bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidities in osteoarthritis (ComOA): a combined cross-sectional, case–control and cohort study using large electronic health records in four European countries
Authors: Swain Subhashisa , Kamps Anne , Runhaar Jos , Dell'Isola Andrea , Turkiewicz Aleksandra , Robinson Danielle , Strauss V , Mallen Christian , Kuo Chang-Fu , Coupland Carol , Doherty Michael , Sarmanova Aliya , Prieto-Alhambra Daniel , Englund Martin , Bierma-Zeinstra Sita M A , Zhang Weiya 
Published: May 2022

IntroductionOsteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be investigated. This paper describes the protocol of a multinational study in four European countries (UK, Netherlands, Sweden and Spain) exploring comorbidities in people with OA.Methods and analysisThis multinational study will investigate (1) the temporal associations of 61 identified comorbidities with OA, (2) the clusters and trajectories of comorbidities in people with OA, (3) the role of analgesics on incidence of comorbidities in people with OA, (4) the potential biomarkers and causality between OA and the comorbidities, and (5) variations between countries.A combined case–control and cohort study will be conducted to find the temporal association of OA with the comorbidities using the national or regional health databases. Latent class analysis will be performed to identify the clusters at baseline and joint latent class analysis will be used to examine trajectories during the follow-up. A cohort study will be undertaken to evaluate the role of non-steroidal anti-inflammatory drugs (NSAIDs), opioids and paracetamol on the incidence of comorbidities. Mendelian randomisation will be performed to investigate the potential biomarkers for causality between OA and the comorbidities using the UK Biobank and the Rotterdam Study databases. Finally, a meta-analyses will be used to examine the variations and pool the results from different countries.Ethics and disseminationResearch ethics was obtained according to each database requirement. Results will be disseminated through the FOREUM website, scientific meetings, publications and in partnership with patient organisations.
Impact of employing primary healthcare professionals in emergency department triage on patient flow outcomes: a systematic review and meta-analysis
Authors: Jeyaraman Maya M , Alder Rachel N , Copstein Leslie , Al-Yousif Nameer , Suss Roger , Zarychanski Ryan , Doupe Malcolm B , Berthelot Simon , Mireault Jean , Tardif Patrick , Askin Nicole , Buchel Tamara , Rabbani Rasheda , Beaudry Thomas , Hartwell Melissa , Shimmin Carolyn , Edwards Jeanette , Halas Gayle , Sevcik William , Tricco Andrea C , Chochinov Alecs , Rowe Brian H , Abou-Setta Ahmed M 
Published: May 2022

ObjectivesTo identify, critically appraise and summarise evidence on the impact of employing primary healthcare professionals (PHCPs: family physicians/general practitioners (GPs), nurse practitioners (NP) and nurses with increased authority) in the emergency department (ED) triage, on patient flow outcomes.MethodsWe searched Medline (Ovid), EMBASE (Ovid), Cochrane Library (Wiley) and CINAHL (EBSCO) (inception to January 2020). Our primary outcome was the time to provider initial assessment (PIA). Secondary outcomes included time to triage, proportion of patients leaving without being seen (LWBS), length of stay (ED LOS), proportion of patients leaving against medical advice (LAMA), number of repeat ED visits and patient satisfaction. Two independent reviewers selected studies, extracted data and assessed study quality using the National Institute for Health and Care Excellence quality assessment tool.ResultsFrom 23 973 records, 40 comparative studies including 10 randomised controlled trials (RCTs) and 13 pre–post studies were included. PHCP interventions were led by NP (n=14), GP (n=3) or nurses with increased authority (n=23) at triage. In all studies, PHCP-led intervention effectiveness was compared with the traditional nurse-led triage model. Median duration of the interventions was 6 months. Study quality was generally low (confounding bias); 7 RCTs were classified as moderate quality. Most studies reported that PHCP-led triage interventions decreased the PIA (13/14), ED LOS (29/30), proportion of patients LWBS (8/10), time to triage (3/3) and repeat ED visits (5/6), and increased the patient satisfaction (8/10). The proportion of patients LAMA did not differ between groups (3/3). Evidence from RCTs (n=8) as well as other study designs showed a significant decrease in ED LOS favouring the PHCP-led interventions.ConclusionsOverall, PHCP-led triage interventions improved ED patient flow metrics. There was a significant decrease in ED LOS irrespective of the study design, favouring the PHCP-led interventions. Evidence from well-designed high-quality RCTs is required prior to widespread implementation.PROSPERO registration numberCRD42020148053.
Comparative safety and efficacy of cognitive enhancers for Alzheimer’s dementia: a systematic review with individual patient data network meta-analysis
Authors: Veroniki Areti Angeliki , Ashoor Huda M , Rios Patricia , Seitidis Georgios , Stewart Lesley , Clarke Mike , Tudur-Smith Catrin , Mavridis Dimitris , Hemmelgarn Brenda R , Holroyd-Leduc Jayna , Straus Sharon E , Tricco Andrea C 
Published: May 2022

ObjectiveTo examine the comparative efficacy and safety of cognitive enhancers by patient characteristics for managing Alzheimer’s dementia (AD).DesignSystematic review and individual patient data (IPD) network meta-analysis (NMA) based on our previously published systematic review and aggregate data NMA.Data sourcesMEDLINE, Embase, Cochrane Methodology Register, CINAHL, AgeLine and Cochrane Central Register of Controlled Trials up to March 2016.Participants80 randomised controlled trials (RCTs) including 21 138 adults with AD, and 12 RCTs with IPD including 6906 patients.InterventionsCognitive enhancers (donepezil, rivastigmine, galantamine and memantine) alone or in any combination against other cognitive enhancers or placebo.Data extraction and synthesisWe requested IPD from authors, sponsors and data sharing platforms. When IPD were not available, we used aggregate data. We appraised study quality with the Cochrane risk-of-bias. We conducted a two-stage random-effects IPD-NMA, and assessed their findings using CINeMA (Confidence in Network Meta-Analysis).Primary and secondary outcomesWe included trials assessing cognition with the Mini-Mental State Examination (MMSE), and adverse events.ResultsOur IPD-NMA compared nine treatments (including placebo). Donepezil (mean difference (MD)=1.41, 95% CI: 0.51 to 2.32) and donepezil +memantine (MD=2.57, 95% CI: 0.07 to 5.07) improved MMSE score (56 RCTs, 11 619 participants; CINeMA score: moderate) compared with placebo. According to P-score, oral rivastigmine (OR=1.26, 95% CI: 0.82 to 1.94, P-score=16%) and donepezil (OR=1.08, 95% CI: 0.87 to 1.35, P-score=30%) had the least favourable safety profile, but none of the estimated treatment effects were sufficiently precise when compared with placebo (45 RCTs, 15 649 patients; CINeMA score: moderate to high). For moderate-to-severe impairment, donepezil, memantine and their combination performed best, but for mild-to-moderate impairment donepezil and transdermal rivastigmine ranked best. Adjusting for MMSE baseline differences, oral rivastigmine and galantamine improved MMSE score, whereas when adjusting for comorbidities only oral rivastigmine was effective.ConclusionsThe choice among the different cognitive enhancers may depend on patient’s characteristics. The MDs of all cognitive enhancer regimens except for single-agent oral rivastigmine, galantamine and memantine, against placebo were clinically important for cognition (MD larger than 1.40 MMSE points), but results were quite imprecise. However, two-thirds of the published RCTs were associated with high risk of bias for incomplete outcome data, and IPD were only available for 15% of the included RCTs.PROSPERO registration numberCRD42015023507.
What is the suitability of clinical vignettes in benchmarking the performance of online symptom checkers? An audit study
Authors: El-Osta Austen , Webber Iman , Alaa Aos , Bagkeris Emmanouil , Mian Saba , Taghavi Azar Sharabiani Mansour , Majeed Azeem 
Published: May 2022

ObjectiveAssess the suitability of clinical vignettes in benchmarking the performance of online symptom checkers (OSCs).DesignObservational study using a publicly available free OSC.ParticipantsHealthily OSC, which provided consultations in English, was used to record consultation outcomes from two lay and four expert inputters using 139 standardised patient vignettes. Each vignette included three diagnostic solutions and a triage recommendation in one of three categories of triage urgency. A panel of three independent general practitioners interpreted the vignettes to arrive at an alternative set of diagnostic and triage solutions. Both sets of diagnostic and triage solutions were consolidated to arrive at a final consolidated version for benchmarking.Main outcome measuresSix inputters simulated 834 standardised patient evaluations using Healthily OSC and recorded outputs (triage solution, signposting, and whether the correct diagnostic solution appeared first or within the first three differentials). We estimated Cohen’s kappa to assess how interpretations by different inputters could lead to divergent OSC output even when using the same vignette or when compared with a separate panel of physicians.ResultsThere was moderate agreement on triage recommendation (kappa=0.48), and substantial agreement on consultation outcomes between all inputters (kappa=0.73). OSC performance improved significantly from baseline when compared against the final consolidated diagnostic and triage solution (p<0.001).ConclusionsClinical vignettes are inherently limited in their utility to benchmark the diagnostic accuracy or triage safety of OSC. Real-world evidence studies involving real patients are recommended to benchmark the performance of OSC against a panel of physicians.
Association between platelets and in-hospital mortality in critically ill patients with tumours: a retrospective cohort study
Authors: Zhao Chaofen , Qin Zuoan , Tang Yaxue , Liu Lina , Li Yuanyuan , He Qianyong , Jiang Jieqing , Chen Yue , Li Yuxin , Zhu Shaoyuan , Xu Xinyu , Zhou Ding’an , Jin Feng 
Published: May 2022

ObjectivesPlatelet count is an independent predictor of mortality in patients with cancer. It remains unknown whether the platelet count is related to in-hospital mortality in severely ill patients with tumours.DesignA retrospective study based on a dataset from a multicentre cohort.SettingThis was a secondary analysis of data from one Electronic Intensive Care Unit Collaborative Research Database survey cycle (2014–2015).ParticipantsThe data pertaining to severely ill patients with tumours were collected from 208 hospitals located across the USA. This study initially a total of 200 859 participants. After the population was limited to patients with combined tumours and platelet deficiencies, the remaining 2628 people were included in the final data analysis.Primary and secondary outcome measuresThe main measure was the platelet count, and the main outcome was in-hospital mortality.ResultsAfter adjustment for the covariates, the platelet count had a curvilinear relationship with in-hospital mortality (p<0.001). The first inflection point was 18.4 (per 10 change). On the left side of the first inflection point (platelet count ≤184 'x10ˆ9/L), an increase of 10 in the platelet count was negatively associated with in-hospital mortality (OR 0.92, 95% CI 0.89 to 0.95, p<0.001). The second inflection point was 44.5 (per 10 change). Additional increases of 10 in the platelet count thereafter were positively associated with hospital mortality (OR 1.13, 95% CI 1.00 to 1.28, p=0.0454). The baseline platelet count was in the range of 184 'x10ˆ9/L–445 'x10ˆ9/L(p=0.0525), and the hospital mortality was lower than the baseline platelet count in other ranges.ConclusionsThe relationship between platelet count and in-hospital mortality in critically ill patients with tumours was curvilinear. The lowest in-hospital mortality was associated with platelet count between 184 'x10ˆ9/Land 445 'x10ˆ9/L. This indicates that both high and low platelet count should receive attention in clinical practice.
Quantitative online survey of self-perceived knowledge and knowledge gaps of medicines research and development among Finnish general public
Authors: Tran Minh Mirjami , Tamminen Manu , Tamminen-Sirkiä Jenni , Majumder Muntasir Mamun , Tabassum Rubina , Lahti Tuuli 
Published: May 2022

ObjectivesThis study explored self-reported knowledge and interest to learn more about medicines research, development and health technology assessment among Finnish general public. It also aimed to define possible knowledge gaps and needs for public education regarding these topics.DesignOnline survey with 503 participants. The questionnaire was originally developed as a part of the Needs Assessment Work Package of the European Patients’ Academy on Therapeutic Innovation Project. The survey was carried out in Finland in 2019.MethodsThe survey was conducted as an online survey by Kantar TNS Gallup Forum online panel. The data were analysed by using the freely available programming language R. Relationships between the demographic characteristics (such as age, gender and education level) of respondents and their knowledge or interest in medicines research and development were determined using Pearson’s χ2 tests. Statistically significant responses of demographic characteristics in the respondents’ knowledge or interest in medicines research were determined by logistic regression.ResultsOf the 503 respondents (age 16–64) only 12% reported having good or very good knowledge of medicines research and development in general. Regarding health technology assessment, pharmacoeconomics and regulation, the percentage of respondents reporting good or very good knowledge was as low as 8%. Respondents were most interested in learning more about predictive and personalised medicine (47%) and least interested in medicines regulation (30%) and pharmacoeconomics (31%).ConclusionsSelf-reported knowledge about medicines research and development and health technology assessment appears to be very low in Finland. Patient and public participation is recognised as an important and essential element in up-to-date medical research and assessment of new treatments. In order to participate as an active and equal partner in these processes, the public needs more information and education in these topics.
Evaluation of the Victorian Healthy Homes Program: protocol for a randomised controlled trial
Authors: Campbell Margaret , Page Katie , Longden Thomas , Kenny Patricia , Hossain Lutfun , Wilmot Kerryn , Kelly Scott , Kim YoHan , Haywood Philip , Mulhern Brendan , Goodall Stephen , van Gool Kees , Viney Rosalie , Cumming Toby , Soeberg Matthew 
Published: May 2022

IntroductionThe evaluation of the Victorian Healthy Homes Program (VHHP) will generate evidence about the efficacy and cost-effectiveness of home upgrades to improve thermal comfort, reduce energy use and produce health and economic benefits to vulnerable households in Victoria, Australia.Methods and analysisThe VHHP evaluation will use a staggered, parallel group clustered randomised controlled trial to test the home energy intervention in 1000 households. All households will receive the intervention either before (intervention group) or after (control group) winter (defined as 22 June to 21 September). The trial spans three winters with differing numbers of households in each cohort. The primary outcome is the mean difference in indoor average daily temperature between intervention and control households during the winter period. Secondary outcomes include household energy consumption and residential energy efficiency, self-reported respiratory symptoms, health-related quality of life, healthcare utilisation, absences from school/work and self-reported conditions within the home. Linear and logistic regression will be used to analyse the primary and secondary outcomes, controlling for clustering of households by area and the possible confounders of year and timing of intervention, to compare the treatment and control groups over the winter period. Economic evaluation will include a cost-effectiveness and cost-benefit analysis.Ethics and disseminationEthical approval was received from Victorian Department of Human Services Human Research Ethics Committee (reference number: 04/17), University of Technology Sydney Human Research Ethics Committee (reference number: ETH18-2273) and Australian Government Department of Veterans Affairs. Study results will be disseminated in a final report and peer-reviewed journals.Trial registration numberACTRN12618000160235.
Intervention studies to encourage vaccination using narrative: a systematic scoping review protocol
Authors: Okuhara Tsuyoshi , Okada Hiroko , Goto Eiko , Kiuchi Takahiro 
Published: May 2022

IntroductionVaccine hesitancy is a global problem, impeding uptake of vaccines against measles, mumps, and rubella and those against human papillomavirus and COVID-19. Effective communication strategy is needed to address vaccine hesitancy. To guide the development of research in the field and the development of effective strategies for vaccine communication, this scoping review aims to analyse studies of interventions using narrative to encourage vaccination.Methods and analysisWe will search the following databases: MEDLINE, CINAHL, PsycINFO and PsycARTICLES. We will identify additional literature by searching the reference lists of eligible studies. Eligible studies will be those that quantitatively examined the persuasiveness of narrative to encourage vaccination. Two independent reviewers will screen the titles, abstracts and full texts of all studies identified. Two independent reviewers will share the responsibility for data extraction and verification. Discrepancies will be resolved through consensus. Data such as study characteristics, participant characteristics, methodology, main results and theoretical foundation will be extracted. The findings will be synthesised in a descriptive and a narrative review.Ethics and disseminationThis work does not warrant any ethical or safety concerns. This scoping review will be presented at a relevant conference and published in a peer-reviewed journal.
Evaluation of freely available data profiling tools for health data research application: a functional evaluation review
Authors: Gordon Ben , Fennessy Clara , Varma Susheel , Barrett Jake , McCondochie Enez , Heritage Trevor , Duroe Oenone , Jeffery Richard , Rajamani Vishnu , Earlam Kieran , Banda Victor , Sebire Neil 
Published: May 2022

ObjectivesTo objectively evaluate freely available data profiling software tools using healthcare data.DesignData profiling tools were evaluated for their capabilities using publicly available information and data sheets. From initial assessment, several underwent further detailed evaluation for application on healthcare data using a synthetic dataset of 1000 patients and associated data using a common health data model, and tools scored based on their functionality with this dataset.SettingImproving the quality of healthcare data for research use is a priority. Profiling tools can assist by evaluating datasets across a range of quality dimensions. Several freely available software packages with profiling capabilities are available but healthcare organisations often have limited data engineering capability and expertise.Participants28 profiling tools, 8 undergoing evaluation on synthetic dataset of 1000 patients.ResultsOf 28 potential profiling tools initially identified, 8 showed high potential for applicability with healthcare datasets based on available documentation, of which two performed consistently well for these purposes across multiple tasks including determination of completeness, consistency, uniqueness, validity, accuracy and provision of distribution metrics.ConclusionsNumerous freely available profiling tools are serviceable for potential use with health datasets, of which at least two demonstrated high performance across a range of technical data quality dimensions based on testing with synthetic health dataset and common data model. The appropriate tool choice depends on factors including underlying organisational infrastructure, level of data engineering and coding expertise, but there are freely available tools helping profile health datasets for research use and inform curation activity.
Association between metformin use and the risk of age-related macular degeneration in patients with type 2 diabetes: a retrospective study
Authors: Jiang Jingjing , Chen Yi , Zhang Hongsong , Yuan Wei , Zhao Tong , Wang Na , Fan Guohui , Zheng Dongxing , Wang Zhijun 
Published: May 2022

ObjectivesTo investigate the effect of metformin on the decreased risk of developing age-related macular degeneration (AMD) in patients with type 2 diabetes mellitus (T2DM) for ≥10 years.DesignA retrospective study.ParticipantsPatients aged ≥50 with a diagnosis of T2DM no less than 10 years were included.MethodsVariables predisposing to AMD were reviewed; the potential confounders related to T2DM or AMD were selected from literature records; AMD and diabetic retinopathy (DR) were diagnosed by funduscopy, optical coherence tomography and/or fluorescein angiography. The subgroup analysis was performed in early and late AMD. The protective effect of metformin was evaluated in duration-response and dose-response patterns.ResultsA total of 324 patients (115 metformin non-users and 209 users) were included in the final analysis. AMD was observed in 15.8% of metformin users and 45.2% of metformin non-users (p<0.0001). The ORs for any AMD, early AMD and late AMD present in patients with DR were 0.06 (0.02–0.20), 0.03 (0.00–0.20) and 0.17 (0.04–0.75). The serum high-density lipoprotein level was positively associated with the late AMD risk (p=0.0054). When analysed by the tertiles of cumulative duration, a similarly reduced risk was observed for the second (5–9 years) (OR: 0.24, 95% CI: 0.08 to 0.75) and third tertiles (≥10 years) (OR: 0.22, 95% CI: 0.09 to 0.52) compared with the first tertile (≤4 years).ConclusionAmong patients with T2DM for ≥10 years, metformin users were less likely to develop any AMD and early AMD than non-users; however, the late AMD was not significantly associated with the use of metformin. Also, AMD was less prevalent in patients with DR. The prolonged metformin treatment with a high cumulative dose enhanced the protective effect against AMD. Metformin significantly reduces the AMD risk when the cumulative duration is >5 years.