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Chowdary P, Ofori-Asenso R, Nissen F, Grazzi EF, Aizenas M, Moreno K, Burke T, Nolan B, O'Hara J, Khair K. Disease Burden, Clinical Outcomes, and Quality of Life in People with Hemophilia A without Inhibitors in Europe: Analyses from CHESS II/CHESS PAEDs. TH Open 2024; 8:e181-e193. [PMID: 38628421 PMCID: PMC11018388 DOI: 10.1055/s-0044-1785524] [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: 11/22/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Limited data relating to treatment burden, quality of life, and mental health burden of hemophilia A (HA) are currently available. Aim To provide a comprehensive overview of unmet needs in people with HA (PwHA) using data generated from the Cost of Haemophilia in Europe: a Socioeconomic Survey-II (CHESS II) and CHESS in the pediatric population (CHESS PAEDs) studies. Methods CHESS II and CHESS PAEDs are cross-sectional surveys of European males with HA or hemophilia B (HB) aged ≥18 and ≤17 years, respectively. Participants with FVIII inhibitors, mild HA, or HB were excluded from this analysis, plus those aged 18 to 19 years. Annualized bleeding rates (ABRs), target joints, and other patient-reported outcomes were evaluated. Results Overall, 468 and 691 PwHA with available data for the outcomes of interest were stratified by hemophilia severity and treatment regimen in CHESS II and CHESS PAEDs, respectively. In these studies, 173 (37.0%) and 468 (67.7%) participants received FVIII prophylaxis, respectively; no participants received the FVIII mimetic emicizumab or gene therapy. ABRs of 2.38 to 4.88 were reported across disease severity and treatment subgroups in both studies. Target joints were present in 35.7 and 16.6% of participants in CHESS II and CHESS PAEDS; 43.8 and 23.0% had problem joints. Chronic pain was reported by a large proportion of PwHA (73.9% in CHESS II; 58.8% in CHESS PAEDs). Participants also reported low EQ-5D scores (compared with people without HA), anxiety, depression, and negative impacts on their lifestyles due to HA. Conclusions These analyses suggest significant physical, social, and mental burdens of HA, irrespective of disease severity. Optimization of prophylactic treatment could help reduce the burden of HA on patients.
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Affiliation(s)
- Pratima Chowdary
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Richard Ofori-Asenso
- Real-World Data Enabling Platform, Roche Products Ltd, Welwyn Garden City, United Kingdom
| | - Francis Nissen
- Department of Real-World Data, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Enrico F. Grazzi
- Health Economics and Outcomes Research, HCD Economics, Daresbury, United Kingdom
| | - Martynas Aizenas
- Department of Access Strategy, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Katya Moreno
- Department of Product Development and Medical Affairs, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Tom Burke
- Health Economics and Outcomes Research, HCD Economics, Daresbury, United Kingdom
- Department of Health and Social Care, University of Chester, Chester, United Kingdom
| | - Beatrice Nolan
- Department of Haematology, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Jamie O'Hara
- Health Economics and Outcomes Research, HCD Economics, Daresbury, United Kingdom
- Department of Health and Social Care, University of Chester, Chester, United Kingdom
| | - Kate Khair
- Department of Research, Haemnet, London, United Kingdom
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Ferri Grazzi E, Blenkiron T, Hawes C, Camp C, O'Hara J, Burke T, O'Brien G. Anxiety and depression among adults with haemophilia A: Patient and physician reported symptoms from the real-world European CHESS II study. Haemophilia 2024. [PMID: 38507035 DOI: 10.1111/hae.14989] [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: 11/01/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The physical pain and disability affecting many people with haemophilia A (PwHA) are known detractors from psychological wellbeing. While psychosocial support is considered a core tenet of the haemophilia comprehensive care structure, the extent to which mental health challenges are detected and monitored by the individuals treating haematologist remains relatively unexplored. AIM To describe prevalence of anxiety and depression in a real-world cohort of adult PwHA and evaluate the congruence in reporting of anxiety or depression (A/D) between PwHA and their treating physicians. METHODS Data for PwHA without inhibitors was drawn from the European 'Cost of Haemophilia: A Socioeconomic Survey II' (CHESS II) study. Haematologist-indicated comorbidities of anxiety and depression were unified into a single A/D indicator. The EQ-5D-5L health status measure was used to characterise self-reported A/D, with individuals stratified into two non-mutually exclusive subgroups based on level of A/D reported (Subgroup A: 'some' or above; Subgroup B: 'moderate' or above). RESULT Of 381 PwHA with evaluable EQ-5D-5L responses, 54% (n = 206) self-reported at least some A/D (Subgroup A) and 17% (n = 66) reported at least moderate A/D (Subgroup B). Patient-physician congruence in A/D reporting was 53% and 76% for Subgroups A and B, respectively. Descriptive analysis suggested that individuals with physician- and/or self-reported A/D experienced worse clinical outcomes (bleeding events, joint disease, chronic pain). CONCLUSION While adverse clinical outcomes appear to correlate with A/D, self-reports of moderate-severe symptoms occasionally lacked formal recognition from treating physicians. Cross-disciplinary surveillance of mental health issues could improve both psychological and clinical outcomes among PwHA.
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Affiliation(s)
| | - Thomas Blenkiron
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
| | | | | | - Jamie O'Hara
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
- Department of Health and Social Care, University of Chester, Chester, UK
| | - Tom Burke
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
- Department of Health and Social Care, University of Chester, Chester, UK
| | - Gráinne O'Brien
- Department of Clinical Psychology, Royal Infirmary of Edinburgh, Edinburgh, UK
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Stevens M, Ní Mhurchú S, Corley E, Egan C, Hallahan B, McDonald C, Donohoe G, Burke T. Uncinate fasciculus microstructural organisation and emotion recognition in schizophrenia: controlling for hit rate bias. Front Behav Neurosci 2024; 18:1302916. [PMID: 38566859 PMCID: PMC10985192 DOI: 10.3389/fnbeh.2024.1302916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Schizophrenia (SCZ) is a complex neurodevelopmental disorder characterised by functional and structural brain dysconnectivity and disturbances in perception, cognition, emotion, and social functioning. In the present study, we investigated whether the microstructural organisation of the uncinate fasciculus (UF) was associated with emotion recognition (ER) performance. Additionally, we investigated the usefulness of an unbiased hit rate (UHR) score to control for response biases (i.e., participant guessing) during an emotion recognition task (ERT). Methods Fifty-eight individuals diagnosed with SCZ were included. The CANTAB ERT was used to measure social cognition. Specific ROI manual tract segmentation was completed using ExploreDTI and followed the protocol previously outlined by Coad et al. (2020). Results We found that the microstructural organisation of the UF was significantly correlated with physical neglect and ER outcomes. Furthermore, we found that the UHR score was more sensitive to ERT subscale emotion items than the standard HR score. Finally, given the association between childhood trauma (in particular childhood neglect) and social cognition in SCZ, a mediation analysis found evidence that microstructural alterations of the UF mediated an association between childhood trauma and social cognitive performance. Discussion The mediating role of microstructural alterations in the UF on the association between childhood trauma and social cognitive performance suggests that early life adversity impacts both brain development and social cognitive outcomes for people with SCZ. Limitations of the present study include the restricted ability of the tensor model to correctly assess multi-directionality at regions where fibre populations intersect.
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Affiliation(s)
- Matthew Stevens
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
| | - Síle Ní Mhurchú
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
| | - Emma Corley
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
| | - Ciara Egan
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
| | - Brian Hallahan
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
| | - Tom Burke
- School of Psychology, University of Galway, Galway, Ireland
- Centre for Neuroimaging Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
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O'Connor S, Hevey D, Burke T, Rafee S, Pender N, O'Keeffe F. A Systematic Review of Cognition in Cervical Dystonia. Neuropsychol Rev 2024; 34:134-154. [PMID: 36696021 PMCID: PMC10920436 DOI: 10.1007/s11065-022-09558-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/12/2021] [Revised: 04/17/2022] [Accepted: 06/10/2022] [Indexed: 01/26/2023]
Abstract
Growing evidence points to a spectrum of non-motor symptoms, including cognitive difficulties that have a greater impact on functional outcomes and quality of life than motor symptoms in cervical dystonia (CD). Some cognitive impairments have been reported; however, findings are inconsistent, and described across mixed groups of dystonia. The current review aimed to examine the evidence for cognitive impairments in CD. MEDLINE, EMBASE, PsychINFO and Web of Science databases were searched. Studies were included if they met the following criteria (i) cross-sectional or longitudinal studies of adults with CD, (ii) where the results of standardised measures of cognitive or neuropsychological function in any form were assessed and reported, (iii) results compared to a control group or normative data, and (iv) were published in English. Results are presented in a narrative synthesis. Twenty studies were included. Subtle difficulties with general intellectual functioning, processing speed, verbal memory, visual memory, visuospatial function, executive function, and social cognition were identified while language, and attention and working memory appear to be relatively spared. Several methodological limitations were identified that should be considered when interpreting the evidence to describe a specific profile of cognitive impairment in CD. Clinical and research implications are discussed.
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Affiliation(s)
- Sarah O'Connor
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland.
| | - David Hevey
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
| | - Tom Burke
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Shameer Rafee
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
- Department of Psychology, St Vincent's University Hospital, Dublin, Ireland
- School of Psychology, University College Dublin, Dublin, Ireland
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Corley E, Gleeson C, Godfrey E, Cowman M, Patlola SR, Cannon DM, McKernan DP, Kelly JP, Hallahan B, McDonald C, Morris DW, Burke T, Donohoe G. Corpus callosum microstructural organization mediates the effects of physical neglect on social cognition in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110875. [PMID: 37844774 DOI: 10.1016/j.pnpbp.2023.110875] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
Exposure to early life adversity is associated with both increased risk of developing schizophrenia and poorer performance on measures of social cognitive functioning. In this study, we examined whether interleukin-6 (IL-6) and Corpus Callosum (CC) microstructure mediated the association between childhood physical neglect and social cognition. Fifty-eight patients with a diagnosis of schizophrenia were included. The CANTAB emotion recognition task (unbiased hit rate) was used to assess social cognition. We found that the microstructural organization of the CC significantly mediated the association between physical neglect and emotion recognition. Furthermore, in a sequential mediation analysis that also considered the role of inflammatory response, the association between physical neglect, and lower emotion recognition performance was sequentially mediated by higher IL-6 and lower fractional anisotropy of the CC. This mediating effect of IL-6 was only present when simultaneously considering the effects of CC microstructural organization and remained significant while controlling for the effects of sex, BMI and medication dosage (but not age). Overall, the findings suggest that the association between physical neglect and poorer emotion recognition in schizophrenia occurs, at least in part, via its association with white matter microstructure.
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Affiliation(s)
- Emma Corley
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Emmet Godfrey
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Megan Cowman
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | | | - Dara M Cannon
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - Declan P McKernan
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - John P Kelly
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - Brian Hallahan
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Colm McDonald
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Derek W Morris
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Tom Burke
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland.
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Fragkoudi A, Rumbold AR, Burke T, Grzeskowiak LE. "A qualitative study of multiple sclerosis specialists' experiences and perspectives in managing family planning in people with multiple sclerosis". Mult Scler Relat Disord 2024; 82:105409. [PMID: 38176286 DOI: 10.1016/j.msard.2023.105409] [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: 09/21/2023] [Revised: 11/02/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Managing multiple sclerosis (MS) in people of reproductive age can be challenging as treatment decisions often need to balance efficacy, safety to reproductive health and an understanding of reproductive intentions. There has been limited examination of how family planning (FP) is approached in people with MS (pwMS) in Australia. This study aimed to explore the experiences and perspectives of Australian MS clinical specialists on managing FP in the context of MS. METHODS We conducted one-on-one semi-structured interviews with nine neurologists and ten MS nurses across Australia who regularly provide care to pwMS of reproductive age. Interview topics examined current approaches to managing FP, availability of FP resources, and opportunities for improvement. Interview recordings were transcribed verbatim and analysed thematically. RESULTS Two main themes emerged. First, 'inconsistent approaches in providing family planning', where neurologists and MS nurses recognised FP provision as essential but revealed differences in the content, timing and extent of FP discussions; conflicts between reproductive considerations and DMT prescriptions according to teratogenic risk; and variable implementation of interdisciplinary approaches. Second, 'barriers in providing family planning' emerged which included a lack of local information resources on FP, lack of contemporary data on safety of DMTs, and a range of patient and professional factors, including time constraints. CONCLUSION MS clinical specialists saw FP as an essential part of the care of their patients and expressed a need for information and service provision consistency in order to improve FP and reproductive care to pwMS.
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Affiliation(s)
- A Fragkoudi
- Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - A R Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - T Burke
- School of Nursing, University of Notre Dame, Sydney, Australia
| | - L E Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Sturgeon K, Judd A, Burke T, Foster C, Gibb DM, Le Prevost M, Mhizha W, Tweed CD. Disseminating the research findings from the adolescents and adults living with Perinatal HIV (AALPHI) study: an approach from young people living with HIV. Res Involv Engagem 2024; 10:9. [PMID: 38238837 PMCID: PMC10797962 DOI: 10.1186/s40900-024-00541-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND The Adolescents and Adults Living with Perinatal HIV (AALPHI) study is one of only three cohort studies worldwide evaluating the impact of HIV on young people living with perinatal HIV (PLHIV) relative to a comparable group of HIV negative young people in close relationship with an HIV positive individual, for example, their mother, sibling or partner. This project aimed to engage young people with the AALPHI study findings, help them take ownership, and decide how they would disseminate the key messages to both study participants and to the wider community. METHODS In brief, 318 PLHIV and 100 HIV negative adolescents participated in AALPHI, where they each were interviewed twice, around two years apart. They were asked a wide range of psychosocial and risk behaviour questions and their cognitive function was assessed. We invited three AALPHI participants and seven members of the Youth Trials Board at the Children's HIV Association (CHIVA) to attend up to four workshops. They were provided with the key AALPHI research findings and asked to develop them into a format that was accessible and understandable for young people. Some who had not participated before formed a group in the fourth dissemination workshop that confirmed the most important concepts and results. RESULTS The young people decided to develop a film and a leaflet about the AALPHI findings and co-produced them with a film maker and graphic designer. Challenges included working with the film maker and the venue for the first three dissemination workshops was an office space which was not ideal. CONCLUSION Engaging young people in the dissemination of the AALPHI findings ensured the results were communicated in a way that was more likely to be relevant, accessible and useful to those affected by the study. This project demonstrates how young people in potentially stigmatised areas of care, such as HIV, can be involved in research dissemination.
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Affiliation(s)
- Kate Sturgeon
- MRC Clinical Trials Unit at University College London, London, UK.
| | - Ali Judd
- MRC Clinical Trials Unit at University College London, London, UK
| | | | | | - Diana M Gibb
- MRC Clinical Trials Unit at University College London, London, UK
| | | | - Warren Mhizha
- Youth Trials Board, London, UK
- Children's HIV Association (CHIVA), Bristol, UK
| | - Conor D Tweed
- MRC Clinical Trials Unit at University College London, London, UK
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Burke T, Holleran L, Mothersill D, Lyons J, O'Rourke N, Gleeson C, Cannon DM, McKernan DP, Morris DW, Kelly JP, Hallahan B, McDonald C, Donohoe G. Bilateral anterior corona radiata microstructure organisation relates to impaired social cognition in schizophrenia. Schizophr Res 2023; 262:87-94. [PMID: 37931564 DOI: 10.1016/j.schres.2023.10.035] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/25/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE The Corona Radiata (CR) is a large white matter tract in the brain comprising of the anterior CR (aCR), superior CR (sCR), and posterior CR (pCR), which have associations with cognition, self-regulation, and, in schizophrenia, positive symptom severity. This study tested the hypothesis that the microstructural organisation of the aCR, as measured by Fractional Anisotropy (FA) using Diffusion Tensor Imaging (DTI), would relate to poorer social cognitive outcomes and higher positive symptom severity for people with schizophrenia, when compared to healthy participants. We further hypothesised that increased positive symptoms would relate to poorer social cognitive outcomes. METHODS Data were derived from n = 178 healthy participants (41 % females; 36.11 ± 12.36 years) and 58 people with schizophrenia (30 % females; 42.4 ± 11.1 years). The Positive and Negative Symptom Severity Scale measured clinical symptom severity. Social Cognition was measured using the Reading the Mind in the Eyes Test (RMET) Total Score, as well as the Positive, Neutral, and Negative stimuli valence. The ENIGMA-DTI protocol tract-based spatial statistics (TBSS) was used. RESULTS There was a significant difference in FA for the CR, in individuals with schizophrenia compared to healthy participants. On stratification, both the aCR and pCR were significantly different between groups, with patients showing reduced white matter tract microstructural organisation. Significant negative correlations were observed between positive symptomatology and reduced microstructural organisation of the aCR. Performance for RMET negative valence items was significantly correlated bilaterally with the aCR, but not the sCR or pCR, and no relationship to positive symptoms was observed. CONCLUSIONS These data highlight specific and significant microstructural white-matter differences for people with schizophrenia, which relates to positive clinical symptomology and poorer performance on social cognition stimuli. While reduced FA is associated with higher positive symptomatology in schizophrenia, this study shows the specific associated with anterior frontal white matter tracts and reduced social cognitive performance. The aCR may have a specific role to play in frontal-disconnection syndromes, psychosis, and social cognitive profile within schizophrenia, though further research requires more sensitive, specific, and detailed consideration of social cognition outcomes.
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Affiliation(s)
- Tom Burke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Laurena Holleran
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - David Mothersill
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Psychology Department, School of Business, National College of, Ireland
| | - James Lyons
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Nathan O'Rourke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Dara M Cannon
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Declan P McKernan
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Derek W Morris
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Brian Hallahan
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Colm McDonald
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland.
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Stafford O, Gleeson C, Egan C, Tunney C, Rooney B, O’Keeffe F, McDermott G, Baron-Cohen S, Burke T. A 20-Year Systematic Review of the 'Reading the Mind in the Eyes' Test across Neurodegenerative Conditions. Brain Sci 2023; 13:1268. [PMID: 37759869 PMCID: PMC10526136 DOI: 10.3390/brainsci13091268] [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: 08/08/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Social cognition has a broad theoretical definition, which includes the ability to mentalise, i.e., recognise and infer mental states to explain and predict another's behaviour. There is growing recognition of the clinical, diagnostic, and prognostic value of assessing a person's ability to perform social cognitive tasks, particularly aspects of theory of mind, such as mentalising. One such measure of mentalising is the 'Reading the Mind in the Eyes' test (RMET). This systematic review and meta-analysis consider performance on the RMET, applied to people with neurodegenerative conditions in matched control studies, since its publication in 2001. Overall, this review includes 22 papers with data from N = 800 participants with neurodegenerative conditions: Alzheimer's disease, n = 31; Parkinson's disease, n = 221; Lewy body dementia, n = 33; motor neuron disease, n = 218; Huntington's disease n = 80; multiple sclerosis, n = 217; and N = 601 matched typical controls. Our meta-analyses show that deficits in mentalising, as measured by the RMET, are consistently reported across neurodegenerative conditions, with participants in both early and late disease stages being affected. Social cognition is an emerging field of cognitive neuroscience requiring specific and sensitive measurement across each subdomain. Adult-based meta-normative data feature, for which future groups or individuals could be compared against, and hypotheses relating to the source of these mentalising deficits are further discussed. This review was registered with PROSPERO (CRD42020182874).
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Affiliation(s)
- Owen Stafford
- School of Psychology, University College Dublin, D04 F6X4 Dublin, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
| | - Ciara Egan
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
| | - Conall Tunney
- Acquired Brain Injury Ireland, Meath Services, Dublin, Ireland
| | - Brendan Rooney
- School of Psychology, University College Dublin, D04 F6X4 Dublin, Ireland
| | - Fiadhnait O’Keeffe
- School of Psychology, University College Dublin, D04 F6X4 Dublin, Ireland
- St Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Garret McDermott
- Department of Psychology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, Cambridge University, Cambridge CB2 8AH, UK
| | - Tom Burke
- School of Psychology, University College Dublin, D04 F6X4 Dublin, Ireland
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
- Centre for Neuroimaging, Cognition, and Genomics,University of Galway, H91 TK33 Galway, Ireland
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10
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Young L, Chen Y, Alvir J, Burke T, Ferri Grazzi E, Winburn I. The impact of bleeding event frequency on health-related quality of life and work productivity outcomes in a European cohort of adults with haemophilia A: insights from the CHESS II study. Orphanet J Rare Dis 2023; 18:227. [PMID: 37537683 PMCID: PMC10398941 DOI: 10.1186/s13023-023-02690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Haemophilia A carries a substantial healthcare burden, affecting health-related quality of life (HRQoL). The Cost of Haemophilia in Men: a Socioeconomic Survey II (CHESS II), a retrospective real-world study, characterised the burden of haemophilia and its impact on HRQoL and work productivity. The current analysis explored the impact of bleeding events on HRQoL and work productivity in Europe. This analysis focused on data collected from males aged 18 to 64 years with haemophilia A without inhibitors who were receiving replacement factor products or a monoclonal antibody and were not participating in a clinical trial at the time of study recruitment. Descriptive statistics were analysed using scores from EuroQoL's EQ-5D-5L index and EQ-VAS analogue scale and the Work Productivity and Activity Index Specific Health Problem (WPAI:SHP) percentage scores stratified by the number of annual bleeding events (ABs) 0, 1, 2, 3-4, or ≥ 5. RESULTS Of 918 males with haemophilia A in CHESS II, 318 met inclusion criteria and had data available for HRQoL measures; mean age (SD) was 33.8 (12.1) years and 96% were White. Mean (SD) ABs of 2.7 (2.9) occurred over the preceding 12 months: 20% had 3 or 4 ABs; 17% had ≥ 5 ABs. Mean EQ-5D-5L index scores for patients with 0, 1, 2, 3-4, or ≥ 5 ABs were 0.92, 0.76, 0.76, 0.71, and 0.56, respectively. Mean (SD) EQ-VAS scores were 86.9 (13.6), with 0 ABs versus 69.5 (19.1) for 3 or 4 ABs and 61.2 (17.2) for ≥ 5 ABs. Mean percentage of overall work productivity loss on the WPAI:SHP questionnaire ranged from 9.70 to 0 ABs to 47.65 for ≥ 5 ABs. CONCLUSIONS In this European sample of adult men with haemophilia A, HRQoL and work productivity scores were lower among those reporting more AB events. Bleeding burden appears to affect HRQoL and productivity; however, this cross-sectional analysis limits the ability to draw firm conclusions on causality.
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Affiliation(s)
- Lisa Young
- Pfizer Ltd, Walton-on-the-Hill Tadworth, Surrey, UK.
| | | | | | - Tom Burke
- HCD Economics, Daresbury, Cheshire, UK
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | | | - Ian Winburn
- Pfizer Ltd, Walton-on-the-Hill Tadworth, Surrey, UK
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11
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King S, Mothersill D, Holleran L, Patlola SR, Burke T, McManus R, Kenyon M, McDonald C, Hallahan B, Corvin A, Morris DW, Kelly JP, McKernan DP, Donohoe G. Early life stress, low-grade systemic inflammation and weaker suppression of the default mode network (DMN) during face processing in Schizophrenia. Transl Psychiatry 2023; 13:213. [PMID: 37339948 DOI: 10.1038/s41398-023-02512-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 05/11/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023] Open
Abstract
Childhood trauma (CT) is associated with lower cognitive and social cognitive function in schizophrenia. Recent evidence suggests that the relationship between CT and cognition is mediated by both low-grade systemic inflammation and reduced connectivity of the default mode network (DMN) during resting state. This study sought to test whether the same pattern of associations was observed for DMN connectivity during task based activity. Fifty-three individuals with schizophrenia (SZ) or schizoaffective disorder (SZA) and one hundred and seventy six healthy participants were recruited from the Immune Response and Social Cognition (iRELATE) project. A panel of pro-inflammatory markers that included IL-6, IL-8, IL-10, tumour necrosis factor-alpha (TNFa), and C-reactive protein (CRP), were measured in plasma using ELISA. DMN connectivity was measured during an fMRI social cognitive face processing task. Patients showed evidence of low grade systemic inflammation and significantly increased connectivity between the left lateral parietal (LLP) cortex-cerebellum and LLP-left angular gyrus compared to healthy participants. Across the entire sample, IL-6 predicted increased connectivity between LLP-cerebellum, LLP-precuneus, and mPFC-bilateral-precentral-gyri and left postcentral gyrus. In turn, and again in the entire sample, IL-6 (but no other inflammatory marker) mediated the relationship between childhood physical neglect and LLP-cerebellum. Physical neglect scores also significantly predicted the positive association between IL-6 and LLP-precuneus connectivity. This is to our knowledge the first study that provides evidence that higher plasma IL-6 mediates the association between higher childhood neglect and increased DMN connectivity during task based activity. Consistent with our hypothesis, exposure to trauma is associated with weaker suppression of the DMN during a face processing task, and this association was mediated via increased inflammatory response. The findings may represent part of the biological mechanism by which CT and cognitive performance are related.
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Affiliation(s)
- Sinead King
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
- School of Psychology, University of Galway, Galway, Ireland
| | - David Mothersill
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- Department of Psychology, National College of Ireland, School of Business, Dublin, Ireland
| | - Laurena Holleran
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Psychology, University of Galway, Galway, Ireland
| | - Saahithh Redddi Patlola
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- Pharmacology & Therapeutics, University of Galway, Galway, Ireland
| | - Tom Burke
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Psychology, University of Galway, Galway, Ireland
| | - Ross McManus
- Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
| | - Marcus Kenyon
- Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
| | - Colm McDonald
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Aiden Corvin
- Department of Psychiatry, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- School of Biological and Chemical Sciences, University of Galway, Galway, Ireland
| | - John P Kelly
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- Pharmacology & Therapeutics, University of Galway, Galway, Ireland
| | - Declan P McKernan
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland
- Pharmacology & Therapeutics, University of Galway, Galway, Ireland
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition and Genomics (NICOG), University of Galway, Galway, Ireland.
- School of Psychology, University of Galway, Galway, Ireland.
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12
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Chowdary P, Nissen F, Burke T, Aizenas M, Czirok T, Dhillon H, O'Hara J. The humanistic and economic burden of problem joints for children and adults with moderate or severe haemophilia A: Analysis of the CHESS population studies. Haemophilia 2023; 29:753-760. [PMID: 36897517 DOI: 10.1111/hae.14766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Adequate prophylactic treatment and physical activity improve joint health and clinical outcomes for people with haemophilia A (HA). However, non-clinical joint-related burden of moderate (MHA) and severe (SHA) HA has not been well characterised. AIM To quantify the joint health-related humanistic and economic burden of MHA and SHA in Europe. METHODS A retrospective analysis of the cross-sectional CHESS population studies using a patient-centric measure of joint health (problem joints, PJs: chronic joint pain and/or limited range of movement due to compromised joint integrity with or without persistent bleeding) was conducted. Descriptive statistics summarised health-related quality of life (HRQoL), work productivity/activity impairment and costs by number of PJs (0, 1 or ≥2) and HA severity. RESULTS A total of 1171 patients were included from CHESS-II (n = 468) and CHESS-PAEDs (n = 703). In both studies, 41 and 59% of patients had MHA and SHA, respectively. Prevalence of ≥2 PJs was similar with MHA and SHA (CHESS-II: 23 and 26%; CHESS-PAEDs: 4 and 3%, respectively). HRQoL was worse with an increasing number of PJs (CHESS-II: .81 vs. .66 with 0 and ≥2 PJs, respectively, for MHA; .79 vs. .51 for SHA; CHESS-PAEDs: .64 vs. .26 and .72 vs. .14). Total costs increased with increasing PJs regardless of severity in CHESS-II (€2923 vs. €22,536 with 0 and ≥2 PJs, respectively, for MHA; €11,022 vs. €27,098 for SHA) and CHESS-PAEDs (€6222 vs. €11,043 for MHA; €4457 vs. €14,039 for SHA). CONCLUSION Presence of PJs was associated with a substantial humanistic and economic burden on patients with MHA or SHA across the lifespan.
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Affiliation(s)
- Pratima Chowdary
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK
| | | | - Tom Burke
- HCD Economics, Daresbury, UK.,University of Chester, Chester, UK
| | | | | | | | - Jamie O'Hara
- HCD Economics, Daresbury, UK.,University of Chester, Chester, UK
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13
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Burke T, Rodriguez-Santana I, Chowdary P, Curtis R, Khair K, Laffan M, Mclaughlin P, Noone D, O'Mahony B, Pasi J, Skinner M, O'Hara J. Humanistic burden of problem joints for children and adults with haemophilia. Haemophilia 2023; 29:608-618. [PMID: 36574369 DOI: 10.1111/hae.14731] [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: 05/10/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The "problem joint" (PJ) concept was developed to address patient-centric needs for a more holistic assessment of joint morbidity for people with haemophilia (PwH). AIM To quantify the humanistic burden of PJs in PwH to further support validation of the PJ outcome measure. METHODS Multivariable regression models evaluated the relationship between PJs and health-related quality of life (HRQoL, EQ-5D-5L) and overall work productivity loss (WPL) using data from the 'Cost of HaEmophilia: a Socioeconomic Survey' population studies (adults: CHESS II, CHESS US+; children/adolescents: CHESS-Paeds). Covariates included were haemophilia severity, age, comorbidities and education. RESULTS The CHESS II sample included 292 and 134 PwH for HRQoL and WPL analyses, mean age 38.6 years (39% ≥1 PJ, 61% none). CHESS US+ included 345 and 239 PwH for HRQoL and WPL, mean age 35 years (43% ≥1 PJ, 57% none). CHESS-Paeds included 198 PwH aged 4-17 (HRQoL only), mean age 11.5 years (19% ≥1 PJ, 81% none). In CHESS II and CHESS US+, presence of PJs was associated with worse HRQoL (Both p < .001). Few CHESS-Paeds participants had PJs, with no significant correlation with HRQoL. In CHESS II, upper body PJs were significantly correlated to WPL (p < .05). In CHESS US+, having ≥1 PJ or upper and lower body PJs were significantly correlated to WPL (vs. none; both p < .05). CONCLUSION This study has shown a meaningful burden of PJs on PwH, which should be considered in clinical and health policy assessments of joint health.
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Affiliation(s)
| | | | - Pratima Chowdary
- Katherine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Randall Curtis
- Hematology Utilization Group Study (HUGS), Walnut Creek, USA
| | - Kate Khair
- HCD Economics, Daresbury, UK.,Haemnet, London, UK
| | - Michael Laffan
- Centre for Haematology, Imperial College London, London, UK
| | - Paul Mclaughlin
- Katherine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Declan Noone
- HCD Economics, Daresbury, UK.,European Haemophilia Consortium, Brussels, Belgium
| | | | - John Pasi
- Royal London Haemophilia Centre, Barts and the London School of Medicine and Dentistry, London, UK
| | - Mark Skinner
- McMaster University, Hamilton, Canada.,Institute for Policy Advancement Ltd, Washington, DC
| | - Jamie O'Hara
- HCD Economics, Daresbury, UK.,University of Chester, Chester, UK
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14
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Carr A, Finneran L, Boyd C, Shirey C, Canning C, Stafford O, Lyons J, Cullen K, Prendergast C, Corbett C, Drumm C, Burke T. The evidence-base for positive psychology interventions: a mega-analysis of meta-analyses. The Journal of Positive Psychology 2023. [DOI: 10.1080/17439760.2023.2168564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Alan Carr
- Psychology, University College Dublin, Dublin, Ireland
- Clanwilliam Institute, Dublin, Ireland
| | | | | | - Claire Shirey
- Psychology, University College Dublin, Dublin, Ireland
| | | | - Owen Stafford
- Psychology, University College Dublin, Dublin, Ireland
| | - James Lyons
- Psychology, University College Dublin, Dublin, Ireland
| | - Katie Cullen
- Psychology, University College Dublin, Dublin, Ireland
| | | | - Chris Corbett
- Psychology, University College Dublin, Dublin, Ireland
| | - Chloe Drumm
- Psychology, University College Dublin, Dublin, Ireland
| | - Tom Burke
- Psychology, University College Dublin, Dublin, Ireland
- Clanwilliam Institute, Dublin, Ireland
- Psychology, National University of Ireland Galway, Galway, Ireland
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15
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Burke T, Shaikh A, Ali TM, Li N, Konkle BA, Noone D, O'Mahony B, Pipe S, O'Hara J. Association of factor expression levels with annual bleeding rate in people with haemophilia B. Haemophilia 2023; 29:115-122. [PMID: 36331904 PMCID: PMC10099781 DOI: 10.1111/hae.14675] [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: 01/13/2022] [Revised: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Gene therapy clinical trials measure steady-state clotting factor expression levels (FELs) to evaluate the modulation of the bleeding phenotype, aiming to offer consistent protection against breakthrough bleeding events. The link between FELs and bleeding risk in people with haemophilia B (PwHB) is not well understood. AIM We evaluated the association between FEL and ABR in PwHB. METHODS This cross-sectional study extended the CHESS burden of illness studies in Europe and the United States. Recruitment of additional adult males with haemophilia B supplemented the existing CHESS sample size of PwHB and FELs. PwHB receiving prophylaxis were excluded, as fluctuating FELs may have confounded the analysis. Demographic and clinical characteristics were reported descriptively. Any recorded baseline FEL was reported by the haemophilia-treating physicians according to the medical records. Generalised linear models with log link explored the association between changes in FEL and ABR. RESULTS The study included 407 PwHB and no inhibitors receiving on-demand treatment. Mean age was 36.7 years; 56% from the EU, 44% from the United States. Mean baseline FEL was 9.95 IU/dl (SD, 10.47); mean ABR was 2.4 bleeds/year (SD, 2.64). After adjusting for covariates, the model showed that for every 1% increase in FEL the average ABR decreased by .08 (p < .001). Predicted number of bleeding events according to FEL showed a significant non-linear relationship between FEL and ABR (p < .05). CONCLUSION This analysis showed a significant relationship between FEL and ABR, where increases in FEL were associated with decreases in ABR among men with HB in Europe and the US.
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Affiliation(s)
- Tom Burke
- HCD Economics, Daresbury, Cheshire, UK.,Faculty of Health and Social Care, University of Chester, Chester, Cheshire, UK
| | | | | | - Nanxin Li
- uniQure Inc., Lexington, Massachusetts, USA
| | - Barbara A Konkle
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Declan Noone
- European Haemophilia Consortium, Brussels, Belgium
| | - Brian O'Mahony
- Irish Haemophilia Society, Dublin, Ireland.,Trinity College Dublin, Dublin, Ireland
| | - Steven Pipe
- Departments of Pediatrics and Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jamie O'Hara
- HCD Economics, Daresbury, Cheshire, UK.,Faculty of Health and Social Care, University of Chester, Chester, Cheshire, UK
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16
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Greenberg M, Lowrie K, Burger J, Burke T. Tom Burke-Listen to the community. Risk Anal 2022; 42:2455-2458. [PMID: 36625041 DOI: 10.1111/risa.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Michael Greenberg
- Edward J. Bloustein School of Planning & Public Policy, Rutgers University, New Brunswick, New Jersey, USA
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
| | - Karen Lowrie
- Edward J. Bloustein School of Planning & Public Policy, Rutgers University, New Brunswick, New Jersey, USA
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
| | - Joanna Burger
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
- Cell Biology and Neurosciences, NIEHS Center of Excellence, Environmental and Occupational Health Sciences Institute (EOHSI), Ecology and Evolution Graduate Program, and Pinelands Research Station, Rutgers University, Piscataway, New Jersey, USA
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17
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Kelly Grealy M, Godfrey E, Brady F, Whyte O’Sullivan E, Carroll GA, Burke T. Borderline personality disorder traits and mentalising ability: The self-other social cognition paradox. Front Psychiatry 2022; 13:1023348. [PMID: 36339858 PMCID: PMC9631768 DOI: 10.3389/fpsyt.2022.1023348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Borderline personality disorder (BPD) is a psychiatric condition characterised by a pervasive pattern of impulsivity, low self-image, and interpersonal conflicts. Previous findings indicate a mixed relationship between BPD and social cognition; little research as investigated whether BPD traits influence performance on specific elements of social cognitive tasks, i.e., positive/negative valence. Method Community-based typical controls (n = 151; 51% female) were recruited through an online survey. Participants completed aspects of the Personality Assessment Inventory pertaining to BPD traits, the Interpersonal Reactivity Index, and measures of both emotion recognition and mentalising. Results Following group stratification into high/low BPD traits, participants with high BPD traits were observed to perform significantly better when identifying negative valence stimuli. Furthermore, high levels of affect instability was found to significantly influence negative valence recognition. Conclusion This research highlights previous research which shows a paradox between higher performance on measures of social cognition, with a group of individuals who report significant interpersonal and relational difficulties. This research supports the assessment of social cognitive processes for people with BPD and/or high BPD traits to support clinical formulation of strengths and difficulties.
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Affiliation(s)
- Molly Kelly Grealy
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Emmet Godfrey
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Finn Brady
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | - Grace A. Carroll
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Tom Burke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
- Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
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Roddy DW, Roman E, Nasa A, Gazzaz A, Zainy A, Burke T, Staines L, Kelleher I, O'Neill A, Clarke M, O'Hanlon E, Cannon M. Microstructural changes along the cingulum in young adolescents with psychotic experiences: An along-tract analysis. Eur J Neurosci 2022; 56:5116-5131. [PMID: 36004608 PMCID: PMC9825926 DOI: 10.1111/ejn.15806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 07/30/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
Psychotic experiences (PEs) such as hallucinations and delusions are common among young people without psychiatric diagnoses and are associated with connectivity and white matter abnormalities, particularly in the limbic system. Using diffusion magnetic resonance imaging (MRI) in adolescents with reported PEs and matched controls, we examined the cingulum white matter tract along its length rather than as the usually reported single indivisible structure. Complex regional differences in diffusion metrics were found along the bundle at key loci following Bonferroni significance adjustment (p < .00013) with moderate to large effect sizes (.11-.76) throughout all significant subsegments. In this prospective community-based cohort of school-age children, these findings suggest that white matter alterations in the limbic system may be more common in the general non-clinical adolescent population than previously thought. Such white matter alternations may only be uncovered using a similar more granular along-tract analysis of white matter tracts.
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Affiliation(s)
- Darren William Roddy
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland,Trinity College Institute of Neuroscience, Lloyd BuildingTrinity College DublinDublinIreland
| | - Elena Roman
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Anurag Nasa
- Trinity College Institute of Neuroscience, Lloyd BuildingTrinity College DublinDublinIreland
| | - Areej Gazzaz
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Ahmed Zainy
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Tom Burke
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Lorna Staines
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Ian Kelleher
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Aisling O'Neill
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Mary Clarke
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Erik O'Hanlon
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland,Trinity College Institute of Neuroscience, Lloyd BuildingTrinity College DublinDublinIreland
| | - Mary Cannon
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
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19
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Ferri Grazzi E, Sun SX, Burke T, O'Hara J. The Impact of Pharmacokinetic-Guided Prophylaxis on Clinical Outcomes and Healthcare Resource Utilization in Hemophilia A Patients: Real-World Evidence from the CHESS II Study. J Blood Med 2022; 13:505-516. [PMID: 36157322 PMCID: PMC9507282 DOI: 10.2147/jbm.s363028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Using a pharmacokinetic (PK)-guided approach to personalize the dose and frequency of prophylactic treatment can help achieve and maintain targeted factor VIII (FVIII) trough levels in patients with hemophilia A. Objective Investigate clinical and healthcare resource use outcomes in patients with hemophilia A treated with or without PK-guided prophylaxis using data from the Cost of Haemophilia in Europe: A Socioeconomic Survey (CHESS) II database. Methods CHESS II was a cross-sectional, retrospective, burden-of-illness study incorporating data from eight European countries. Patients were eligible for this analysis if they were male, ≥18 years of age, and diagnosed with congenital hemophilia A of any severity. The clinical endpoints included annualized bleeding rate (ABR), presence and number of problem/target joints, and occurrence of joint surgeries. Healthcare resource utilization endpoints included the number of hematologist consultations and bleed-related hospitalizations or emergency department admissions. Data from November 2018 to October 2020 were included and were stratified according to treatment regimen and use of PK-guided dosing. Results Altogether, 281 patients on prophylaxis had available FVIII trough level data. Mean (SD) age was 35.7 (13.8) years. A specific FVIII trough level was targeted in 120 (42.7%) patients and 47 (39.2%) received PK-guided dosing. Patients receiving PK-guided dosing had a mean (SD) ABR of 2.8 (2.1) and target joint number of 0.5 (0.7), compared with 3.9 (2.7) and 0.9 (1.4), respectively, for patients receiving non-PK-guided treatment. The mean (SD) number of hematologist consultations was 7.1 (5.3) for patients receiving PK-guided dosing versus 10.7 (5.7) for those who were not. A higher proportion of patients in the non-PK-guided group required hospitalization during their lifetime compared with the PK-guided group. Conclusion This analysis of real-world data suggests that PK-guided dosing for prophylaxis has a beneficial impact on clinical and healthcare resource utilization outcomes in patients with hemophilia A.
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Affiliation(s)
- Enrico Ferri Grazzi
- Health Economics and Outcomes Research, HCD Economics Ltd, Daresbury, Warrington, UK
| | - Shawn X Sun
- Global Evidence and Outcomes, Takeda Development Center Americas, Inc, Cambridge, MA, USA
| | - Tom Burke
- Health Economics and Outcomes Research, HCD Economics Ltd, Daresbury, Warrington, UK.,Department of Health and Social Care, University of Chester, Chester, UK
| | - Jamie O'Hara
- Health Economics and Outcomes Research, HCD Economics Ltd, Daresbury, Warrington, UK.,Department of Health and Social Care, University of Chester, Chester, UK
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20
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Burke T, Ersche K. I can’t wait! An investigation into time processing in cocaine use disorder. Eur Psychiatry 2022. [PMCID: PMC9566885 DOI: 10.1192/j.eurpsy.2022.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Almost all definitions of impulsivity include the notion of distorted time perception such as impaired awareness of the future or premature responses. Preclinical evidence suggests that stimulant drugs speed up the internal clock, making time pass faster than it actually is. However, stimulant-addicted humans, who are drug-abstinent seem to over-estimate long time intervals. Objectives The present study aims to investigate time processing in actively using patients with cocaine use disorder (CUD). We hypothesise that active cocaine use will be associated with an under-estimation of long time intervals. Methods We recruited 48 men with a chronic history of cocaine use, meeting the DSM-5 criteria for CUD, and 42 healthy men without a history of substance use disorders. All participants completed a time reproduction task in which they were presented four times with six different time durations and were subsequently asked to reproduce them by pressing the space bar for the same time duration of the target interval they had just seen. Participants also completed the Barratt Impulsiveness Scale (BIS-11). Results Overall precision in time reproduction was significantly reduced in CUD patients (F6,81=3.97,p=0.002), which was particularly evident for longer time delays. CUD patients’ estimated-to-target-duration ratios were marginally shorter for the 11000ms (F1,86=3.1,p=0.084) and significantly shorter for the 18000ms and 24000ms time intervals (both p<0.05). Time reproduction performance correlated with self-reported attentional impulsivity on the BIS-11 in both CUD patients and healthy controls (all p<0.05). Conclusions Consistent with preclinical work, the inner clock of humans with regular cocaine use seems to be accelerated. Disclosure No significant relationships.
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Monaghan R, McCormack D, Ndukwe I, O’Riordan S, Burke T, Pender N, Hutchinson M, O’Keeffe F. 238 Cogniton and mood disorder in cervical dystonia. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCervical dystonia patients have a high prevalence of anxiety and depression which is the main predictor of quality of life. Reports of abnormal cognition in cervical dystonia may be confounded by concurrent mood disorder.AimTo assess the relationships between measures of cognition, mood disorder, disease severity, and quality of life in cervical dystonia.MethodsIn 45 cervical dystonia partici- pants, we assessed clinical measures of disease severity, mood disorder using the Beck Anxiety Inventory and Beck Depression Inventory, quality of life by the Cervical Dystonia Impact Profile and Utility Values from the EQ-5D-5L and administered an extensive neuropsychological assessment battery. The outcomes of clinical and neuropsychological variables were compared between participants with and without signifi- cant mood disorder.ResultsSignificant anxiety and/or depression were reported in 18 participants (40%); 27 participants (60%) had no prevalent anxiety or depression. Significant deficits in executive function were found in participants with mood disorder in comparison to those without mood disorder; otherwise neuropsychological testing showed no between-group abnormalities. Mood disorder significantly cor- related with measures of executive function and quality of life. Abnormal Social Cognition was found in cervical dystonia, unrelated to prevalent mood disorder.ConclusionMood disorder in cervical dystonia is a significant independent predictor of both measures of executive function and quality of life. Other than in Social Cognition, there was no evidence of any primary cognitive impairment in cervical dystonia.mhutchin2@mac.com
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Rodriguez-Santana I, DasMahapatra P, Burke T, Hakimi Z, Bartelt-Hofer J, Nazir J, O’Hara J. Differential humanistic and economic burden of mild, moderate and severe haemophilia in european adults: a regression analysis of the CHESS II study. Orphanet J Rare Dis 2022; 17:148. [PMID: 35379282 PMCID: PMC8981861 DOI: 10.1186/s13023-022-02300-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/22/2022] [Indexed: 12/30/2022] Open
Abstract
Background The lifelong nature of haemophilia makes patient-centred and societal assessments of its impact important to clinical and policy decisions. Quantifying the humanistic and economic burden by severity is key to assessing the impact on healthcare systems. We analysed the annual direct medical (excluding factor replacement therapy costs) and non-medical costs as well as societal costs and health-related quality of life (HRQoL) of mild, moderate and severe disease among adults with haemophilia A or B without inhibitors in Europe. Participants in the CHESS II study reported their HRQoL, non-medical costs, and work impairment; physicians provided costs and consultation history from the medical chart. Descriptive statistics summarized patient characteristics, costs, and HRQoL scores. Regression models estimated differences in outcomes for moderate and severe versus mild disease, adjusting for age, body mass index, country, comorbidities, weight-adjusted factor consumption and education. Results The analytic sample included 707 patients with a mean age of 38 years; the majority of patients had haemophilia A (81%), and 47% had severe disease, followed by moderate (37%) and mild disease (16%). Patients with severe or moderate disease had on average higher direct costs, €3105 and €2469 respectively, versus mild disease. Societal costs were higher for patients with severe and moderate disease by €11,115 and €2825, respectively (all P < 0.01). HRQoL scores were also significantly worse for severe and moderate patients versus those with mild disease. Conclusion Severity of haemophilia is predictive of increasing economic and humanistic burden. The burden of moderate disease, as measured by direct costs and HRQoL, did not appear to be substantially different than that observed among patients with severe haemophilia. Supplementary information The online version contains supplementary material available at 10.1186/s13023-022-02300-1.
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Rodriguez-Santana I, DasMahapatra P, Burke T, Hakimi Z, Bartelt-Hofer J, Nazir J, O’Hara J. Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study. Orphanet J Rare Dis 2022; 17:150. [PMID: 35379284 PMCID: PMC8981697 DOI: 10.1186/s13023-022-02301-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Haemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption. Results The analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p < 0.001; N = 794), while societal costs were more than half of the predicted costs for children with severe haemophilia (€6950 vs. €3666; p < 0.001; N = 220). Mean predicted HRQoL scores were 0.74 and 0.69 for moderate and severe disease, respectively (p < 0.05; N = 185). Conclusion Children with haemophilia and their caregivers displayed a significant economic and humanistic burden. While severe patients showed the highest direct medical and societal costs, and worse HRQoL, the burden of moderate haemophilia on its own was substantial and far from negligible. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02301-0.
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West H, Hu X, Burke T, Walker M, Wang Y, Samkari A. 90P Disease-free survival (DFS) as a predictor of overall survival (OS) in completely resected early stage non-small cell lung cancer (NSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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West H, Hu X, Burke T, Walker M, Wang Y, Samkari A. 89P Treatment patterns, overall survival (OS), and disease-free survival (DFS) in early stage non-small cell lung cancer (NSCLC) following complete resection. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Burke T, Deffew A, Stafford O, Docherty C, Burke S, Mostert R, van Loon J, Lombardi M, Vaughan M, Brickell R, Keogh M, Mahon W, O'Halloran D. Quality of Life Outcomes in a Community Cohort of Adults With an Intellectual Disability Using the Personal Outcome Scale. Front Rehabilit Sci 2022; 3:848492. [PMID: 36188891 PMCID: PMC9397816 DOI: 10.3389/fresc.2022.848492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/22/2022] [Indexed: 11/19/2022]
Abstract
Objectives Quality of life (QoL) is a multi-dimensional phenomenon composed of core domains that are influenced by personal characteristics, values, and environmental contributions. There are eight core domains of QoL aligned with both the United Nations and the International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD). The Personal Outcome Scale (POS), is a semi-structured self and proxy instrument that specifically measures these aspects of QoL for people with an intellectual disability. Methods A total of 85 people with an intellectual disability and their primary keyworker (n = 85) took part in this study. A convenience sample recruitment strategy was employed to recruit participants during the calendar year from January–December 2020. Participants completed the self-report and proxy POS, and clinic-demographic data was also considered. Results QoL is higher in those who have a dedicated service planner and also for those with a less severe to profound disability. People who were in gainful employment reported significantly higher QoL as did those availing of outreach and residential services, over and above local services. Conclusions This research shows that there are distinct and specific factors that relate to QoL for people with an intellectual disability community-based services in Ireland. Future research could aim to investigate these longitudinally, and specifically how QoL relates to cognitive and functional outcomes.
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Affiliation(s)
- Tom Burke
- KARE Services, Kilcullen, Ireland
- School of Psychology, John Henry Newman Building, University College Dublin, Dublin, Ireland
- School of Psychology, National University of Ireland Galway, Galway, Ireland
- *Correspondence: Tom Burke
| | - Andrew Deffew
- KARE Services, Kilcullen, Ireland
- School of Psychology, University of Limerick, Limerick, Ireland
| | - Owen Stafford
- KARE Services, Kilcullen, Ireland
- School of Psychology, John Henry Newman Building, University College Dublin, Dublin, Ireland
| | - Caroline Docherty
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | | | | | | | | | | | | | | | - David O'Halloran
- KARE Services, Kilcullen, Ireland
- School of Psychology, John Henry Newman Building, University College Dublin, Dublin, Ireland
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Browne A, Stafford O, Berry A, Murphy E, Taylor LK, Shevlin M, McHugh L, Carr A, Burke T. Psychological Flexibility Mediates Wellbeing for People with Adverse Childhood Experiences during COVID-19. J Clin Med 2022; 11:377. [PMID: 35054070 PMCID: PMC8778161 DOI: 10.3390/jcm11020377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The psychological impact of COVID-19 is multifaceted, both acute and chronic, and has not affected everyone equally. METHOD This longitudinal study compared those with and without Adverse Childhood Experiences (ACEs) on measures of psychological distress and wellbeing over time. RESULTS All groups (No ACE, Low ACE, and High ACE) had similar levels of distress at Time 1, with significant increases in psychological distress for those with ACEs over time, but not for those without. Psychological Flexibility was strongly and significantly associated with decreases in psychological distress and improved wellbeing. It significantly mediated the relationship between ACE and wellbeing. CONCLUSIONS Those with ACEs report significantly increased psychological distress over time, compared to those without ACE during the COVID-19 pandemic. Evidence-based interventions using Psychological Flexibility may improve mental health and wellbeing to help further mediate its effects.
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Affiliation(s)
- Angela Browne
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
| | - Owen Stafford
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
| | - Anna Berry
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
- Health Service Executive, CHO 8 (Laois/Offaly), R32 YFW6 Laois, Ireland
| | - Eddie Murphy
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
- Health Service Executive, CHO 8 (Laois/Offaly), R32 YFW6 Laois, Ireland
| | - Laura K. Taylor
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
- School of Psychology, Queen’s University Belfast, Belfast BT7 1NN, UK
| | - Mark Shevlin
- School of Psychology, University of Ulster, Belfast BT1 6DN, UK;
| | - Louise McHugh
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
| | - Alan Carr
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
| | - Tom Burke
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland; (A.B.); (O.S.); (A.B.); (E.M.); (L.K.T.); (L.M.); (A.C.)
- School of Psychology, National University of Ireland, H91 CF50 Galway, Ireland
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Burke T, Shaikh A, Ali TM, Li N, Curtis R, Garcia Diego DA, Recht M, Sannie T, Skinner M, O'Hara J. Association of factor expression levels with health-related quality of life and direct medical costs for people with haemophilia B. J Med Econ 2022; 25:386-392. [PMID: 35253589 DOI: 10.1080/13696998.2022.2049552] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIMS Gene therapy trials aim to provide a functional cure for patients with haemophilia B (HB), and treatment impact is analyzed by factor IX expression levels (FELs). We investigated the relationship of FELs with health-related quality of life (HRQoL) and costs. MATERIALS AND METHODS This was a retrospective cross-sectional analysis of the European (CHESS I-II) and US (CHESS-US) CHESS population studies. Physicians recruited consecutive patients and extracted information from the medical records; patients completed questionnaires between 2014 and 2015 (CHESS-I), 2018-2019 (CHESS-II) and 2019 (CHESS US). Patients with inhibitors were excluded. HRQoL was assessed using the EQ-5D-5L. Twelve-month haemophilia-related direct medical costs included office visits and hospitalizations based on country-level unit costs. A Tobit model was used to analyze FELs and HRQoL and generalized linear models for direct medical costs. RESULTS A total of 191 men with HB completed the EQ-5D questionnaire; the mean age was 36.8 years, with a mean FEL of 10.1 IU/dL (median, 4.0). Mean EQ-5D was 0.77 (SD, 0.23). The Tobit model adjusting for age, body mass index and blood-borne viruses showed every 1% increase in FEL was associated with +0.006 points in the mean EQ-5D score (p = .003). Mean haemophilia-related direct medical costs excluding factor replacement therapy were €2,028/year (median, €919) in CHESS I-II (EU, n = 226), and $7,171/year (median, $586) in CHESS US (n = 181). Adjusted EU and US models showed every 1% increase in FEL was associated with a decrease in haemophilia-related direct medical costs of €108/year and $529/year, respectively. LIMITATIONS Direct medical costs were based on physician extraction of encounters from medical records, potentially underestimating costs of care. The voluntary nature of participation may have introduced selection biases. CONCLUSIONS We observed a significant association of increases in FEL with increased HRQoL and decreased costs in Europe and the United States among men with HB and no inhibitors.
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Affiliation(s)
- Tom Burke
- HCD Economics, Daresbury, Cheshire, UK
- Faculty of Health and Social Care, University of Chester, Chester, Cheshire, UK
| | | | | | | | | | | | - Michael Recht
- Oregon Health & Science University, Portland, OR, USA
- American Thrombosis and Hemostasis Network, Rochester, NY, USA
| | - Thomas Sannie
- Association Française des Hémophiles, Paris, Île-de-France, France
| | - Mark Skinner
- Institute for Policy Advancement, Ltd, Washington, DC, USA
- McMaster University, Hamilton, ON, Canada
| | - Jamie O'Hara
- HCD Economics, Daresbury, Cheshire, UK
- Faculty of Health and Social Care, University of Chester, Chester, Cheshire, UK
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Burke T, Asghar S, O'Hara J, Chuang M, Sawyer EK, Li N. Clinical, humanistic, and economic burden of severe haemophilia B in adults receiving factor IX prophylaxis: findings from the CHESS II real-world burden of illness study in Europe. Orphanet J Rare Dis 2021; 16:521. [PMID: 34930388 PMCID: PMC8691083 DOI: 10.1186/s13023-021-02152-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Real-world studies of the burden of severe haemophilia B in the context of recent therapeutic advances such as extended half-life (EHL) factor IX (FIX) products are limited. We analysed data from the recent CHESS II study to better understand the clinical, humanistic, and economic burden of severe haemophilia B in Europe. Data from male adults with severe haemophilia B receiving prophylaxis were analysed from the retrospective cross-sectional CHESS II study conducted in Germany, France, Italy, Spain and the United Kingdom. Inhibitors were exclusionary. Patients and physicians completed questionnaires on bleeding, joint status, quality of life, and haemophilia-related direct and indirect costs (2019-2020). All outcomes were summarised using descriptive statistics. RESULTS A total of 75 CHESS II patients were eligible and included; 40 patients (53%) provided self-reported outcomes. Mean age was 36.2 years. Approximately half the patients were receiving EHL versus standard half-life (SHL) prophylaxis (44% vs 56%). Most patients reported mild or moderate chronic pain (76%) and had ≥ 2 bleeding events per year (70%), with a mean annualised bleed rate of 2.4. Mean annual total haemophilia-related direct medical cost per patient was €235,723, driven by FIX costs (€232,328 overall, n = 40; €186,528 for SHL, €290,620 for EHL). Mean annual indirect costs (€8,973) were driven by early retirement or work stoppage due to haemophilia. Mean quality of life (EQ-5D) score was 0.67. CONCLUSIONS These data document a substantial, persistent real-world burden of severe haemophilia B in Europe. Unmet needs persist for these patients, their caregivers, and society.
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Affiliation(s)
| | | | - Jamie O'Hara
- HCD Economics, Daresbury, UK.,Faculty of Health and Social Care, University of Chester, Chester, UK
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Berry A, Burke T, Carr A. The impact of the first wave of the Covid-19 pandemic on parents of children with externalising difficulties in ireland: A longitudinal cohort study. Int J Clin Pract 2021; 75:e14941. [PMID: 34610195 PMCID: PMC8646641 DOI: 10.1111/ijcp.14941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/01/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This longitudinal cohort study aimed to examine the impact of the first wave of the COVID-19 pandemic in Ireland on parents of children with externalising difficulties, in comparison to parents of children without such difficulties. METHOD Parents of 159 children completed online self-report measures at three time points during the first wave of the COVID-19 pandemic; (a) Delay and Mitigation Phase (March 2020 to May 2020), (b) Reopening of Society Phase (June 2020 to July 2020) and (c) Wave 2 Case Acceleration Phase (September 2020 to October 2020). Participants were allocated to the clinical group if they met the clinical cut off point on the Conduct or Hyperactivity/Inattention subscales of the Strengths and Difficulties Questionnaire at Time 1. RESULTS Parents of children with externalising difficulties experienced significantly higher levels of stress, lower levels of wellbeing and engaged in higher levels of avoidant-focused coping strategies longitudinally. There was a significant difference between outcomes at the different phases of the COVID-19 pandemic, for stress related to parenting, personal/family stress related to the impact of the COVID-19 and type of coping strategies employed. Children with externalising difficulties, in comparison to children without externalising difficulties, showed significantly greater adjustment over time for behavioural and emotional difficulties, as reported by their parents. CONCLUSIONS Results provide important information regarding the trajectory of psychological outcomes in parents of children with externalising difficulties over the first wave of the COVID-19 pandemic, highlighting the need for increased parental supports during, and after, the COVID-19 pandemic.
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Affiliation(s)
- Anna Berry
- School of PsychologyUniversity College Dublin (UCD)DublinIreland
- Health Service Executive (HSE)Laois/OffalyIreland
| | - Tom Burke
- School of PsychologyUniversity College Dublin (UCD)DublinIreland
- Health Service Executive (HSE)Laois/OffalyIreland
- School of PsychologyNational University of Ireland Galway (NUIG)GalwayIreland
| | - Alan Carr
- School of PsychologyUniversity College Dublin (UCD)DublinIreland
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Carey E, Gillan D, Burke T, Burns A, Murphy TM, Kelleher I, Cannon M. Social cognition and self-reported ASD traits in young adults who have reported psychotic experiences: A population-based, longitudinal study. Schizophr Res 2021; 237:54-61. [PMID: 34500376 DOI: 10.1016/j.schres.2021.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Social cognition is considered a trait marker of psychosis, and has rarely been investigated in young adults who have reported psychotic experiences (PE). The aim of the present study was to explore whether social cognition, self-reported Autism Spectrum Disorder (ASD) traits and functioning were associated with PE. METHODS Participants were invited to take part in a 10-year follow-up study (mean age 20.9 years), of whom 103 participants returned, including 41 who had reported PE either past or current. Social cognition (theory of mind, social perception and locus of control) was assessed and a self-report measure of ASD traits was administered. Psychopathology and global functioning were assessed using the SCID-5. Analyses investigated group differences between PE and controls, and the association between social cognition and functioning in the PE group. A mediation analysis investigated if the association between PE and social cognition was explained by ASD traits. RESULTS The PE group had poorer theory of mind scores (F = 4.22, p = .043), specifically for neutral and negative stimuli, and an external locus of control (F = 5.73, p = .019) in young adulthood. The PE group had a significantly greater number of self-reported ASD traits than the controls (χ2(2) = 10.65). External locus of control had a significant negative correlation with current role functioning in the PE group. The association between PE and social cognition abilities was not mediated by ASD traits. CONCLUSION Psychotic experiences are associated with poorer theory of mind and an external locus of control, as well as proportionally more self-reported ASD traits, in young adulthood.
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Affiliation(s)
- Eleanor Carey
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity College Institute of Neuroscience, Dublin, Ireland.
| | - Diane Gillan
- Dept. of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Tom Burke
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Annette Burns
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya M Murphy
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Ian Kelleher
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Dept. of Psychiatry, Beaumont Hospital, Dublin, Ireland
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O'Donnell K, Healy A, Staines A, Corrigan C, Burke T, McGettrick G, Waldron B. Pathways through rehabilitation for traumatic brain injury: preliminary results from an Irish study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In Ireland, little data exists on the number of TBI survivors or the availability of brain injury rehabilitation services. To address this, we examined nationally representative data to estimate the number of moderate to severe TBI survivors and to learn of their rehabilitation experiences.
Methods
A two-year mixed-methods, observational, cohort study was used to investigate the rehabilitation pathways of moderate to severe TBI survivors (N = 120). Participants were surveyed on two occasions six months apart using a range of standardised instruments (EQ-5D-3L, WHOQOL BREF and EBIQ). Preliminary findings from first surveys are reported.
Results
Fifty percent of participants reported having received some rehabilitation during their initial hospitalization. Following discharge, inpatient rehabilitation was recommended in 55.8% of cases (N = 67); 62.5% (N = 75) in an outpatient setting and 52.1% (N = 62) in a specialised brain injury community-based setting. Rehabilitation was not recommended in 9.2% (N = 11) of cases. Univariant analyses showed statistically significant differences between the experiences of males (N = 87) and females (N = 33) in three main elements; Isolation: males (M), mean 1.88, SD .488, females (F) mean 1.64, SD .476, (p = .015); Communication: M mean 1.85, SD .565, F mean 1.57, SD .469 (p = .012); Cognitive difficulties: M mean 1.81, SD .456, F mean 1.59, SD .426 (p = .020).
Discussion
Referrals to rehabilitation services varied substantially in this cohort of TBI survivors with evidence to suggest that, overall, males experience greater impacts on quality of life than do females. These findings support the need to, a) increase political priority and resource allocation for rehabilitation services for TBI survivors in Ireland and b) further study gender differences in TBI survivor outcome.
Key messages
Survivors of moderate to severe brain injury in Ireland have very divergent, and often inadequate experiences of rehabilitation. There is some evidence that male survivors of moderate to severe traumatic brain injury face more challenges than do female survivors.
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Affiliation(s)
- K O'Donnell
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - A Healy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - A Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - C Corrigan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - T Burke
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - B Waldron
- Acquired Brain Injury Ireland, Dublin, Ireland
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van Eijk RPA, Beelen A, Kruitwagen ET, Murray D, Radakovic R, Hobson E, Knox L, Helleman J, Burke T, Rubio Pérez MÁ, Reviers E, Genge A, Steyn FJ, Ngo S, Eaglesham J, Roes KCB, van den Berg LH, Hardiman O, McDermott CJ. A Road Map for Remote Digital Health Technology for Motor Neuron Disease. J Med Internet Res 2021; 23:e28766. [PMID: 34550089 PMCID: PMC8495582 DOI: 10.2196/28766] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/05/2022] Open
Abstract
Despite recent and potent technological advances, the real-world implementation of remote digital health technology in the care and monitoring of patients with motor neuron disease has not yet been realized. Digital health technology may increase the accessibility to and personalization of care, whereas remote biosensors could optimize the collection of vital clinical parameters, irrespective of patients’ ability to visit the clinic. To facilitate the wide-scale adoption of digital health care technology and to align current initiatives, we outline a road map that will identify clinically relevant digital parameters; mediate the development of benefit-to-burden criteria for innovative technology; and direct the validation, harmonization, and adoption of digital health care technology in real-world settings. We define two key end products of the road map: (1) a set of reliable digital parameters to capture data collected under free-living conditions that reflect patient-centric measures and facilitate clinical decision making and (2) an integrated, open-source system that provides personalized feedback to patients, health care providers, clinical researchers, and caregivers and is linked to a flexible and adaptable platform that integrates patient data in real time. Given the ever-changing care needs of patients and the relentless progression rate of motor neuron disease, the adoption of digital health care technology will significantly benefit the delivery of care and accelerate the development of effective treatments.
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Affiliation(s)
- Ruben P A van Eijk
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, Netherlands.,Biostatistics & Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Anita Beelen
- Department of Rehabilitation, University Medical Centre Utrecht, Utrecht, Netherlands.,Center of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Esther T Kruitwagen
- Department of Rehabilitation, University Medical Centre Utrecht, Utrecht, Netherlands.,Center of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Deirdre Murray
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland.,Department of Physiotherapy, Beaumont Hospital, Dublin, Ireland
| | - Ratko Radakovic
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom.,Euan MacDonald Centre for Motor Neuron Disease Research, University of Edinburgh, Edinburgh, United Kingdom.,Norfolk and Norwich University Hospital, Norwich, United Kingdom.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Esther Hobson
- Department of Neuroscience, Sheffield Institute for Translational Neuroscien, University of Sheffield, Sheffield, United Kingdom
| | - Liam Knox
- Department of Neuroscience, Sheffield Institute for Translational Neuroscien, University of Sheffield, Sheffield, United Kingdom
| | - Jochem Helleman
- Department of Rehabilitation, University Medical Centre Utrecht, Utrecht, Netherlands.,Center of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Tom Burke
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland.,Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | | | - Evy Reviers
- European Organization for Professionals and Patients with ALS (EUpALS), Leuven, Belgium
| | - Angela Genge
- Department of Neurology, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Frederik J Steyn
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia.,The Royal Brisbane and Women's Hospital, Herston, Australia.,Wesley Medical Research, the Wesley Hospital, Auchenflower, Australia
| | - Shyuan Ngo
- The Royal Brisbane and Women's Hospital, Herston, Australia.,Wesley Medical Research, the Wesley Hospital, Auchenflower, Australia.,Centre for Clinical Research, University of Queensland, Brisbane, Australia.,Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, Australia
| | - John Eaglesham
- Advanced Digital Innovation (UK) Ltd, Salts Mill, United Kingdom
| | - Kit C B Roes
- Department of Health Evidence, Section Biostatistics, Radboud Medical Centre Nijmegen, Nijmegen, Netherlands
| | | | - Orla Hardiman
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin, Ireland.,FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Christopher J McDermott
- Department of Neuroscience, Sheffield Institute for Translational Neuroscien, University of Sheffield, Sheffield, United Kingdom
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Stafford O, Prendergast C, Berry A, Breslin N, Murphy E, Gillan D, Godfrey E, Barrett K, K. Taylor L, Shevlin M, McHugh L, Carr A, Burke T. A remote self-directed psychological intervention for the public: The PAUSE programme protocol. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13363.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: This protocol outlines procedures for the development and evaluation of a remotely accessible intervention tool known as the ‘Psychology And yoU: Self-Enhancement programme’ (i.e., PAUSE programme). The PAUSE programme aims to support and promote psychological well-being using positive psychological concepts and principles. The programme has been developed in the context of the coronavirus disease 2019 pandemic, where effective and evidence-based remote interventions are needed. The PAUSE programme will provide users with valuable tools and skills that they may choose to implement in their daily lives, in order to foster and support positive mental well-being. The programme includes six modules: Well-being and Happiness; Healthy Body and Mind; Being Grateful and Savouring Life; Thought and Action; Strengthening Relationships; and Overcoming Challenges. Methods: Participants will be recruited using media outlets, social media, and professional networking websites in Ireland. Those who choose to participate in this study will be asked to complete a set of measures at baseline, immediate follow-up, and six weeks post-intervention. This will allow for changes in subjective well-being scores to be analysed and interpreted over time. This study adopts a Groups x Time design, with participants being randomly assigned to either an intervention or wait-list control group. Ethical approval is currently under review at the host institution. Dissemination: The dissemination strategy will follow the Evidence-based model for the Transfer and Exchange of Research Knowledge (EMTReK) and study findings will be prepared in line with various formats (e.g. study newsletters, conferences/meetings) in order to meet the needs of different audiences. Targeted and timely dissemination activities are anticipated, and the team intends to disseminate research in an ongoing manner, throughout the lifetime of the project. Registration: This RCT protocol is pre-results and has been registered with an international database resulting in an International Standard Randomised Controlled Trials Number (ISRCTN14772616)
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O'Hara J, Noone D, Jain M, Pedra G, Landis S, Hawes C, Burke T, Camp C. Clinical attributes and treatment characteristics are associated with work productivity and activity impairment in people with severe haemophilia A. Haemophilia 2021; 27:938-946. [PMID: 34273215 DOI: 10.1111/hae.14302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/21/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Few studies have examined the real-world impact of haemophilia on daily activities and work productivity in people with severe haemophilia A (PWSHA). AIM To determine clinical attributes and treatment characteristics associated with impairment in daily activities and work among PWSHA using the patient-reported Work Productivity and Activity Impairment-General Health Questionnaire (WPAI-GH). METHODS PWSHA were asked to complete the WPAI-GH as part of the Cost of Haemophilia in Europe: A Socioeconomic Survey (CHESS) study. Outcomes were determined for activity impairment (AI), absenteeism, presenteeism and overall work productivity loss (WPL). Descriptive statistics and regression analyses were used to evaluate the association between these outcomes and clinical and treatment attributes. RESULTS Overall, 376 participants completed the AI element of WPAI-GH; 175 were employed and thus also reported on work impact. Mean ± standard deviation scores were as follows: AI = 34.2% ± 25.8%; absenteeism = 0.06% ±0.2%; presenteeism = 26.8% ± 22.4%; WPL = 28.6% ± 24.0%. Increased AI and WPL were associated with high haemophilia-related morbidity, measured both as chronic pain (p < .001 for both) and joint synovitis (AI: p <0.001; WPL: p = .017). In descriptive and multivariate analyses, lifelong prophylaxis was associated with reduced AI (p < .001 and p = .031, respectively); high therapy adherence was associated with reduced AI (p = .001 and p = .012, respectively) and with reduced WPL (p < .001 and p = .012, respectively). CONCLUSION The WPAI-GH identified haemophilia-related morbidity and treatment characteristics, including therapy regimen and adherence, as key attributes impacting functional impairment and work contributions of PWSHA. Early prophylactic intervention and greater adherence to therapy may lead to lower AI and WPL in PWSHA.
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Affiliation(s)
- Jamie O'Hara
- HCD Economics, The Innovation Centre, Daresbury, UK
| | - Declan Noone
- European Haemophilia Consortium, Brussels, Belgium
| | | | | | | | | | - Tom Burke
- HCD Economics, The Innovation Centre, Daresbury, UK.,BioMarin Europe, London, UK
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Deffew A, Coughlan B, Burke T, Rogers E. Staff member's views and attitudes to supporting people with an Intellectual Disability: A multi-method investigation of intimate relationships and sexuality. J Appl Res Intellect Disabil 2021; 35:1049-1058. [PMID: 34009719 DOI: 10.1111/jar.12897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/08/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Staff member's views and attitudes can have a significant impact on people with an intellectual disability. This study explores staff attitudes and experiences of people with an intellectual disability's expression of relationships and sexuality across service providers in Ireland. METHODS Staff (n = 86) from service providers (n = 5) completed the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) and open-ended questions. RESULTS Multidirectional significant differences were noted on staff attitudes to sexuality based on demographic factors, that is, age, education, as well as non-demographics, for example, attendance at training, and active practising of religion. Qualitatively, three themes emerged: "Unsupported and Frustration"; "Taboo Subject Matter" and "Vulnerability and Access to Education". Staff reported a lack of service supports, dominant conservative cultures and people with an intellectual disability's vulnerability. CONCLUSION This study highlights the need for improved service practices and enhanced provisions for staff and the people with an intellectual disability that they support.
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Affiliation(s)
- Andrew Deffew
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Barry Coughlan
- Department of Psychology, University of Limerick, Limerick, Ireland.,Brothers of Charity Services, Limerick, Ireland
| | - Tom Burke
- Department of Psychology, University College Dublin, Dublin, Ireland
| | - Elaine Rogers
- Department of Psychology, University of Limerick, Limerick, Ireland
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Costello E, Rooney J, Pinto-Grau M, Burke T, Elamin M, Bede P, McMackin R, Dukic S, Vajda A, Heverin M, Hardiman O, Pender N. Cognitive reserve in amyotrophic lateral sclerosis (ALS): a population-based longitudinal study. J Neurol Neurosurg Psychiatry 2021; 92:460-465. [PMID: 33563807 DOI: 10.1136/jnnp-2020-324992] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort. METHODS Longitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out. RESULTS CR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out. CONCLUSIONS These findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.
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Affiliation(s)
- Emmet Costello
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland .,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - James Rooney
- Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Institute and Clinic for Occupational, Social- and Environmental Medicine, University Hospital, Munich, Germany
| | - Marta Pinto-Grau
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Marwa Elamin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Peter Bede
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Roisin McMackin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland.,Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Alice Vajda
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
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Carroll GA, Montrose VT, Burke T. Correlates of Social Cognition and Psychopathic Traits in a Community-Based Sample of Males. Front Psychol 2021; 12:656299. [PMID: 33995215 PMCID: PMC8120153 DOI: 10.3389/fpsyg.2021.656299] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 01/21/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Social cognition is the ability to identify, understand, and interpret mental states and emotions. Psychopathic traits are typically described in two ways; Primary: shallow affect, emotional detachment, and relationship difficulties, and Secondary Psychopathic Traits: antisocial traits, impulsiveness, and emotional dysregulation. People with high psychopathic traits tend to perform lower on measures of social cognition. This study investigated the relationship of social cognition (mentalising) to primary and secondary psychopathic traits in a non-clinical sample, and investigated the psychometric properties of the Reading the Mind in the Eyes Test (RMET) Short Forms (A and B). A community-based male sample (N = 1,000; age range 18-78) was recruited through an online platform. Psychopathic traits were measured using Levenson, Kiehl, and Fitzpatrick's Self-Report Psychopathy Scale, and stratified into Primary and Secondary Psychopathic traits. Secondary validation of the RMET Short Forms was completed investigating scale reliability, and validity. Findings suggest excellent psychometrics in a large community cohort for the RMET Short Forms (A and B), with significant negative correlations on social cognitive performance and high self-report psychopathy. The item valence within the social cognitive measure (positive, negative, and neutral affect stimuli) was also examined, and correlated significantly with both Primary and Secondary Psychopathic traits. This study provides further validation of the RMET Short Forms (A and B), and adds to the literature on the scale by investigating performance on short-form specific valence. This study further suggests that in a non-clinical community sample of males, that higher psychopathic traits correlated significantly, and negatively, with social cognitive performance.
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Affiliation(s)
- Grace A Carroll
- School of Psychology, Queens University Belfast, Belfast, United Kingdom
| | | | - Tom Burke
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Psychology, National University of Ireland Galway, Galway, Ireland
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Pérol M, Quantin X, Lena H, Filleron T, Chouaid C, Valette CA, Kaderbhai C, Chenuc G, Santorelli M, Bensimon L, Burke T, Simon G, Martin AL, Debieuvre D, Gervais R, Schott R, Carton M, Courtinard C, Girard N. 110P Real-world evaluation of pembrolizumab monotherapy for previously treated PD-L1 positive (TPS>1%) advanced NSCLC in France. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01952-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dodd P, McEvoy J, Lockhart K, Burke T, O'Keeffe L, Guerin S. An exploratory study of self-reported complicated grief symptoms in parentally bereaved adults with intellectual disability. J Intellect Disabil Res 2021; 65:297-305. [PMID: 33426748 DOI: 10.1111/jir.12812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Complicated grief involves the experience of grief-related symptoms at a time, and severity, beyond which could be considered adaptive, while persistent complex bereavement disorder (PCBD) has been identified as a condition that requires further study in the typical population. The aims of this study are to (1) explore the symptoms of complicated grief associated with parental bereavement as self-reported by adults with intellectual disabilities (IDs) who have experienced a parental bereavement and (2) conduct an initial examination of how the existing criteria for PCBD apply to this group. METHODS This study uses a comparative group design, assessing self and staff (proxy) reports for a group of parentally bereaved individuals and a matched group of non-bereaved individuals using the Complicated Grief Questionnaire - ID Self-Report. Participants were 46 individuals with ID, 30 (65%) of whom who had experienced a parental bereavement within the previous 2 years. The age range was 23-67 years (mean = 43.8; SD = 10.3). RESULTS The results highlight the presence of a range of symptoms of complicated grief in individuals' self-reports, although there was some evidence that separation distress-related symptoms were more apparent. An analysis of individual symptoms showed patterns of higher reports among the bereaved group as would be expected. Comparing staff and self-reports, key criteria showed higher levels in self-reports among the bereaved group. CONCLUSIONS This study has demonstrated the capacity of people with ID to self-report personal experience of symptoms of complicated grief, when appropriate and accessible assessment tools are used. Some symptoms were more evident among bereaved individuals (compared with non-bereaved participants), and they tended to be from separation distress criteria. This may indicate the relevance of these symptoms for people with ID and question the existing criteria for PCBD in this population, which may have clinical implications for supporting people with ID experiencing a more complicated bereavement response.
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Affiliation(s)
- P Dodd
- Department of Psychiatry, St Michael's House Disability Services, Dublin, Ireland
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
| | - J McEvoy
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
- Prosper Services, Dublin, Ireland
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - K Lockhart
- Department of Psychiatry, St Michael's House Disability Services, Dublin, Ireland
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - T Burke
- UCD School of Psychology, University College Dublin, Dublin, Ireland
- KARE Services, Kildare, Ireland
| | - L O'Keeffe
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - S Guerin
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
- UCD School of Psychology, University College Dublin, Dublin, Ireland
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Liu S, Hu X, Li Y, Burke T, Piperdi B. 108P Real-world time on treatment (rwToT) analysis for first-line pembrolizumab combination therapy in advanced nonsquamous NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01950-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pérol M, Filleron T, Quantin X, Chouaid C, Valette CA, Lena H, Kaderbhai C, Fabre C, Santorelli M, Bensimon L, Burke T, Couch D, Nguyen E, Courtinard C. 109P Real-world evaluation of pembrolizumab monotherapy for PD-L1 positive (TPS>50%) metastatic NSCLC in France. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Burke T, Asghar S, O'Hara J, Sawyer EK, Li N. Clinical, humanistic, and economic burden of severe hemophilia B in the United States: Results from the CHESS US and CHESS US+ population surveys. Orphanet J Rare Dis 2021; 16:143. [PMID: 33743752 PMCID: PMC7981988 DOI: 10.1186/s13023-021-01774-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hemophilia B is a rare congenital bleeding disorder that has a significant negative impact on patients' functionality and health-related quality of life. The standard of care for severe hemophilia B in the United States is prophylactic factor IX replacement therapy, which incurs substantial costs for this lifelong condition. Accurate estimates of the burden of hemophilia B are important for population health management and policy decisions, but have only recently accounted for current management strategies. The 'Cost of Severe Hemophilia across the US: a Socioeconomic Survey' (CHESS US) is a cross-sectional database of medical record abstractions and physician-reported information, completed by hematologists and care providers. CHESS US+ is a complementary database of completed questionnaires from patients with hemophilia. Together, CHESS US and CHESS US+ provide contemporary, comprehensive information on the burden of severe hemophilia from the provider and patient perspectives. We used the CHESS US and CHESS US+ data to analyze the clinical, humanistic, and economic burden of hemophilia B for patients treated with factor IX prophylaxis between 2017 and 2019 in the US. RESULTS We conducted analysis to assess clinical burden and direct medical costs from 44 patient records in CHESS US, and of direct non-medical costs, indirect costs, and humanistic burden (using the EQ-5D-5L) from 57 patients in CHESS US+. The mean annual bleed rate was 1.73 (standard deviation, 1.39); approximately 9% of patients experienced a bleed-related hospitalization during the 12-month study period. Nearly all patients (85%) reported chronic pain, and the mean EQ-5D-5L utility value was 0.76 (0.24). The mean annual direct medical cost was $614,886, driven by factor IX treatment (mean annual cost, $611,971). Subgroup analyses showed mean annual costs of $397,491 and $788,491 for standard and extended half-life factor IX treatment, respectively. The mean annual non-medical direct costs and indirect costs of hemophilia B were $2,371 and $6,931. CONCLUSIONS This analysis of patient records and patient-reported outcomes from CHESS US and CHESS US+ provides updated information on the considerable clinical, humanistic, and economic burden of hemophilia B in the US. Substantial unmet needs remain to improve patient care with sustainable population health strategies.
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Affiliation(s)
| | | | - Jamie O'Hara
- HCD Economics, Daresbury, UK.,Faculty of Health and Social Care, University of Chester, Chester, UK
| | | | - Nanxin Li
- uniQure Inc, 113 Hartwell Avenue, Lexington, MA, 02421, USA.
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Burke T, Rooney B. Multi-Modal Dual-Task Measurement: A New Virtual Reality for Assessment. Front Psychol 2021; 11:635413. [PMID: 33679500 PMCID: PMC7933656 DOI: 10.3389/fpsyg.2020.635413] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tom Burke
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Brendan Rooney
- School of Psychology, University College Dublin, Dublin, Ireland
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Apter L, Moser SS, Arunachalam A, Burke T, Shalev V, Chodick G, Siegelmann-Danieli N. P09.39 PD-L1 Testing Patterns and Treatment in Patients With Metastatic Non-Small Cell Lung Cancer in Israel – Analysis of Real-World Data. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Burke T, Rooney B. Multi-Modal Dual-Task Measurement: A New Virtual Reality for Assessment. Front Psychol 2021. [DOI: 10.3389/fpsyg.2021.635413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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O'Hara J, Hirst C, Cabre Marquez JF, Burke T. Real-world evidence on Kovaltry (81-8973) in children with moderate or severe hemophilia A in Europe: a nested cohort analysis. Orphanet J Rare Dis 2021; 16:33. [PMID: 33451335 PMCID: PMC7809751 DOI: 10.1186/s13023-021-01676-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Untreated hemophilia A patients may experience recurrent bleeding events leading to debilitating joint damages. While RCT and pharmacokinetic data support the value of Kovaltry [an unmodified full-length recombinant factor VIII (FVIII) product], real world evidence in children is lacking. This report describes a descriptive and multivariate analysis of the effectiveness of Kovaltry in children with hemophilia A in the real-world setting, using data from medical chart abstraction and cross-sectional surveys of physicians, patients, and caregivers.
Results Male patients aged < 18 years with moderate or severe hemophilia A, residing in five European countries and treated with FVIII were studied. The co-primary endpoints were the annualized bleeding rate (ABR) and the annual FVIII utilization rate. Twenty nine patients treated with Kovaltry were included, of whom 93% had severe disease and 75% were on continuous prophylactic treatment. The mean ABR was 2.66 ± 2.06, with rates decreasing with age. The children received on average 2.45 infusions per week, consistent across age groups (median 3; range 1–3). There were no reports of inhibitor development or adverse events in the study (AEs), and all patients were satisfied or very satisfied with the treatment. An exploratory multivariate analysis suggests no significant difference in ABR or units utilized between Kovaltry and some extended half life products in children with severe hemophilia A, though characteristics of these patient cohorts were markedly different.
Conclusion This analysis demonstrates the effectiveness and safety of Kovaltry in a pan-European pediatric population with severe hemophilia A.
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Affiliation(s)
- Jamie O'Hara
- Department of Health and Social Care, University of Chester, Chester, UK.,HCD Economics, Daresbury, UK
| | - Ceri Hirst
- Real World Evidence, Bayer, Basel, Switzerland.
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Halmos B, Burke T, Kalyvas C, Insinga R, Vandormael K, Frederickson A, Piperdi B. MO01.18 An indirect Comparison of Pembrolizumab+Chemo vs Ipilimumab+Nivolumab as First-Line Therapies in Patients with PD-L1 TPS≥1% Metastatic NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Li N, Sawyer EK, Maruszczyk K, Guzauskas G, Slomka MT, Burke T, Martin AP, O'Hara J, Stevenson M, Recht M. Adult lifetime cost of hemophilia B management in the US: payer and societal perspectives from a decision analytic model. J Med Econ 2021; 24:363-372. [PMID: 33591884 DOI: 10.1080/13696998.2021.1891088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS Hemophilia B (HB) is a rare congenital disorder characterized by bleeding-related complications which are managed by prophylactic or post-bleeding event ("on-demand") replacement of clotting factor IX (FIX). The standard of care for severe HB is life-long prophylaxis with standard half-life (SHL) or extended half-life (EHL) products given every 2-3 or 7-14 days, respectively. FIX treatment costs in the US have been investigated, but the lifetime costs of HB treatment have not been well characterized, particularly related to the impact of joint health deterioration and associated health resource utilization. We developed a decision-analytic model to explore outcomes, costs and underlying cost drivers associated with FIX treatment options over the lifetime of an adult with severe or moderately severe HB. MATERIALS AND METHODS With participation from clinicians, health technology assessment specialists and patient advocates, a Markov model was constructed to estimate bleeding events and costs associated with health states including "bleed into joint", "bleed not into joint", "no bleed" and "death". Sub-models of joint health were based on 0, 1, or ≥2 areas of chronic joint damage. US third-party payer and societal perspectives were considered with a lifetime horizon; sensitivity analyses tested the robustness of primary findings. RESULTS Total adult lifetime costs per patient with severe and moderately severe HB were $21,086,607 for SHL FIX prophylaxis, $22,987,483 for EHL FIX prophylaxis, and $20,971,826 for on-demand FIX treatment. For FIX prophylaxis, the cost of FIX treatment accounts for >90% of the total HB treatment costs. CONCLUSIONS This decision analytic model demonstrated significant economic burden associated with the current HB treatment paradigm.
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Affiliation(s)
| | | | | | - Greg Guzauskas
- HCD Economics, Daresbury, UK
- CHOICE Institute, University of Washington, Seattle, WA, USA
| | - Marta T Slomka
- HCD Economics, Daresbury, UK
- Mossakowski Medical Research Centre PAS, Warsaw, Poland
| | | | | | - Jamie O'Hara
- HCD Economics, Daresbury, UK
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | - Matt Stevenson
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Michael Recht
- American Thrombosis and Hemostasis Network, Rochester, NY, USA
- The Hemophilia Center, Oregon Health & Science University, Portland, OR, USA
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