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Smith ME, Hardman JC, Mehta N, Jones GH, Mandavia R, Anderson C, Khan M, Abdelaziz A, Al-Dulaimy B, Amin N, Anmolsingh R, Anwar B, Bance M, Belfield K, Bhutta M, Buchanan R, Chandrasekharan D, Chu M, Chundu S, Conroy K, Crundwell G, Daniel M, Daniels J, De S, Dobbs S, Doshi J, Farr M, Ferdous T, Fragkouli E, Freeman S, Ghosh S, Gosnell E, Hannan SA, Heward E, Javed F, John D, Nicholls H, Kasbekar AV, Khan H, Khan H, Khwaja S, Kotecha B, Krishnan M, Kumar N, Lamb T, Lancer H, Manjaly JG, Martinez Del Pero M, McClenaghan F, Milinis K, Mistry N, Mohammed H, Morris E, Morris-Jones S, Padee J, Pal S, Patel S, Pericleous A, Qayyum A, Rouhani M, Saeed H, Santhiyapillai M, Seymour K, Sharma S, Siau R, Singh A, Stapleton E, Stephenson K, Stynes G, Subramanian B, Summerfield N, Swords C, Trinidade A, Tse A, Twumasi E, Ubhi H, Unadkat S, Vijendren A, Wasson J, Watson G, Williams G, Wilson J, Yao A, Youssef A, Lloyd SKW, Tysome JR. Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development. PLoS One 2021; 16:e0251395. [PMID: 33989313 PMCID: PMC8121300 DOI: 10.1371/journal.pone.0251395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/25/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Evidence for the management of acute otitis externa (AOE) is limited, with unclear diagnostic criteria and variably reported outcome measures that may not reflect key stakeholder priorities. We aimed to develop 1) a definition, 2) diagnostic criteria and 3) a core outcome set (COS) for AOE. STUDY DESIGN COS development according to Core Outcome Measures in Effectiveness Trials (COMET) methodology and parallel consensus selection of diagnostic criteria/definition. SETTING Stakeholders from the United Kingdom. SUBJECTS AND METHODS Comprehensive literature review identified candidate items for the COS, definition and diagnostic criteria. Nine individuals with past AOE generated further patient-centred candidate items. Candidate items were rated for importance by patient and professional (ENT doctors, general practitioners, microbiologists, nurses, audiologists) stakeholders in a three-round online Delphi exercise. Consensus items were grouped to form the COS, diagnostic criteria, and definition. RESULTS Candidate COS items from patients (n = 28) and literature (n = 25) were deduplicated and amalgamated to a final candidate list (n = 46). Patients emphasised quality-of-life and the impact on daily activities/work. Via the Delphi process, stakeholders agreed on 31 candidate items. The final COS covered six outcomes: pain; disease severity; impact on quality-of-life and daily activities; patient satisfaction; treatment-related outcome; and microbiology. 14 candidate diagnostic criteria were identified, 8 reaching inclusion consensus. The final definition for AOE was 'diffuse inflammation of the ear canal skin of less than 6 weeks duration'. CONCLUSION The development and adoption of a consensus definition, diagnostic criteria and a COS will help to standardise future research in AOE, facilitating meta-analysis. Consulting former patients throughout development highlighted deficiencies in the outcomes adopted previously, in particular concerning the impact of AOE on daily life.
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Affiliation(s)
| | - John C Hardman
- The Royal Marsden Hospital London, London, United Kingdom
| | - Nishchay Mehta
- Royal National ENT Hospital London, London, United Kingdom
| | - Gareth H Jones
- Aintree University Hospitals Liverpool, Liverpool, United Kingdom
| | - Rishi Mandavia
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Maha Khan
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Nikul Amin
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Bilal Anwar
- Salford Royal Hospital, Salford, United Kingdom
| | - Manohar Bance
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Katherine Belfield
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Mahmood Bhutta
- Brighton Sussex University Hospitals, Brighton, United Kingdom
| | | | | | - Michael Chu
- Health Education North West, Manchester, United Kingdom
| | | | - Katherine Conroy
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Gemma Crundwell
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Mat Daniel
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Jessica Daniels
- Tameside and Glossop NHS Integrated Care Trust, Ashton-under-Lyne, United Kingdom
| | - Sujata De
- Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Sian Dobbs
- Health Education North West, Manchester, United Kingdom
| | - Jayesh Doshi
- Heartlands Hospital Birmingham, Birmingham, United Kingdom
| | - Matthew Farr
- University of Sheffield, Sheffield, United Kingdom
| | - Tanjinah Ferdous
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Eleni Fragkouli
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
| | | | - Samit Ghosh
- Pennine Acute Trust, Manchester, United Kingdom
| | - Emma Gosnell
- Royal Bolton Hospital, Farnworth, United Kingdom
| | - S Alam Hannan
- Royal National ENT Hospital London, London, United Kingdom
| | - Elliot Heward
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Faisal Javed
- Heartlands Hospital Birmingham, Birmingham, United Kingdom
| | - Deepa John
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Anand V Kasbekar
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Haroon Khan
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Hammad Khan
- Royal Preston Hospital, Fulwood, United Kingdom
| | - Sadie Khwaja
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Bhik Kotecha
- Nuffield Health Brentwood Hospital, Brentwood, United Kingdom
| | | | - Nirmal Kumar
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom
| | - Tamara Lamb
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Hannah Lancer
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | | | | | - Kristijonas Milinis
- Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Nina Mistry
- Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom
| | - Hassan Mohammed
- Newcastle Upon Tyne University Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Elizabeth Morris
- Nuffield Department of Primary Care Health Sciences, United Kingdom
| | - Stephen Morris-Jones
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jessica Padee
- University of Manchester, Manchester, United Kingdom
| | - Surojit Pal
- London North West University Healthcare NHS Trust, London, United Kingdom
| | - Sanjay Patel
- Aintree University Hospitals Liverpool, Liverpool, United Kingdom
| | | | - Asad Qayyum
- North West Anglia NHS Foundation Trust, Peterborough, United Kingdom
| | - Maral Rouhani
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Haroon Saeed
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Kay Seymour
- Barts Health NHS Trust, London, United Kingdom
| | - Sunil Sharma
- Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Richard Siau
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Arvind Singh
- London North West University Healthcare NHS Trust, London, United Kingdom
| | - Emma Stapleton
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Gill Stynes
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | | | - Neil Summerfield
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Aaron Trinidade
- Southend University Hospital NHS Foundation Trust, Southend-on-Sea, United Kingdom
| | - Antonia Tse
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Emmanuel Twumasi
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Harmony Ubhi
- London North West University Healthcare NHS Trust, London, United Kingdom
| | - Samit Unadkat
- Royal National ENT Hospital London, London, United Kingdom
| | | | - Joe Wasson
- East Kent Hospitals NHS Foundation Trust, Canterbury, United Kingdom
| | - Glen Watson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Janet Wilson
- Newcastle Upon Tyne University Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | | | - Ahmed Youssef
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Simon K W Lloyd
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Dobson R, Siddiqi K, Ferdous T, Huque R, Lesosky M, Balmes J, Semple S. Diurnal variability of fine-particulate pollution concentrations: data from 14 low- and middle-income countries. Int J Tuberc Lung Dis 2021; 25:206-214. [PMID: 33688809 PMCID: PMC7948758 DOI: 10.5588/ijtld.20.0704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Scientific understanding of indoor air pollution is predominately based on research carried out in cities in high-income countries (HICs). Less is known about how pollutant concentrations change over the course of a typical day in cities in low- and middle-income countries (LMICs).OBJECTIVE: To understand how concentrations of fine particulate matter smaller than 2.5 microns in diameter (PM2.5) change over the course of the day outdoors (across a range of countries) and indoors (using measurements from Dhaka, Bangladesh).DESIGN: Data on PM2.5 concentrations were gathered from 779 households in Dhaka as part of the MCLASS II (Muslim Communities Learning About Second-hand Smoke in Bangladesh) project, and compared to outdoor PM2.5 concentrations to determine the temporal variation in exposure to air pollution. Hourly PM2.5 data from 23 cities in 14 LMICs, as well as London (UK), Paris (France) and New York (NY, USA), were extracted from publicly available sources for comparison.RESULTS: PM2.5 in homes in Dhaka demonstrated a similar temporal pattern to outdoor measurements, with greater concentrations at night than in the afternoon. This pattern was also evident in 19 of 23 LMIC cities.CONCLUSION: PM2.5 concentrations are greater at night than during the afternoon in homes in Dhaka. Diurnal variations in PM2.5 in LMICs is substantial and greater than in London, Paris or New York. This has implications for public health community approaches to health effects of air pollution in LMICs.
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Affiliation(s)
- R. Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
| | - K. Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - T. Ferdous
- Advancement through Research and Knowledge Foundation Bangladesh, Dhaka, Bangladesh
| | - R. Huque
- Advancement through Research and Knowledge Foundation Bangladesh, Dhaka, Bangladesh
| | - M. Lesosky
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - J. Balmes
- Department of Medicine, University of California, San Francisco, CA
,School of Public Health, University of California, Berkeley, CA, USA
| | - S. Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
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Mandavia R, Hannink G, Ahmed MN, Premakumar Y, Chu TSM, Blackshaw H, Ferdous T, Mehta N, Manjaly J, Khan M, Schilder AG. Prognostic factors for outcomes of idiopathic sudden sensorineural hearing loss: protocol for the SeaSHeL national prospective cohort study. BMJ Open 2020; 10:e038552. [PMID: 32988948 PMCID: PMC7523222 DOI: 10.1136/bmjopen-2020-038552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The mainstay of treatment for idiopathic sudden sensorineural hearing loss (SSNHL) includes oral steroids, intratympanic steroid injections or a combination of both. The National Institute for Health and Care Excellence, in their recent hearing loss guidelines, highlighted the paucity of evidence assessing the comparative effectiveness of these treatments; and the National Institute for Health Research (NIHR) Health Technology Assessment Programme has since released a commissioned call for a trial to identify the most effective route of administration of steroids as a first-line treatment for idiopathic SSNHL. For such trials to be run effectively, reliable information is needed on patients with SSNHL: where they present, numbers, demographics, treatment pathways, as well as outcomes. This study will collect these data in a nationwide cohort study of patients presenting with SSNHL across 97 National Health Service (NHS) trusts. The study will be delivered through ear, nose and throat (ENT) trainee networks, the NIHR Clinical Research Network (CRN) Audiology Champions and the NIHR CRN. Importantly, this study will also provide a dataset to develop a prognostic model to predict recovery for patients with idiopathic SSNHL. The study objectives are to: (1) map the patient pathway and identify the characteristics of adult patients presenting to NHS ENT and hearing services with SSNHL, (2) develop a prognostic model to predict recovery for patients with idiopathic SSNHL and (3) establish the impact of idiopathic SSNHL on patients' quality of life (QoL). METHODS AND ANALYSIS Study design: national multicentre prospective cohort study across 97 NHS trusts. INCLUSION CRITERIA adult patients presenting to NHS ENT and hearing services with SSNHL. OUTCOMES change in auditory function; change in QoL score. ANALYSIS multivariable prognostic model, using prespecified candidate predictors. Mean change in QoL scores will be calculated from initial presentation to follow-up. ETHICS AND DISSEMINATION Health Research Authority and NHS Research Ethics Committee approved the study. Publication will be on behalf of study sites and collaborators. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04108598).
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Affiliation(s)
- Rishi Mandavia
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
- SFO UK Students and Foundation Doctors in Otolaryngology, London, UK
| | - Gerjon Hannink
- Department of Operating Rooms, Radboudumc, Nijmegen, The Netherlands
| | - Muhammad Nayeem Ahmed
- evidENT, University College London Ear Institute, London, UK
- University of Leeds School of Medicine, Leeds, UK
| | | | - Timothy Shun Man Chu
- SFO UK Students and Foundation Doctors in Otolaryngology, London, UK
- Newcastle University School of Clinical Medical Sciences, Newcastle upon Tyne, UK
| | - Helen Blackshaw
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
| | - Tanjinah Ferdous
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
| | - Nishchay Mehta
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
| | - Joseph Manjaly
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
| | - Maha Khan
- Health Education North West, Manchester, UK
| | - Anne Gm Schilder
- University College London Hospitals Biomedical Research Centre, National Institute for Health Research, London, UK
- evidENT, University College London Ear Institute, London, UK
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Questa K, Das M, King R, Everitt M, Rassi C, Cartwright C, Ferdous T, Barua D, Putnis N, Snell AC, Huque R, Newell J, Elsey H. Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews. Int J Equity Health 2020; 19:51. [PMID: 32252778 PMCID: PMC7137248 DOI: 10.1186/s12939-020-01169-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of communicable disease control (CDC) in low and lower-middle income countries (LLMIC). We conducted an umbrella review to identify approaches to CE in communicable disease control, effectiveness of these approaches, mechanisms and factors influencing success. Methods We included systematic reviews that: i) focussed on CE interventions; ii) involved adult community members; iii) included outcomes relevant to communicable diseases in LLMIC; iv) were written in English. Quantitative results were extracted and synthesised narratively. A qualitative synthesis process enabled identification of mechanisms of effect and influencing factors. We followed guidance from the Joanna Briggs Institute, assessed quality with the DARE tool and reported according to standard systematic review methodology. Results Thirteen systematic reviews of medium-to-high quality were identified between June and July 2017. Reviews covered the following outcomes: HIV and STIs (6); malaria (2); TB (1); child and maternal health (3) and mixed (1). Approaches included: CE through peer education and community health workers, community empowerment interventions and more general community participation or mobilisation. Techniques included sensitisation with the community and involvement in the identification of resources, intervention development and delivery. Evidence of effectiveness of CE on health outcomes was mixed and quality of primary studies variable. We found: i) significantly reduced neonatal mortality following women’s participatory learning and action groups; ii) significant reductions in HIV and other STIs with empowerment and mobilisation interventions with marginalised groups; iii) significant reductions in malaria incidence or prevalence in a small number of primary studies; iv) significant reductions in infant diarrhoea following community health worker interventions. Mechanisms of impact commonly occurred through social and behavioural processes, particularly: changing social norms, increasing social cohesion and social capacity. Factors influencing effectiveness of CE interventions included extent of population coverage, shared leadership and community control over outcomes. Conclusion Community engagement interventions may be effective in supporting CDC in LLMIC. Careful design of CE interventions appropriate to context, disease and community is vital.
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Affiliation(s)
- K Questa
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - M Das
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R King
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK.
| | - M Everitt
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - C Rassi
- Malaria Consortium, London, UK
| | - C Cartwright
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | | | - D Barua
- ARK Foundation, Dhaka, Bangladesh
| | - N Putnis
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - A C Snell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R Huque
- ARK Foundation, Dhaka, Bangladesh
| | - J Newell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - H Elsey
- University of York, York, UK
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