bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the value of routinely collected data on EQ-5D-5L and other electronic patient-reported outcome measures as prognostic factors in adults with advanced non-small cell lung cancer receiving immunotherapy
Authors: Liao Kuan , Wong David C , Gomes Fabio , Faivre-Finn Corinne , Moliner Laura , Sperrin Matthew , Yorke Janelle , van der Veer Sabine N
Published: May 2024

Objective

Investigate whether routinely collected electronic patient-reported outcome measures (ePROMs) add prognostic value to clinical and tumour characteristics for adults with advanced non-small cell lung cancer (NSCLC) receiving immunotherapy.

Methods and analysis

We retrospectively analysed data from adults with advanced NSCLC commencing immunotherapy between April 2019 and June 2022. Prognostic factors were ePROMs on quality of life (EuroQoL five-dimension five-level (EQ-5D-5L); EuroQoL Visual Analogue Scale (EQ-VAS)) and symptoms (patient-reported version of the Common Terminology Criteria for Adverse Events v5.0) completed at baseline and the first follow-up. We performed Cox proportional hazard regression for overall survival and time-to-progression as outcomes, and logistic regression for the onset of severe treatment toxicities (grade ≥3).

Results

We included 379 patients; 161 (42.5%) completed ePROMs at baseline. Median overall survival and time-to-progression were 13.5 months (95% CI 11.3 to 16.7) and 10.5 months (95% CI 8.8 to 13.7), respectively. 36 (9.5%) experienced severe treatment toxicities during follow-up. Patients with lower EQ-5D-5L utility scores (HR per 0.1 unit increase 0.84, 95% CI 0.74 to 0.95) and higher symptom burden (HR 1.11; 95% CI 1.04 to 1.19) had poorer overall survival. This was also true for those with decreased EQ-VAS and increased symptom burden between baseline and the first follow-up. Lastly, only decreased EQ-5D-5L utility scores between baseline and the first follow-up were associated with shorter time-to-progression.

Conclusion

ePROMs may add prognostic value to clinical and tumour characteristics for overall survival in adults with advanced NSCLC receiving immunotherapy.
Serum levels of endothelial glycocalyx constituents in women at 20 weeks' gestation who later develop gestational diabetes mellitus compared to matched controls: a pilot study
Authors: Long David S , Hou Weilin , Taylor Rennae S , McCowan Lesley M E
Published: May 2024

Objectives

The aim of this pilot study was to determine the serum concentration of heparan sulfate, hyaluronan, chondroitin sulfate and syndecan-1 and if these serum concentrations can be used to identify women at 20 weeks' gestation who later develop gestational diabetes mellitus (GDM).

Design

Nested case–control study from Auckland, New Zealand participants in the prospective cohort Screening for Pregnancy Endpoints study.

Setting

Auckland, New Zealand.

Participants

20 pregnant women (70% European, 15% Indian, 10% Asian, 5% Pacific Islander) at 20 weeks' gestation without any hypertensive complications who developed GDM by existing New Zealand criteria defined as a fasting glucose ≥5.5 mmol/L and/or 2 hours ≥9.0 mmol/L after a 75 g Oral Glucose Tolerance Test. Women not meeting these criteria were excluded from this study. The patients with GDM were matched with 20 women who had uncomplicated pregnancies and negative screening for GDM and matched for ethnicity, maternal age and BMI.

Primary and secondary outcome measures

The primary measures were the serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate determined by quantitative ELISA. There were no secondary outcome measures.

Results

Binary logistic regression was performed to determine if serum concentrations of endothelial glycocalyx layer constituents in women at 20 weeks' gestation would be useful in predicting the subsequent diagnosis of GDM. The model was not statistically significant χ2=12.5, df=8, p=0.13, which indicates that the model was unable to distinguish between pregnant women at 20 weeks' gestation who later developed GDM and those who did not.

Conclusions

Serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate in pregnant women at 20 weeks' gestation were not associated with later development of GDM. To further explore whether there is any relationship between endothelial glycocalyx constituents and GDM, the next step is to evaluate serum concentrations at the time diagnosis of GDM.
Trends in activities of daily living disability in a large sample of community-dwelling Chinese older adults in Hong Kong: an age-period-cohort analysis
Authors: Yu Ruby , Wong Moses , Chang Billy , Lai Xin , Lum C M , Auyeung T W , Lee Jenny , Tsoi Kelvin , Lee Ruby , Woo Jean
Published: May 2024

Background

To examine the trends in activities of daily living (ADL) disability in older Chinese adults in Hong Kong between 2001 and 2012.

Methods

Using data from the Elderly Health Centres (EHCs) of the Department of Health comprising a total of 54 808 community-dwelling Chinese adults aged ≥65 years in 1 early cohort (1904–1917) and 10 3-year birth cohorts (1918–1920, 1921–1923, 1924–1926, 1927–1929, 1930–1932, 1933–1935, 1936–1938, 1939–1941, 1942–1944, 1945–1947), we examined trends in ADL disability by using age-period-cohort (APC) models. ADL disability was defined as being unable to perform at least 1 of 7 ADL activities (bathing, dressing, toileting, transferring, feeding, grooming, walking) independently. Cross-classified random-effects logistic regressions were performed for each of the APC trends with adjustment for age, period, cohort, sociodemographic, lifestyle, comorbidity and self-rated health.

Results

The mean age of the cohort was 70.9±4.7 (range 65–99) years. The prevalence rate of ADL disability was 1.6%. ADL disability increased with age (p<0.001) and the gradient of the increase was steeper in the older age groups. At the same age, women (1.7%) were more likely to report ADL disability than men (1.4%, p=0.001). For both genders, there was an increase in ADL disability between 2003 and 2012; adjustment for age, cohort and other covariates has diminished the trends observed among men. There was no cohort effect in ADL disability.

Conclusions

ADL disability in older adults has increased over the last decade. Further study is required to identify possible causes behind the disability trends.
11: AN EVIDENCE BASED APPROACH TO IMPROVEMENT OF TIME VISIT IN THE BIGGEST UNIVERSITY POLICLINIC TABRIZ UNIVERSITY OF MEDICAL SCIENCES EXPERIENCE
Authors: Bakhshian Fariba , Beirami Hossein Jabbari , Beirami Saba Jabbari , Fatollahi Seiied Yaaghoob
Published: May 2024

Background and aims:

Today health systems all around the world have paid more attention to the concept of patient Time visit. This duration is one of the most valuable resources in healthcare and is considered as an important subject in the quality of services. This study has been conducted with evidence based approach in one of the biggest polyclinics of Tabriz University of Medical Sciences (TUMS) aiming in order to increasing patients' visit time.

Methods:

The first stage of study started with utilization, cost, and satisfaction data review –environmental analysis –problem prioritize - systematically searches- focus groups and intervention selection. In the second stage data of visit time (from time of entering to examination room until exit) were gathered and analyzed using simple method of chronometry by secretaries of wards and under supervision of experts in two time intervals of winter 2015 with sample of 850 patients and spring 2016 with sample of 421 patients.

Results:

Mean visit duration has increased from 6.04 minutes to more than 14.6 minutes and doubled improvement was observed in most of specialties and even in generalists. On the other hand the number of physicians employed in the center shows 4 times increase, where physicians with benefits of visit promotion have increased from 30% to about 50%, so all subsequences have led to increase in satisfaction of people and the number of service receivers has increased from 15000 to 70000 in month, and the center has reached positive financial balance.

Conclusion:

Following instructions of evolution plan we witnessed doubling of visit duration and qualitative and quantitative promotion of services comparing with the past, where in previous studies of the country we had 4.7, 7.6, and 8 minutes comparing with numbers above 23 minutes in America. Therefore it would not be surprising to expect significant improvements and reach standards (20 minutes) if there are on-time payments for physicians' receivables as well as managerial efforts with evidence based approach.
110: SEASONALITY IN HUMAN CASES OF CRIMEAN-CONGO HEMORRHAGIC FEVER AND ITS DEPENDENCE ON TEMPERATURE – EMPIRICAL EVIDENCE FROM PAKISTAN
Authors: Abbas Tariq , Younus Muhammad , Qayyum Abdul , Riaz Muhammad Tahir
Published: May 2024

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Pakistan. There is limited literature on epidemiology of the disease in the country. In this study, we carried out time series analysis of data (2007–2010) from three tertiary care hospitals to provide empirical evidence of seasonality in disease occurrence and its association with temperature. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the hospitals. The estimated amplitude was 3.24 cases per month with phase (i.e. peak location) in mid-June and low point (i.e. nadir) in mid-December. Generalized linear model revealed association between monthly number of CCHF admissions and average monthly temperature. A unit increase in temperature increased expected number of patients by 1.10 (95% CI : 1.07–1.13). A strong positive correlation (r=0.98) between between fitted values of GLM and cosinor models indicate relation between seasonal pattren and temperature. The risk should be managed according to seasonality and temperatue can be used as predictor in disease modeling.
112: SITUATION OF RELAPSING FEVER BORRELIOSIS IN BIJAR, IRAN
Authors: Kassiri Hamid , Dostifar Kobra , Karimi Mansor
Published: May 2024

Background and aims:

Tick-Borne Relapsing Fever (TBRF) is a zoonotic disease involving many species of rodents and small mammals in widely distributed areas throughout the world. We describe the epidemiological and demographic characters of found cases of TBRF in the Bijar County, and briefly review it for preventing this illness in the year of 2007–2008.

Methods:

A confirmed patient was defined as a person who had both febrile illness and detection of spirochetes by Wright-Giemsa or dark-field microscopy in a peripheral blood smear. All patients were asked to complete a questionnaire including demographic characteristics and clinical and epidemiological data of TBRF. Data was analyzed using SPSS. Eleven cases have been reported.

Results:

There were 5 cases (45.4%) of the patients younger than 10 years. Of the patients, 63.6% occurred in summer. All cases developed during the months of May to October. All of the reported cases were living in rural areas. Fever and chills, the most common symptoms, occurred in all patients. Recurrent fever occurred in 54.5% cases. All of the cases were cured according the national guideline for TBRF treatment. Only 18.2% of the patients were hospitalized. No patients this study died of TBRF. Most (54.5%) of the cases were students. Approximately 72.7% of the patients were keeping cattle and sheep near or inside their homes.

Conclusion:

As demonstrated, TBRF is a considerable public health concern, especially for children and students living in Bijar County. Considering the epidemiology of the disease, new control measures should be established.
13: AN IMPROVEMENT ON THE SURGICAL SAFETY CHECKLIST ACCORDING TO PRACTICE-BASED EVIDENCE
Authors: Ghadami Ahmad , Irajpour Ali reza , Mosleh Sorour , Fard Fereshteh Baradaran , Azari Maryam , Sajadi Shokouh , Sanaei Mohammad Reza
Published: May 2024

Background and aims:

One of the primary duties that circulating and scrub nurses fulfill is to record instruments used and procedures adopted during a surgical operation. An appropriate checklist based on evidence and guidelines can reduce the occurrence of legal and ethical complications in this field. The present research was performed to explore perspectives of operating room personnel on both the existing checklist and the improved one that was produced on the basis of evidence and guidelines available in Isfahan's Alzahra University Hospital.

Methods:

This one-group and two-stage trial study examined perspectives of 28 operating room personnel on both the existing Surgical Safety Checklist and the improved one. The latter was provided on the basis of books, results of studies, and qualified specialists' attitudes. The first section of the questionnaire was distributed to the sample in order to conduct an opinion poll about the present checklist. Next, they were asked to have the improved checklist for 3 weeks. Finally, another opinion poll was carried out about this checklist. The data were analyzed using the SPSS software as well as descriptive and analytical statistical tests.

Results:

Of the respondents, 25% (7 persons) and 75% (21 persons) were men and women respectively. The majority of the respondents, i.e. 60% (17 persons), had a bachelor's degree. Moreover, 21.6% of the sample had more than 5 years of professional experience. The items in the improved surgical safety checklist were as follows: including a space for the signature of the scrub nurse and personnel during the shift change and mentioning instruments used during an operation as well as different phases of surgery one by one. In general, the personnel's perspectives on the improved checklist, compared with the present checklist, were statistically significantly different (p<0.05). That is to say the improved checklist is a more comprehensive guide than the existing checklist as for keeping a checklist of instruments applied and procedures adopted. Furthermore, it is crucial to mention names of instruments on the checklist completely and individually.

Conclusion:

It is essential to keep a complete and comprehensive checklist of procedures implemented and instruments used during a surgical operation. It is therefore better to improve and complete the Surgical Safety Checklist on the basis of existing evidence and results so as to enhance operating room personnel's performance.
156: ANTENATAL SCREENING FOR CHROMOSOMAL ABNORMALITIES: COST EFFECTIVENESS AND OUTCOME
Authors: Farhadi Fereshteh , Taghavi Simin , Alikhah Hossein , Naghavi-Behzad Mohammad
Published: May 2024

Background and aims:

As an essential part of antenatal care, pregnant women of all ages should be offered screening for chromosomal abnormalities before 20 weeks gestation. This study was aimed to evaluate the type and frequency of chromosomal abnormalities following pregnancy screening tests so that we can compare the actual pregnancy outcomes with test results, this will help us in decision making whether the tests are reliable to use in practice or not.

Methods:

A “cross-sectional” study was conducted on 557 pregnant patients, presenting for prenatal diagnostic amniocentesis for chromosomal abnormalities, to Tabriz Al-Zahra Hospital since 2008 to 2011. Amniocentesis was conducted by an expert obstetrician at second trimester between 16 and 22 weeks of gestation. 15 to 20 ml of amniotic fluid was aspirated for chromosomal study. An interview was set for pregnancy outcomes to assess the test results.

Results:

Of 557 cases, the mean maternal age in amniocentesis was 31.84±6.92 y (range, 15-47y). Amniocentesis revealed the presence of chromosomal abnormalities in 32 cases (5.74%) including 18 girls (56.25%) and 16 boys (43.75%). The most common diagnosed chromosomal abnormality in studying cases was Down syndrome (50%) followed by other chromosomal abnormalities. Following up the patients, 92.4% of newborns did not have any congenital abnormality, but the remaining 7.6% had both chromosomal and non-chromosomal abnormalities. No fetal loss was reported in this study. So the effectiveness of this test was evaluated 75.52%. Assessment of total costs revealed that $US100 had been spent for hospitalization, and about $US500 for genetic tests. Also, the cost of three days hospitalization for pregnancy termination was evaluated as about $US1000.

Conclusion:

Several studies have evaluated the cost-effectiveness of each diagnostic method for detecting chromosomal anomalies. There is still no consensus on the most cost-effective strategy that should be implemented to diagnose chromosomal anomalies. So we didn't have an actual gold standard to compare with amniocentesis. More studies analyzing natural outcome after prenatal diagnosis of these chromosomal abnormalities are needed.
165: COMPARISON OF SHIRAZ AND RAFSANJAN MEDICAL STUDENTS ENTERING CLINICAL TRAINING IN EVIDENCE BASED MEDICINE (EBM) KNOWLEDGE IN 1395
Authors: Kazemi Mahsa
Published: May 2024

Background and aims:

Evidence based medicine (EBM) is a systematic process that can lead to enhancement of clinician's traditional skills in diagnosis and treatment. Teaching EBM to medical students will improve their performance and help them to be up-to-date in their profession. The aim of this study was to compare Shiraz (type 1 university) and Rafsanjan (type 2) students in clinical stage in Evidence Based Medicine (EBM) knowledge.

Methods:

this is a comparative descriptive study that was conducted in Shiraz and Rafsanjan University of medical sciences in 2016. Questionnaires were distributed among 100 medical students in clinical stage (including externs and interns). In fact, 50 students were randomly selected from each university. The questioners included 10 questions; each question had 5 choices from very low (score 1) to very high (score 5). Therefore, the minimum score could be 10 and the maximum score 50. Data analysis was done using SPSS18 and independent T-Test.

Results:

Our study indicate that there is no significant difference between shiraz and Rafsanjan students in EBM knowledge (p>0.05). In Shiraz, the minimum score the knowledge of evidence base ranking of articles (1.78+−0.84) and in Rafsanjan minimum score belonged to the knowledge of critiquing an article (1.76+−0.79).In both Shiraz and Rafsanjan, the maximum score belonged to the question in which their knowledge of appropriate treatment was evaluated. To compare total scores, there were no considerable differences between Rafsanjan (25.5±6.01) and Shiraz (25.8±6.05).

Conclusion:

The results of this study indicate that there is no significant difference between the knowledge of medical students in type 1 (Shiraz) and type 2 (Rafsanjan) universities. This can be due to the absence of EBM in the universities curriculum, and we suggest that EBM needs more attention in education and curriculum.
168: DESIGNING OF THE HEALTH JOURNALISTS TRAINING COURSE IN THE AREA OF HEALTH PROMOTION
Authors: Kheshvari Mahrokh , Yamani Niko , Abidi Peyman , Shahnazi Hossein
Published: May 2024

Background and aims:

The media play a vital role in the dissemination of information about health and medical sciences and provide important information about medical researches, health policies, and health professions for the people. They can effect on knowledge and believes of the people; therefore we cannot ignore their impact on public attitudes. Given the importance of providing accurate health news reports, and the need for health-conscious and competent journalists in the country, the aim of this study was. “Designing of the health journalists training course in the area of health promotion“.

Methods:

This study was conducted in Isfahan University of Medical Sciences 1394–95. This study was a cross-sectional study that during the two phases of “need assessment”, and curriculum planning carried out. In the beginning of the study, in order to obtain accessible curriculums in the high rank universities in the world, the library search was done. And then through the study of quantitative study and interview, the training needs of journalists identified, and ultimately, the educational objectives of the proposed training course of health journalists was developed.

Results:

The results of this research led to the development of a curriculum of Medical Journalism Course in the area of health promotion. The highest level of health awareness of reporters was related to the field of health economy (3/19±0/68) and the lowest level of awareness was related to the scope of health promotion (2/3±0/84), respectively. Reporters lowest level of educational priorities was for the area of health promotion (1/76±0/71) and the highest priority level for the area of health economics (2/12±0/84) was held. Given the level of awareness and prioritize training needs, the developed course was consisted of 8 health subjects, environmental health, epidemiology, nutrition, economics, health promotion, family and community health, the aging in society, and Medical Ethics.

Conclusion:

The results of this study led to designing of a curriculum of health journalists training course in the area of health promotion. It is hoped that by implementing through the course by intersectional collaboration of the Ministry of Health and Medical Education and the press, health reporters can publish correct and accurate medical events and improve the health literacy of the community.
172: ECONOMIC BURDEN OF ROAD TRAFFIC INJURIES IN LOW AND MIDDLE INCOME COUNTRIES VERSUS HIGH INCOME COUNTRIES: A SYSTEMATIC REVIEW
Authors: Zakeri Raana , Nosratnejad Shirin
Published: May 2024

Background and aims:

Road traffic injury (RTI) as a major public health problem is the ninth leading cause of death globally. Cases of RTIs are increasing in most of the regions of the world. Research into RTIs indicates that there are distinct differences in the pattern of economic growth between high-income countries (HIC) and low-middle-income countries (LMIC). We aimed to address the economic burden of RTI among LMIC versus HIC; for this purpose we gathered the evidences through a review of the literature.

Methods:

We systematically searched databases (PubMed, Web of Science, Science Direct, Scopus, ProQuest, SID, IranMedex and Magiran) up to February 2016 and included the original articles on economic burden of RTI in national levels. Two authors appraised the identified studies. We examined the direct, indirect and intangible costs of RTI as a percentage of GDP, and also as a percentage of household consumption expenditure in LMIC versus HIC.

Results:

20 studies from fifteen countries met the inclusion criteria, of which five are HIC and ten are LMIC. The mean cost of direct plus indirect costs of RTI as a percentage of GDP and as a percentage of households consumption expenditure in LMIC and HIC are respectively 1.29, 1.61 and 1.74, 3.50; and mean of total economic burden of RTI (direct+indirect+intangible cost) as a percentage of GDP and as a percentage of households consumption expenditure in LMIC versus HIC are respectively 2.35, 1.43 and 2.01, 2.90. Among LMIC, the economic burden of RTI in Iran is the highest (6.64% GDP) and among HIC, it's Australia (2.28% GDP).

Conclusion:

The economic burden of RTI in LMIC is nearly a half of the health expenditure in these countries. Also the economic burden of RTI in HIC is a quarter of total health expenditure. This evidence emphasizes the importance of road safety interventions as cost-benefit interventions.
177: EYE CARE IN THE INTENSIVE CARE PATIENTS: AN EVIDENCE BASED REVIEW
Authors: Taheri-Kharameh Zahra
Published: May 2024

Background and aims:

A complication of sedation and coma is that some patients are unable to maintain effective eyelid closure. These patients present a higher risk of eye complications. However, in the intensive care unit (ICU), treatment is usually focused on the management of organ failures, and eye care becomes a side issue. Early diagnosis and effective treatment will help prevent microbial keratitis and visual loss. To identify the best available evidence in providing the best eye care to prevent exposure keratopathy, a literature review was performed.

Methods:

A literature review was conducted using electronic databases of Pub-Med and Google scholar to identify citations published in English language between 2005 and 2016, using the keywords 'keratopathy', 'eye care', 'dry eye', 'intensive care', 'critical patients'. Identified titles and abstracts were screened separately by researchers for relevance and eligibility and papers were independently assessed for inclusion. Data were abstracted from included papers and quality evaluation of included papers was conducted. The papers were analyzed and reported in a narrative synthesis.

Results:

Generally eye care measures were including lubricants (ointments, drops, normal saline irrigation of the eyes), chambers (polyethylene covers, swimming goggles, shields, pads, eye patch), eyelid closure (taping the eyes closed with transparent tape, tarsorrhaphy). Among various eye care measures that have been advocated to prevent exposure keratopathy, the most effective is the application of polyethylene moisture chamber.

Conclusion:

With application of simple protocols, exposure keratopathy can be prevented, thus improving patient care in the intensive care unit. ICU staff should be educated about the eye care of critical care patients.
187: MEDICAL LIBRARY AND INFORMATION SCIENCE STUDENTS' READINESS AND ATTITUDES TO ENTER HOSPITALS AS CLINICAL LIBRARIANS: A CASE STUDY OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES
Authors: Daei Azra , Vaighan Ali Sadeghzadeh , Imani Sona Tayebi , Ashrafi-rizi Hassan
Published: May 2024

Background and aims:

Expert searcher, teacher, content manager, and patient advocate are clinical librarian roles. Clinical Librarian has a potential role in facilitating evidence-based practice in hospital settings. Nowadays, clinical librarian has a role in the treatment group and even in clinical decision makings. The Clinical librarian job is empty in Iran's hospitals but efforts are emerging that clinical librarian enter to Hospital jobs. So the purpose of this research was to investigate the medical library and information science students' readiness to enter hospitals as a clinical librarians.

Method:

The survey method was used. The population of this research was medical library and information science students (N=74, BSc, MSc, PhD students) in Isfahan University of Medical Sciences. The instrument utilized in study was a questionnaire developed by the researchers themselves and its validity was established through a panel of experts. The reliability of questionnaire was determined by calculating the Cronbach's alpha coefficient.

Results:

Great number of students indicated clinical librarian's mission is to facilitate access to quality information that is necessary for improving health. Students largely stated their current curriculum didn't prepared to clinical librarian mission so they didn't have enough self-confidence to work with physicians and the medical team.

Conclusion:

Health services are facing organizational change. New technologies and rapid growth of medical knowledge and information creates a demand for new ways of providing information. Clinical librarian programs may deliver patients specific information in a timely manner. To get this target students must be prepared with courses helping them to improve clinical knowledge; so medical library and information science curriculums must change in each level.
200: THE EFFECT OF PATIENT- PHYSICIAN RELATIONSHIP ON HEALTH INFORMATION SEEKING BEHAVIOR OF DIABETIC PATIENTS
Authors: Zare-Farashbandi Firoozeh , Lalazaryan Anasik , Rahimi Alireza
Published: May 2024

Background and aims:

The base of any relation between patients and physician is patients' needs for medical services. By providing the most needed medical services, the control of patients' diseases could be improved. The goal of the current study is to investigate the effect of patient-doctor relation on the health information seeking behavior of the patients.

Methods:

This is an applied cross sectional study. 362 diabetic patients were selected using non-percentage stratified random sampling for this study. The data gathering tool was the Lango questionnaire. The gathered data were analyzed using descriptive (frequency distribution, average, standard deviation) and analytical (Person correlation, one way ANOVA, independent t-test) statistics with the help of SPSS 20 software.

Results:

According to the patients, having health related information increases their self-management and their satisfaction regarding treatment process. Independent t-test showed that there is a significant difference between the health information seeking behavior of patients that rely on their doctor and patients that don't rely on their doctor in the dimension of receiving information (P=0.003). Also there is a statistically significant relation between consulting the doctor and three of the four dimensions of health information seeking behavior and between satisfaction regarding the transfer of medical information with the dimension of information sources of health information seeking behavior of diabetic patients (P<0.05).

Conclusion:

The patients and physicians relations effect on patients' health information seeking behavior. Identifying the patients' needs through investigating their health information seeking behavior and presenting the results to frontline medical practitioners can improve the satisfaction of the services provided and can improve the relation between patients and doctors.
209: UNLOCKING EVIDENCE REVERSAL IN THE LITERATURE: A KEY TO TERMINOLOGY
Authors: Sutton Desirée , Qureshi Riaz , Martin Janet
Published: May 2024

Background and aims:

Evidence Reversal (ER) is the phenomenon whereby new evidence – most often strong randomized controlled trials – finds an already established clinical practice to be less effective, or even more harmful, than was originally believed. This phenomenon is very prevalent with up to 46% of trials testing an already established practice leading to a reversal of that practice. Before reducing the adverse impact of reversals on clinical practice, we must first understand the phenomenon and how it has been explored. The objectives of this review are to explore the terminology and definitions for ER in the literature and then map the terms onto a framework.

Methods:

Multiple academic and grey literature databases were systematically searched between 2000 and 2016 using combinations of relevant subject headings and key words. Hand searches of relevant journals, websites, and blogs were also performed. Two reviewers independently screened the returned citations and performed data extraction and quality assessment using a modified AMSTAR rating tool. All reviews and collections of studies that discussed aspects or examples of ER – either directly or indirectly – were included.

Results:

After the removal of duplicate citations, 48936 items were retrieved for screening. The final number of included reviews was 87. The concept of reversal first appeared in the literature in the early 2000s, but the majority of articles have been published in the past four years. Terms for ER that we found in our search include: medical reversal, de-implementation, de-adoption, un-diffusion, disinvestment, abandonment, discontinuation, Proteus phenomenon, contradicted findings, POEMS likely to change practice, evidence to change practice, and overtreatment. These terms, and others, have been mapped onto a framework for identifying reversal in the literature. The overall quality of the articles was very low.

Conclusion:

Evidence reversal, though not a new phenomenon, has only recently been explored in the literature. There are many different terms for the process of reversal and identifying medical practices to be targeted for reversal. Consensus should be reached on which terms are most appropriate so that subject headings can be developed and cohesion can be brought to this emerging field of meta-research.
24: ASSOCIATION OF RS3850641 POLYMORPHISM IN OX40 LIGAND GENE AND PREMATURE MYOCARDIAL INFARCTION, SOUTHERN OF IRAN
Authors: Rahmanian Zhila , Shojaei Mohammad , Jahromi Abdolreza Sotoodeh
Published: May 2024

Background and aims:

Tumor necrosis factor (TNF) is one of the inflammatory cytokines which has an important role in inflammation and migration of other inflammatory cells to the atherosclerotic plaques. OX40L is a member of the TNF super family receptor protein. OX40 and OX40 ligand are co-stimulators for T-cells and can increase inflammatory response in atherosclerotic plaques. The aim of this study was to determine the association of rs3850641 polymorphism in OX40L gene with premature myocardial infarction.

Methods:

This case control study was done on 100 patients with premature acute myocardial infarction (AMI) and a similar number of sex, age and some other cardiovascular risk factor matched healthy people.

Results:

The OX40L rs3850641 polymorphism was genotyped, using PCR-RFLP method. AA genotype frequency of rs3850641 SNP was higher non-significantly in Premature AMI, compared to healthy subjects (58.80% vs. 57.50%). AG genotype frequency of rs3850641 SNP was lower non-significantly in Premature AMI, compared to healthy subjects (0.0% vs. 1.40%), also GG genotype frequency of rs3850641 SNP was lower non-significantly in Premature AMI, compared to healthy subjects (41.20% vs. 41.10%), (P>0.05).

Conclusion:

The results of this study indicate that the rs3850641 SNP of OX40L gene is not associated with premature AMI in the evaluated population.
62: EVIDENCE-BASED “PODCAST”; A QUEST TO REDUCE UNNECESSARY DEMANDS
Authors: Mostafaei Hadi , Hajebrahimi Sakineh
Published: May 2024

Background and aims:

The unnecessary demands both from patients and doctors cause a great amount of financial waste and negative impact on patients' health. Thus there is a need for informing the public about the necessity of certain demands and the evidence behind them. Therefor we decided to launch a podcast channel with the aim of discussing top health issues and top demands and giving the listeners and understanding of what demands are their real need.

Methods:

We began recording the 20 minute podcasts discussing some of the most widespread demands. The podcasts were recorded in a studio with asking guest experts to join. These podcast were spread in public using common national social media app “Telegram” and creating a telegram channel. After two series of podcasts and sharing them in the Telegram channel, we shared a short and simple questionnaire and we asked the public to fill it up. We asked them about: Popularity of the discussed topics, their previous wrong beliefs, Usefulness of the data, the effect of the provided information on their education and impact on their habit change. The data gathered was finally analyzed.

Results:

From 200 members of the channel 80 members responded for our questionnaire call. All the respondents at least had primary education. Most of them spend a minimum of one hour per day using Telegram and the information derived of Telegram has a high impact in their education. The respondents were shocked when hearing the two of their most common demands were completely unnecessary. They mostly agreed that high quality, Inviting well-known experts and discussing common and relevant issues makes the Podcast more trustworthy. All known the members of the channel were unfamiliar with the importance of Evidence-Based education after listening to podcasts; they agreed not to trust any data at a glance. Most of them decided for making a habit change. This concludes the importance of Evidence-Based education and the great role of the social media in its success.
78: IMPACT OF DECISION AIDS IN PROSTATE CANCER SCREENING: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Arab-Zozani Morteza , Vahdatimanesh Zahra , Kakemam Edris , Sokhanvar Mobin , Ghoddosineghad Djavad , Hasanpoor Edris
Published: May 2024

Background and aims:

Patient Decision Aids are specially designed information resources that help people make decisions about difficult healthcare options. The aim of this review was to examine the impact of decision aids in patients with prostate cancer screening.

Methods:

Embase, PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) and reference list of the included studies were searched without year and language restriction through July 2016. Two independent reviewers checked studies for quality and eligibility and finally extracted the data. We used comprehensive meta-analysis software version 2 (CMA 2.0) for analysing the data.

Results:

Seven randomized controlled trials and well-designed quasi-experimental studies with total number of 5195 were included in the meta-analysis. The quality of included studies was faired. The overall mean quality score for the 7 included studies was 3.2 out of 5 (SD=0.87). Decision aids show better impact on decrease interest in prostate-specific antigen testing and screening behaviour among patients seeking routine care (M-H RR 0.59, 95% CI 0.41 to 0.76), proportion of people who were passive in decision making (M-H RR 0.76, 95% CI 0.60 to 0.96) and proportion of people who remained undecided post-intervention (M-H RR 0.66, 95% CI 0.43 to 0.84).

Conclusion:

According to the results, decision Aids resulted in significant benefit over usual care in patients with prostate cancer screening.
Epidemiology of venous thromboembolism in Africa: a systematic review and meta-analysis protocol
Authors: Danwang Celestin , Temgoua Mazou N , Agbor Valirie Ndip , Tankeu Aurel T , Noubiap Jean Jacques
Published: May 2024

Introduction

Venous thromboembolism (VTE) is among the three major causes of cardiovascular diseases worldwide after ischaemic heart disease and stroke. Knowledge on the global epidemiology of this condition is deficient in Africa. Accurate data are needed to evaluate the burden of VTE in Africa to design effective preventive and treatment strategies. This systematic review and meta-analysis aims to summarise epidemiological data on VTE in Africa and to evaluate the use of prophylaxis in African patients at risk of VTE.

Methods and analysis

Medline, Embase, Scopus and African Journal Online will be searched for relevant abstracts of studies published between 1 January 1986 and 5 December 2016, without language restriction. After a screening of abstracts, study selection, data extraction and assessment of the risk of bias, we shall assess studies individually for clinical and statistical heterogeneity. Appropriate meta-analytic technics will then be used to pool studies judged to be clinically homogeneous. Funnel-plots analysis and Egger’s test will be used to detect publication bias. Results will be presented by geographical region (Central, Eastern, Northern, Southern and Western Africa). This systematic review will be reported according to the Meta-analysis of Observational Studies in Epidemiology Guidelines.

Ethics and dissemination

The current study will be based on published data, and thus ethics consideration is not required. This review is expected to provide relevant data to help in quantifying the magnitude of this disease in Africa. The final report of this study will be published in a peer-reviewed journal and the findings will be submitted to relevant health authorities.

Trial registration number

The protocol for this review has been published in the International Prospective Register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO), registration number: PROSPERO CRD42017056253.
How information about overdetection changes breast cancer screening decisions: a mediation analysis within a randomised controlled trial
Authors: Hersch Jolyn , McGeechan Kevin , Barratt Alexandra , Jansen Jesse , Irwig Les , Jacklyn Gemma , Houssami Nehmat , Dhillon Haryana , McCaffery Kirsten
Published: May 2024

Objectives

In a randomised controlled trial, we found that informing women about overdetection changed their breast screening decisions. We now present a mediation analysis exploring the psychological pathways through which study participants who received the intervention processed information about overdetection and how this influenced their decision-making. We examined a series of potential mediators in the causal chain between exposure to overdetection information and women’s subsequently reported breast screening intentions.

Design

Serial multiple mediation analysis within a randomised controlled trial.

Setting

New South Wales, Australia.

Participants

811 women aged 48–50 years with no personal history of breast cancer.

Interventions

Two versions of a decision aid giving women information about breast cancer deaths averted and false positives from mammography screening, either with (intervention) or without (control) information on overdetection.

Main outcome

Intentions to undergo breast cancer screening in the next 2–3 years.

Mediators

Knowledge about overdetection, worry about breast cancer, attitudes towards breast screening and anticipated regret.

Results

The effect of information about overdetection on women’s breast screening intentions was mediated through multiple cognitive and affective processes. In particular, the information led to substantial improvements in women’s understanding of overdetection, and it influenced—both directly and indirectly via its effect on knowledge—their attitudes towards having screening. Mediation analysis showed that the mechanisms involving knowledge and attitudes were particularly important in determining women’s intentions about screening participation.

Conclusions

Even in this emotive context, new information influenced women’s decision-making by changing their understanding of possible consequences of screening and their attitudes towards undergoing it. These findings emphasise the need to provide good-quality information on screening outcomes and to communicate this information effectively, so that women can make well-informed decisions.

Trial registration number

This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001035718) on 17 September 2013.
Prevalence and incidence of hypertension in the global HIV-infected population: a systematic review and meta-analysis protocol
Authors: Bigna Jean Joel , Tankeu Aurel T , Kaze Arnaud D , Noubiap Jean Jacques , Nansseu Jobert Richie
Published: May 2024

Introduction

Hypertension, representing one of the most frequent cardiovascular risk factors, is thought to increase in individuals living with HIV as well as in general population, but summarised global data on the topic are scarce. We conduct this systematic review and meta-analysis to assess the prevalence/incidence of hypertension in the global HIV-infected population.

Methods and analysis

This review will include observational studies conducted among HIV-infected people, which reported prevalence/incidence of hypertension or enough data for its appraisal. We will consider published and unpublished studies from 1 January 2007 to 31 May 2017. Relevant records will be searched using PubMed/Medline, Global Index Medicus, Web of Science and EMBASE. Reference lists of eligible papers and relevant review articles will be screened. Two investigators will independently screen, select studies and extract data, with discrepancies resolved by consensus or by arbitration of a third investigator. Methodological quality of the included studies will be assessed using the scale developed by Hoy and colleagues. Funnel plots and Egger’s test will be used to determine publication bias. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate. To keep the effect of studies with extremely small or extremely large estimates on the overall estimate to a minimum, the variance of the study-specific prevalence/incidence will be stabilised with the Freeman-Tukey single arcsine transformation. The heterogeneity will be evaluated by the χ² test on Cochrane’s Q statistic. Results will be presented by geographic region, income and antiretroviral therapy status.

Ethics and dissemination

This study is based on published data; therefore, ethical approval is not a requirement. The final report of this study in the form of a scientific paper will be published in peer-reviewed journals.

Trial registration number

CRD42016051684.
Midwife or doctor local opinion leader to implement a national guideline in babies on postnatal wards (DesIGN): protocol of a cluster-randomised, blinded, controlled trial
Authors: Alsweiler Jane Marie , Crowther Caroline A , Harding Jane E
Published: May 2024

Introduction

Neonatal hypoglycaemia is a common condition that can cause developmental delay. Treatment of neonatal hypoglycaemia with oral dextrose gel has been shown to reverse hypoglycaemia and reduce admissions to neonatal intensive care for hypoglycaemia. An evidence-based clinical practice guideline was written to guide the use of dextrose gel to treat neonatal hypoglycaemia in New Zealand. However, it is unclear what clinical discipline might most effectively lead the implementation of the guideline recommendations.

Objective

To determine if midwife or doctor local opinion leaders are more effective in implementing a clinical practice guideline for use of oral dextrose gel to treat hypoglycaemia in babies on postnatal wards.

Methods and analysis

A cluster-randomised, blinded, controlled trial. New Zealand maternity hospitals that care for babies born at risk of neonatal hypoglycaemia will be randomised to having either a local midwife or doctor lead the guideline implementation at that hospital. The primary outcome will be the change in the proportion of hypoglycaemic babies treated with dextrose gel from before implementation of the guideline to 3 months after implementation.

Ethics and dissemination

Approved by Health and Disability Ethics Committee: 15/NTA/31. Findings will be disseminated to peer-reviewed journals, guideline developers and the public.

Trial registration number

ISRCTN61154098.