quantitative and qualitative data separately; results will then be integrated. Discussion: The results of this systematic review will provide an overview of the effectiveness and acceptability of different summary formats for evidence synthesis findings. These findings can be helpful for those in or communicating to guideline development groups. The results can also inform the development and pilot-testing of summary formats for evidence summaries.
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Sharp MK, Glonti K, Hren D. Online survey about the STROBE statement highlighted diverging views about its content, purpose, and value. J Clin Epidemiol 2020; 123:100-106. [PMID: 32259582 DOI: 10.1016/j.jclinepi.2020.03.025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE The endorsement rates of The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement are low and little is known about authors' opinions about this reporting guideline. We conducted an online survey with observational study authors on attitude toward and experiences with the STROBE Statement with the aim of understanding how to effectively implement STROBE. METHODS A thematic analysis on the responses to an open-ended question was conducted using inductive coding. Two coders classified responses independently into themes using a codebook. The inter-rater agreement ranged from 87.7 to 99.9%. RESULTS 15% (n = 150) of survey participants (n = 1,015) shared perceptions and insights on STROBE. We established four themes: 1) perceptions of the checklist, 2) academic confidence, 3) use in education and training, and 4) journal endorsement and use in peer review. Views were diverse and revealed multiple misunderstandings about the checklist's purpose and content, and lack of incentives for its use. CONCLUSIONS Better communication efforts are needed when disseminating STROBE and other reporting guidelines. These should focus on content, education for early career researchers, and encouragement of critical self-reflection on one's own work. In addition, results emphasized the need for better incentive and enforcement mechanisms.
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Affiliation(s)
- Melissa K Sharp
- University of Split, Department of Psychology, Faculty of Humanities and Social Sciences, Split, Croatia; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France.
| | - Ketevan Glonti
- University of Split, Department of Psychology, Faculty of Humanities and Social Sciences, Split, Croatia; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
| | - Darko Hren
- University of Split, Department of Psychology, Faculty of Humanities and Social Sciences, Split, Croatia
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Sharp MK, Bertizzolo L, Rius R, Wager E, Gómez G, Hren D. Using the STROBE statement: survey findings emphasized the role of journals in enforcing reporting guidelines. J Clin Epidemiol 2019; 116:26-35. [DOI: 10.1016/j.jclinepi.2019.07.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/19/2019] [Accepted: 07/30/2019] [Indexed: 12/14/2022]
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Abstract
OBJECTIVES To assess the intention of using a Writing Aid software, which integrates four research reporting guidelines (Consolidated Standards of Reporting Trials, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Strengthening the Reporting of Observational Studies in Epidemiology and STrengthening the Reporting of Observational Studies in Epidemiology-nutritional epidemiology) and their Elaboration & Explanation (E&E) documents during the write-up of research in Microsoft Word compared with current practices. DESIGN Two-arms crossover randomised controlled trial with no blinding and no washout period. SETTING Face-to-face or online sessions. PARTICIPANTS 54 (28 in arm 1 and 26 in arm 2) doctoral and postdoctoral researchers. INTERVENTIONS Reporting guidelines and their E&E document were randomly administered as Writing Aid or as Word documents in a single 30 min to 1 hour session, with a short break before crossing over to the other study intervention. PRIMARY AND SECONDARY OUTCOMES Using the Technology Acceptance Model, we assessed the primary outcome: the difference in the mean of intention of use; and secondary outcomes: the difference in mean perceived ease of use and perceived usefulness. The three outcomes were measured using questions with a 7-point Likert-scale. Secondary analysis using structural equation modelling (SEM) was applied to explore the relationships between the outcomes. RESULTS No significant difference in reported intention of use (mean difference and 95% CI 0.25 (-0.05 to 0.55), p=0.10), and perceived usefulness (mean difference and 95% CI 0.19 (-0.04 to 0.41), p=0.10). The Writing Aid performed significantly better than the word document on researchers' perceived ease of use (mean difference and 95% CI 0.59 (0.29 to 0.89), p<0.001). In the SEM analysis, participants' intention of using the tools was indirectly affected by perceived ease of use (beta 0.53 p=0.002). CONCLUSIONS Despite no significant difference in the intention of use between the tools, administering reporting guidelines as Writing Aid is perceived as easier to use, offering a possibility to further explore its applicability to enhance reporting adherence.
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Affiliation(s)
- Dana Hawwash
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
| | - Melissa K Sharp
- Department of Psychology, University of Split, Split, Croatia
- Universite de Paris,CRESS, INSERM, INRA, Paris, France
| | - Alemayehu Argaw
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
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Sharp MK, Tokalić R, Gómez G, Wager E, Altman DG, Hren D. A cross-sectional bibliometric study showed suboptimal journal endorsement rates of STROBE and its extensions. J Clin Epidemiol 2019; 107:42-50. [PMID: 30423373 DOI: 10.1016/j.jclinepi.2018.11.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 08/07/2018] [Revised: 10/10/2018] [Accepted: 11/06/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The STrengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement provides guidance on reporting observational studies. Many extensions have been created for specialized methods or fields. We determined endorsement prevalence and typology by journals in extension-related fields. STUDY DESIGN AND SETTING A published protocol defined search strategies to identify journals publishing observational studies (2007-2017) across seven fields relating to STROBE extensions. We extracted text regarding STROBE, seven STROBE extensions, reporting guidelines Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and transparent reporting documents/groups: International Committee of Medical Journal Editors, Committee on Publication Ethics (COPE), and the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) networks. Relationships between endorsing STROBE, endorsing other guidelines, and journal impact factor were tested using chi square and Mann-Whitney tests. RESULTS Of 257 unique journals, 12 (5%) required STROBE on submission, 22 (9%) suggested use, 12 (5%) recommended a "relevant guideline," 72 (28%) mentioned it indirectly (via editorial policies or International Committee of Medical Journal Editors recommendations), and 139 (54%) did not mention STROBE. The relevant extension was required by 2 (<1%) journals; 4 (1%) suggested use. STROBE endorsement was not associated with journal impact indices but was with Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses endorsements. CONCLUSION Reporting guideline endorsement rates are low; information is vague and scattered. Unambiguous language is needed to improve adherence to reporting guidelines and increase the quality of reporting.
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Affiliation(s)
- Melissa K Sharp
- Department of Psychology, University of Split, Faculty of Humanities and Social Sciences, Split, Croatia; INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France.
| | | | - Guadalupe Gómez
- Universitat Politècnica de Catalunya-BarcelonaTech, Departament d'Estadística i Investigació Operativa, Barcelona, Spain
| | - Elizabeth Wager
- Sideview, Buckinghamshire, UK; University of Split, School of Medicine, Split, Croatia
| | - Douglas G Altman
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Darko Hren
- Department of Psychology, University of Split, Faculty of Humanities and Social Sciences, Split, Croatia
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21
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Affiliation(s)
- Melissa K Sharp
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia, INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of therapeutic evaluation of chronic diseases Team (METHODS), Paris, France, Paris Descartes University, Sorbonne Paris Cité, France, ; Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
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22
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Olsen M, Sharp MK, Bossuyt PM. From the theoretical to the practical: how to evaluate the ethical and scientific justifications of randomized clinical trials. J Clin Epidemiol 2018; 99:170-171. [PMID: 29596973 DOI: 10.1016/j.jclinepi.2018.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/20/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Olsen
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France
| | - Melissa K Sharp
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Poljicka cesta 35, Split 2100, Croatia.
| | - Patrick M Bossuyt
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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23
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Abstract
OBJECTIVE To explore how the results from the 2014 dual antiplatelet therapy (DAPT) trial were disseminated to the scientific community and online media. DESIGN A a systematic review of scholarly and public attention surrounding the DAPT study. SETTINGS Data were collected from the ISI Web of Knowledge, Google Scholar, PubMed Commons, EurekAlert, the DAPT study website (www.daptstudy.org) and the New England Journal of Medicine website (for scholarly attention) and Altmetric Explorer, Snap Bird, YouTube (for public attention) citing DAPT study results appearing from 16 November 2014 to 10 June 2015. PARTICIPANTS No participants were involved in this study. MAIN OUTCOME MEASURE Proportion of contents highlighting the increased risk of mortality and critical to the author's interpretation of the results. RESULTS We identified 425 items reported by seven sources; 164 (39%) disseminated the authors' interpretation via an electronic link or a reference, with no additional text. Among 81 items (19 %), the message favoured prolonged treatment and consequently overstated the article conclusions. Among 119 items (28 %), the text was uncertain about the benefit of prolonged treatment but was reported with no or inappropriate mention of increased risk of mortality. Only 34 items (8 %) were uncertain about the benefit of prolonged treatment and mentioned increased risk of mortality. In all, 27 items (6 %) did not favour prolonged treatment, and only 12 of these (3 %) clearly raised some concerns about the reporting of increased risk of death. CONCLUSION Dissemination of the DAPT study results to the scientific community and on different media sources rarely criticised the interpretation of the study results.
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Affiliation(s)
- Melissa K Sharp
- Mailman School of Public Health, Columbia University, New York, USA
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
| | - Romana Haneef
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Mailman School of Public Health, Columbia University, New York, USA
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
- Cochrane France, Paris, France
| | - Isabelle Boutron
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
- Cochrane France, Paris, France
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Abstract
INTRODUCTION The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was developed in response to inadequate reporting of observational studies. In recent years, several extensions to STROBE have been created to provide more nuanced field-specific guidance for authors. The content and the prevalence of extension endorsement have not yet been assessed. Accordingly, there are two aims: (1) to classify changes made in the extensions to identify strengths and weaknesses of the original STROBE checklist and (2) to determine the prevalence and typology of endorsement by journals in fields related to extensions. METHODS AND ANALYSIS Two independent researchers will assess additions in each extension. Additions will be coded as 'field specific' (FS) or 'not field specific' (NFS). FS is defined as particularly relevant information for a single field and guidance provided generally cannot be extrapolated beyond that field. NFS is defined as information that reflects epidemiological or methodological tenets and can be generalised to most, if not all, types of observational research studies. Intraclass correlation will be calculated to measure reviewers' concordance. On disagreement, consensus will be sought. Individual additions will be grouped by STROBE checklist items to identify the frequency and distribution of changes.Journals in fields related to extensions will be identified through National Library of Medicine PubMed Broad Subject Terms, screened for eligibility and further distilled via Ovid MEDLINE® search strategies for observational studies. Text describing endorsement will be extracted from each journal's website. A classification scheme will be created for endorsement types and the prevalence of endorsement will be estimated. Analyses will use NVivo V.11 and SAS University Edition. ETHICS AND DISSEMINATION This study does not require ethical approval as it does not involve human participants. This study has been preregistered on Open Science Framework.
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Affiliation(s)
- Melissa K Sharp
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
- Sorbonne Paris Cité, Pierre Louis Doctoral School: Epidemiology and Biomedical Sciences, Université Paris Descartes, Paris, France
| | - Ana Utrobičić
- School of Medicine, University of Split, Split, Croatia
| | - Guadalupe Gómez
- Departament d'Estadística i Investigació Operativa, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - Erik Cobo
- Departament d'Estadística i Investigació Operativa, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - Elizabeth Wager
- School of Medicine, University of Split, Split, Croatia
- Sideview, Buckinghamshire, UK
| | - Darko Hren
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
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25
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Abstract
The 2006 Consensus Statement on Management of Intersex Disorders describes peer support as integral to a comprehensive model of care for disorders of sex development (DSD). Affected adults and families look to peer support groups (PSG) for informational, emotional and social support to strengthen coping and assist with the process of shared and informed decision making. Peer support for DSD is relatively new and much can potentially be learned from studies examining the relationship between PSG characteristics and their benefits in other medical conditions. Healthcare providers' awareness of and attitudes toward PSG can influence the degree to which families value such support. This chapter begins with a brief history of peer support for DSD, followed by a summary of the evidence-based literature on PSG across varied medical conditions. We then summarize findings from a recently conducted poll of key DSD peer support and advocacy organizations. The chapter concludes with recommendations for further development of DSD-specific PSG, opportunities for more complete integration of peer support in the model of healthcare and the advantages of input of patient stakeholders in establishing clinical research priorities.
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Affiliation(s)
- Arlene B Baratz
- Temple University School of Medicine, Department of Radiology, Pittsburgh, Pa., USA
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26
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Abstract
The flow around rigid cylinders of elliptical cross section placed transverse to Poiseuille flow between parallel plates was simulated to investigate issues related to the tumbling of red blood cells and other particles of moderate aspect ratio in the similar flow in a Field Flow Fractionation (FFF) channel. The torque and transverse force on the cylinder were calculated with the cylinder freely translating, but prevented from rotating, in the flow. The aspect ratios (long axis to short axis) of the elliptical cylinders were 2, 3, 4, and 5. The cylinder was placed transversely at locations of y0/H = 0.1, 0.2, 0.3, and 0.4, where y0 is the distance from the bottom of the channel and H is the height of the channel, and the orientation of the cylinder was varied from 0 to 10 deg with respect to the axis of the channel for a channel Reynolds number of 20. The results showed that equilibrium orientations (indicated by a zero net torque on the cylinder) were possible for high-aspect-ratio cylinders at transverse locations y0/H < 0.2. Otherwise, the net torque on the cylinder was positive, indicating that the cylinder would rotate. For cylinders with a stable orientation, however, a transverse lift forced existed up to about y0/H = 0.25. Thus, a cylinder of neutral or low buoyancy might be lifted with a stable orientation from an initial position near the wall until it reached y0/H < 0.2, whereupon it would begin to tumble or oscillate. The dependence of lift and torque on cylinder orientation suggested that neutral or low-buoyancy cylinders may oscillate in both transverse location and angular velocity. Cylinders more dense than the carrier fluid could be in equilibrium both in terms of orientation and transverse location if their sedimentation force matched their lift force for a location y0/H < 0.2.
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Affiliation(s)
- Y Zhao
- Department of Bioengineering, University of Utah, Salt Lake City 84112, USA
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27
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Abstract
Flow and pressure measurements were performed in the ascending aortas of six pediatric patients ranging in age from 1 to 4 yr and in weight from 7.2 to 16.4 kg. From these measurements, input impedance was calculated. It was found that total vascular resistance decreased with increasing patient weight and was approximately one to three times higher than those of adults. Conductance per unit weight was relatively constant but was approximately three times higher than for adults. Strong inertial character was observed in the impedance of four of the six patients. Among a three-element and two four-element lumped-parameter models, the model with characteristic aortic resistor (R(c)) and inertance in series followed by parallel peripheral resistor (R(p)) and compliance fitted the data best. R(p) decreased with increasing patient weight and was one to three times higher than in adults, and R(c) decreased with increasing patient weight and was 2 to 15 times higher. The R(p)-to-R(c) ratio differed significantly between infants and children vs. adults. The results suggested that R(p) developed more rapidly with patient weight than did R(c). Compliance values increased with increasing patient weight and were 3 to 16 times lower than adult values.
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Affiliation(s)
- M K Sharp
- Biofluid Mechanics Laboratory, Department of Bioengineering, University of Utah, Salt Lake City 84112, USA.
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28
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Abstract
Orbital measurements of the cardiac function of Space Shuttle crew members have shown an initial increase in cardiac stroke volume upon entry into weightlessness, followed by a gradual reduction in stroke volume to a level approximately 15% less than preflight values. In an effort to explain this response, it was hypothesized that gravity plays a role in cardiac filling. A mock circulatory system was designed to investigate this effect. Preliminary studies carried out with this system on the NASA KC-135 aircraft, which provides brief periods of weightlessness, showed a strong correlation between cardiac filling, stroke volume, and the presence or absence of gravity. The need for extended periods of high quality zero gravity was identified to verify this observation. To accomplish this, the aircraft version of the experiment was reduced in size and fully automated for eventual integration into a Get Away Special canister to conduct an orbital version of the experiment. This article describes the automated system, as well as the development and implementation of a control algorithm for the servoregulation of the mean aortic pressure in the orbital experiment. Three nonlinearities that influence the ability of the apparatus to regulate to a mean aortic pressure of 95 mm Hg were identified and minimized. In preparation for a Space Shuttle flight, the successful function of the servoregulatory scheme was demonstrated during ground tests and additional test flights aboard the KC-135. The control algorithm was successful in carrying out the experimental protocol, including regulation of mean aortic pressure. The algorithm could also be used for the automated operation of long-term tests of circulatory support systems, which may require a scheduled cycling of the pumping conditions on a daily basis.
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Affiliation(s)
- D S O'Leary
- University of Utah, Biofluid Mechanics Laboratory, Salt Lake City 84112, USA
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29
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Abstract
Physical and numeric models of the human circulation are constructed for a number of objectives, including studies and training in physiologic control, interpretation of clinical observations, and testing of prosthetic cardiovascular devices. For many of these purposes it is important to quantitatively validate the dynamic response of the models in terms of the input impedance (Z = oscillatory pressure/oscillatory flow). To address this need, the authors developed an improved physical model. Using a computer study, the authors first identified the configuration of lumped parameter elements in a model of the systemic circulation; the result was a good match with human aortic input impedance with a minimum number of elements. Design, construction, and testing of a hydraulic model analogous to the computer model followed. Numeric results showed that a three element model with two resistors and one compliance produced reasonable matching without undue complication. The subsequent analogous hydraulic model included adjustable resistors incorporating a sliding plate to vary the flow area through a porous material and an adjustable compliance consisting of a variable-volume air chamber. The response of the hydraulic model compared favorably with other circulation models.
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Affiliation(s)
- M K Sharp
- Department of Bioengineering, University of Utah, Salt Lake City 84112, USA
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30
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Zhao Y, Sharp MK. Finite element analysis of the lift on a slightly deformable and freely rotating and translating cylinder in two-dimensional channel flow. J Biomech Eng 1999; 121:148-52. [PMID: 10211447 DOI: 10.1115/1.2835096] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/08/2022]
Abstract
Motivated by the lateral migration phenomena of fresh and glutaraldehyde-fixed red blood cells in a field flow fractionation (FFF) separation system, we studied the transverse hydrodynamic lift on a slightly flexible cylinder in a two-dimensional channel flow. The finite element method was used to analyze the flow field with the cylinder at different transverse locations in the channel. The shape of the cylinder was determined by the pressure on the surface of the cylinder from the flow field solution and by the internal elastic stress. The cylinder deformation and the flow field were solved simultaneously. The transverse lift exerted on the cylinder was then calculated. The axial and angular speed of the cylinder were iterated such that the drag and torque on the cylinder were nulled to represent a freely translating and rotating state. The results showed that the transverse lift on a deformable cylinder increased greatly and the equilibrium position moved closer to the center of the channel compared to a rigid cylinder. Also, with the same elastic modulus but a higher flow rate, a larger deformation and higher equilibrium location were found. The maximum deformation of the cylinder occurred when the cylinder was closest to the wall where a larger shear rate existed. The numerical results and experimental studies are discussed.
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Affiliation(s)
- Y Zhao
- Department of Civil and Environmental Engineering, University of Utah, Salt Lake City 84112, USA
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31
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Pantalos GM, Sharp MK, Woodruff SJ, O'Leary DS, Lorange R, Everett SD, Bennett TE, Shurfranz T. Influence of gravity on cardiac performance. Ann Biomed Eng 1998; 26:931-43. [PMID: 9846932 DOI: 10.1114/1.30] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Results obtained by the investigators in ground-based experiments and in two parabolic flight series of tests aboard the NASA KC-135 aircraft with a hydraulic simulator of the human systemic circulation have confirmed that a simple lack of hydrostatic pressure within an artificial ventricle causes a decrease in stroke volume of 20%-50%. A corresponding drop in stroke volume (SV) and cardiac output (CO) was observed over a range of atrial pressures (AP), representing a rightward shift of the classic CO versus AP cardiac function curve. These results are in agreement with echocardiographic experiments performed on space shuttle flights, where an average decrease in SV of 15% was measured following a three-day period of adaptation to weightlessness. The similarity of behavior of the hydraulic model to the human system suggests that the simple physical effects of the lack of hydrostatic pressure may be an important mechanism for the observed changes in cardiac performance in astronauts during the weightlessness of space flight.
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Affiliation(s)
- G M Pantalos
- Artificial Heart Research Laboratory, University of Utah, Salt Lake City 84112, USA
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32
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Abstract
Hemolysis in clinical blood samples leads to inaccurate assay results and often to the need for repeated blood draws. In vitro experiments were conducted to determine the influence on hemolysis in phlebotomy needles and catheters of pressure difference, cannula diameter, and cannula material. Fresh blood from five human volunteers was forced from a syringe inside a pressurized chamber through 14, 18, and 22 gauge 304 stainless steel needles and polyurethane and Teflon catheters, all 40 mm long. Hemolysis was measured in the samples by a spectrophotometer. It was found that hemolysis increased with increases in pressure difference and cannula diameter and no consistent trend could be identified with regard to cannula material. The pressure differences required for significant hemolysis were above those typical of clinical venipuncture blood draws. While there was substantial variability among individuals, the hemolysis values scaled with exponent S = (t/t0)[(tau/tau0)-1]2, where t is the characteristic duration of shear, t0 is a time constant, tau is the wall shear stress, and tau0 is the wall shear stress threshold below which no hemolysis occurs. A hemolysis threshold including both time and shear stress was also defined for S = constant. The threshold implies that a threshold shear stress exists below which erythrocytes are not damaged for any length of exposure time, but that red cells may be damaged by an arbitrarily short period of exposure to sufficiently large shear stress.
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Affiliation(s)
- M K Sharp
- Department of Civil and Environmental Engineering, University of Utah, Salt Lake City 84112, USA.
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33
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Woodruff SJ, Sharp MK, Pantalos GM. Compact compliance chamber design for the study of cardiac performance in microgravity. ASAIO J 1997; 43:316-20. [PMID: 9242946] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A need was identified for a Mock Circulation System (MCS) of small size and weight that could function in a microgravity environment for the investigation of cardiovascular response to the weightlessness of space flight. Part of the MCS development involved the redesign of the compliance chamber from a Penn State MCS using a coil spring instead of the leaf spring system employed in the Penn State system. The new compliance chambers achieve a weight reduction of 47% and a volume reduction of 64% over the original Penn State design. Testing showed the coil spring compliance chambers retained physiologic characteristics and adjustability by using coil springs of various stiffness, and functioned equivalently to the original Penn State design.
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Affiliation(s)
- S J Woodruff
- University of Utah, Biofluid Mechanics Laboratory, Salt Lake City 84112, USA
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Sharp MK, Cook J, McCarvill WT, Lee CS, Arieta F, Tarbell JM. A blood analog for laser-induced photochemical anemometry. Biorheology 1996; 33:471-6. [PMID: 9093442 DOI: 10.1016/s0006-355x(97)00035-8] [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] [Indexed: 02/04/2023]
Abstract
A transparent viscoelastic blood analog fluid was developed for use with Laser-Induced Photochemical Anemometry. To provide solubility of the photochemical tracer, 1', 3', 3'-trimethyl-6-nitroindoline-2-benzopyran (TNSB dye, Kodak Chemicals), the analog solvent needed to be nonpolar, thus currently available aqueous blood analogs were not suitable. An analog consisting of 0.04% ethylhydroxyethylcellulose dissolved in gamma-butyrolactone produced a pseudoplastic steady shear response with low elasticity in unsteady shear, while being compatible with the photochemical tracer.
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Affiliation(s)
- M K Sharp
- Department of Civil Engineering, University of Utah, Salt Lake City 84112, USA.
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35
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Abstract
An analytical solution for pulsatile flow of a generalized Maxwell fluid in straight rigid tubes, with and without axial vessel motion, has been used to calculate the effect of blood viscoelasticity on velocity profiles and shear stress in flows representative of those in the large arteries. Measured bulk flow rate Q waveforms were used as starting points in the calculations for the aorta and femoral arteries, from which axial pressure gradient delta P waves were derived that would reproduce the starting Q waves for viscoelastic flow. The delta P waves were then used to calculate velocity profiles for both viscoelastic and purely viscous flow. For the coronary artery, published delta P and axial vessel acceleration waveforms were used in a similar procedure to determine the separate and combined influences of viscoelasticity and vessel motion. Differences in local velocities, comparing viscous flow to viscoelastic flow, were in all cases less than about 2% of the peak local velocity. Differences in peak wall shear stress were less than about 3%. In the coronary artery, wall shear stress differences between viscous and viscoelastic flow were small, regardless of whether axial vessel motion was included. The shape of the wall shear stress waveform and its difference, however, changed dramatically between the stationary and moving vessel cases. The peaks in wall shear stress difference corresponded with large temporal gradients in the combined driving force for the flow.
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Affiliation(s)
- M K Sharp
- Department of Civil Engineering, University of Utah, Salt Lake City 84112, USA
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36
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Sharp MK. An orbiting scroll blood pump without valves or rotating seals. ASAIO J 1994; 40:41-8. [PMID: 8186491] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Valves in blood pumps are expensive and provide modes of failure. Rotating seals offer sites of thrombus formation and infection. In this study, a prototype pump incorporating no valves or rotating seals was constructed and tested. In this device, fluid is pumped by the orbital action of a spiral shaped scroll relative to an identical stationary scroll whose starting axis is rotated 180 degrees with respect to the orbiting scroll. The two scrolls, which are machined integral with scroll plates, form pockets that are filled from the outside and then ejected in the center as the orbiting scroll completes each cycle. The orbiting scroll is driven by a crank mechanism connected to a motor. Fluid is contained in the space around the scrolls by a flexible collar and does not contact the driving mechanism. The prototype pump is approximately 7.6 cm in diameter and 2.5 cm thick and has an orbiting radius of 5.1 mm. The output of the pump was very sensitive to the clearance between the scroll tip and the base of the opposite scroll plate. For a clearance of 51 microns, pressure differences as high as 400 mmHg and flows as high as 7.7 l/min (of water) were produced at 260 rpm. At 450 rpm with a 330 microns clearance, pressure differences as high as 185 mmHg and flows as high as 7.3 l/min resulted. The relationships between pressure difference and flow were very linear in all cases. Volumetric efficiency was as high as 70% and increased with speed.
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Affiliation(s)
- M K Sharp
- Biofluid Mechanics Laboratory, Department of Civil Engineering, University of Utah, Salt Lake City 84112
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37
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Abstract
The rate of spread of a passive species is modified by the superposition of a velocity gradient on the concentration field. Taylor (18) solved for the rate of axial dispersion in fully developed steady Newtonian flow in a straight pipe under the conditions that the dispersion be relatively steady and that longitudinal transport be controlled by convection rather than diffusion. He found that the resulting effective axial diffusivity was proportional to the square of the Peclet number Pec and inversely proportional to the molecular diffusivity. This article shows that under similar conditions in Casson and power law fluids, both simplified models for blood, and in Bingham fluids the same proportionalities are found. Solutions are presented for fully developed steady flow in a straight tube and between flat plates. The proportionality factor, however, is dependent upon the specific rheology of the fluid. For Bingham and Casson fluids, the controlling parameter is the radius of the constant-velocity core in which the shear stress does not exceed the yield stress of the fluid. For a core radius of one-tenth the radius of the tube, the effective axial diffusivity in Casson fluids is reduced to approximately 0.78 times that in a Newtonian fluid at the same flow. Using average flow conditions, it is found that the core radius/tube radius ratio is 0 (10(-2)) to 0 (10(-1)) in canine arteries and veins. Even at these small values, the effective diffusivity is diminished by 5% to 18%. For power law fluids, Pec2 dependence is again found, but with a proportionality constant dependent upon the power law exponent n.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M K Sharp
- Department of Civil Engineering, University of Utah, Salt Lake City 84112
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38
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Pantalos GM, Sharp MK. Influence of viscosity and pressure on prosthetic valve regurgitation. Int J Artif Organs 1993; 16:151-4. [PMID: 8314639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Blood viscosity varies during the course of artificial heart implants and is affected by pathological conditions. To gauge the potential effect of changing viscosity on valve performance, leakage rates were measured across a closed Medtronic-Hall valve with water, water/glycerol and fresh whole bovine blood for aortic and pulmonary pressure ranges. As might be expected from the low Reynolds numbers (< 140), losses across the valve were found to be primarily viscous. For the two Newtonian fluids, leakage was slightly less than linearly proportional to pressure. This is comparable with empirical data for orifice flow, which predicts three fifths power dependence on pressure. For blood, however, the greater than linear dependence on pressure found suggests that the pseudoplasticity (shear-thinning behavior) of blood is important. These data provide evidence that the viscous and non-Newtonian properties of blood must be taken into account in modelling prosthetic valve performance and may affect the test methods and flow regulation strategies for prosthetic blood pumps.
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Affiliation(s)
- G M Pantalos
- Artificial Heart Research Laboratory, University of Utah, Salt Lake City
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Sharp MK, Olsen DB. Sensitivity of the artificial heart to changes in vascular resistance. ASAIO Trans 1990; 36:805-10. [PMID: 2268483 DOI: 10.1097/00002480-199010000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For conditions near those for normal operation, the cardiac output of the healthy natural heart is inherently sensitive to systemic venous resistance but is relatively insensitive to arterial resistance. A mathematical comparison was undertaken to discover the differences in the sensitivity of two configurations of artificial hearts to these resistances. It was found that one design incorporating independently pumping ventricles can be tailored to passively mimic the sensitivity of the natural heart. However, the other design with volumetrically coupled pumping is incapable of exhibiting similar sensitivity through passive means.
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Affiliation(s)
- M K Sharp
- Department of Civil Engineering, University of Utah, Salt Lake City 84112
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