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Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne D, Farmer A, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson D, Vohra S, White IR, Boutron I. CONSORT 2025 explanation and elaboration: updated guideline for reporting randomised trials. BMJ 2025; 389:e081124. [PMID: 40228832 PMCID: PMC11995452 DOI: 10.1136/bmj-2024-081124] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 04/16/2025]
Affiliation(s)
- Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, OH, USA
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | | | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ian R White
- MRC Clinical Trials Unit at University College London, London, UK
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
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Xu T, Chen C, Liu C, Rose GM. The effects of relaxation interventions on physical and psychological distress among informal cancer caregivers: A systematic review. Geriatr Nurs 2025; 63:207-222. [PMID: 40209598 DOI: 10.1016/j.gerinurse.2025.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 02/03/2025] [Accepted: 03/19/2025] [Indexed: 04/12/2025]
Abstract
OBJECTIVES To evaluate the effects of relaxation interventions on physical and psychological distress in informal cancer caregivers and identify effective intervention components. METHODS A systematic review was conducted. PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL Complete, Nursing & Allied Health Premium, Scopus, WHO International Clinical Trial Registry Platform, and PsycINFO were searched from January 1, 2010, to March 31, 2024. Risk of bias was conducted using the Mixed Methods Appraisal Tool. RESULTS We identified a diverse range of relaxation interventions including aerobic exercise, back massage, music therapy, art therapy, mindfulness meditation, and progressive muscle relaxation, demonstrating reduced caregiver burden, anxiety, and stress levels while improving sleep quality and overall quality of life. However, studies were limited by short follow-up periods and methodological diversity. CONCLUSION Relaxation interventions show promise in alleviating distress among cancer caregivers. Future studies should focus on optimizing intervention components and extending follow-up durations.
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Affiliation(s)
- Tuzhen Xu
- Prairie View A&M University, College of Nursing, Houston, USA
| | - Chunfang Chen
- University of Mount Saint Vincent, St Joseph's school of nursing, New York, USA
| | - Caiyi Liu
- Prairie View A&M University, College of Nursing, Houston, USA
| | - Gloria M Rose
- Prairie View A&M University, College of Nursing, Houston, USA.
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Malmsiø D, Norlén S, Jespersen C, Neesgaard VE, Song Z, Chan AW, Hróbjartsson A. Scoping review of registration of observational studies finds inadequate registration policies, increased registration, and a debate converging toward proregistration. J Clin Epidemiol 2025; 180:111686. [PMID: 39862933 DOI: 10.1016/j.jclinepi.2025.111686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 12/20/2024] [Accepted: 01/17/2025] [Indexed: 01/27/2025]
Abstract
OBJECTIVES We aimed to examine a) the policies of national and international clinical trial registries regarding observational studies; b) the time trends of observational study registration; and c) the published arguments for and against observational study registration. STUDY DESIGN AND SETTING Scoping review of registry practices and published arguments. We searched the websites and databases of all 19 members of the World Health Organization's Registry Network to identify policies relating to observational studies and the number of observational studies registered annually from the beginning of the registries to 2022. Regarding documents with arguments, we searched Medline, Embase, Google Scholar, and top medical and epidemiological journals from 2009 to 2023. We classified arguments as "main" based on the number (n ≥ 3) of documents they occurred in. RESULTS Of 19 registries, 15 allowed observational study registration, of which seven (35%) had an explicit policy regarding what to register and two (11%) about when to register. The annual number of observational study registrations increased over time in all registries; for example, ClinicalTrials.gov increased from 313 in 1999 to 9775 in 2022. Fifty documents provided arguments concerning observational study registration: 31 argued for, 18 against, and one was neutral. Since 2012, 19 out of 25 documents argued for. We classified nine arguments as main: five for and four against. The two most prevalent arguments for were the prevention of selective reporting of outcomes (n = 16) and publication bias (n = 12), and against were that it will hinder exploration of new ideas (n = 17) and it will waste resources (n = 6). CONCLUSION Few registries have policies regarding observational studies; an increasing number of observational studies were registered; there was a lively debate on the merits of registration of observational studies, which, since 2012, seems to converge toward proregistration.
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Affiliation(s)
- Daniel Malmsiø
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark.
| | - Simon Norlén
- Department of Emergency Medicine at Lillebælt Hospital, Kolding, Denmark
| | - Cecilie Jespersen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
| | | | - Zexing Song
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - An-Wen Chan
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
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4
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Chan AW, Karam G, Pymento J, Askie LM, da Silva LR, Aymé S, Taylor CM, Hooft L, Ross AL, Moorthy V. Reporting summary results in clinical trial registries: updated guidance from WHO. Lancet Glob Health 2025; 13:e759-e768. [PMID: 40155113 DOI: 10.1016/s2214-109x(24)00514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 11/10/2024] [Accepted: 11/21/2024] [Indexed: 04/01/2025]
Abstract
The importance of publicly registering clinical trials and reporting their results in registries is widely recognised. While substantial progress has been made with registering trials before enrolment, the availability of results in registries remains uncommon despite expanding legislative and funder requirements-leading to an incomplete evidence base and avoidable waste of resources, particularly for unpublished trials. This paper discusses the rationale for reporting summary results in trial registries, reviews the current landscape of registry policies, and presents new WHO guidance for reporting results in registries. The 2025 WHO guidance was developed after consultation with relevant parties, including researchers, patients, sponsors, funders, regulators, journal editors, registry administrators, and the public. The guidance defines eight minimum items that are essential for understanding and interpreting the summary results for all trials. Implementation of the WHO guidance by trial registries, broad adherence by investigators and sponsors, and endorsement by funders, regulators, legislators, research ethics committees, patient organisations, and journals can help enhance the contribution of trials to scientific knowledge, patient care, and health policy.
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Affiliation(s)
- An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada.
| | - Ghassan Karam
- Research for Health Department, Science Division, WHO, Geneva, Switzerland
| | - Justin Pymento
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Lisa M Askie
- Quality Assurance for Norms and Standards Department, Science Division, WHO, Geneva, Switzerland
| | - Luiza R da Silva
- Public Relations Department, School of Social Communication, Rio de Janeiro State University, Rio de Janeiro, Brazil; Vice Presidency of Research and Biological Collections of the Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ségolène Aymé
- Inserm U 1127, Brain and Spinal Cord Institute, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Lotty Hooft
- Cochrane Netherlands, Department of Epidemiology & Health Economics, Julius Center, UMC Utrecht, Netherlands
| | - Anna Laura Ross
- Research for Health Department, Science Division, WHO, Geneva, Switzerland
| | - Vasee Moorthy
- Research for Health Department, Science Division, WHO, Geneva, Switzerland
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Ren Z, Webster AC, Hunter KE, Zhang J, Yao Y, Tan-Koay AG, Tan AC. Reducing risk of bias in interventional studies during their design and conduct: a scoping review. BMC Med Res Methodol 2025; 25:85. [PMID: 40169978 PMCID: PMC11963288 DOI: 10.1186/s12874-025-02467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 11/07/2024] [Indexed: 04/03/2025] Open
Abstract
BACKGROUND Interventional studies are intended to provide robust evidence. Yet poorly designed or conducted studies may bias research results and skew resulting evidence. While there have been advances in the assessment of risk of bias, it is unclear how to intervene against risks of bias during study design and conduct. OBJECTIVE To identify interventions to reduce or predict risk of bias in interventional studies during their design and conduct. SEARCH STRATEGY For this scoping review, we searched three electronic bibliographic databases (MEDLINE, Embase, and Cochrane Library) and nine grey literature sources and Google from in September 2024. This was supplemented by a natural language processing fuzzy matching search of the top 2000 relevant publications in the electronic bibliographic databases. Publications were included if they described the implementation and effectiveness of an intervention during study design or conduct aimed at reducing risk of bias in interventional studies. The characteristics and effect of the interventions were recorded. RESULT We identified, and reviewed the title and abstracts of, a total of 41,793 publications, reports, documents and grey literature, with 24,677 from electronic bibliographic databases and 17,140 from grey literature sources. There were 67 publications from bibliographic databases and 24 items from grey literature that were considered potentially eligible for inclusion, and the full-text of these were reviewed. Only three studies met the inclusion criteria. The first intervention was offering education and training to researchers during study design. This training included the implementation of a more rigorous participant screening process and systematic participant tracking program that reduced loss to follow-up and missing data, particularly for long-term follow-up trials. The second intervention was introducing an independent clinical events committee during study conduct. This was intended to mitigate bias due to conflicts of interest affecting the analysis and interpretation of results. The third intervention was to provide participants with financial incentives in randomized controlled trials, so that participants could more actively accomplish the requirements of the trials. CONCLUSION Despite the major impact of risk of bias on study outcomes, there are few empirical interventions to address this during study design or conduct.
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Affiliation(s)
- Zhilin Ren
- NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia
| | - Angela Claire Webster
- NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia
| | - Kylie Elizabeth Hunter
- NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia
| | - Jiexin Zhang
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Yi Yao
- School of International Relations and Public Affairs, Fudan University, Shanghai, China
| | - Ava Grace Tan-Koay
- NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia
| | - Aidan Christopher Tan
- NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia.
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Kondo S, Kubota T, Tsujimoto Y. Comments on "Effect of colistin combined with sulbactam: 9 g versus 12 g per day on mortality in the treatment of carbapenems resistant Acinetobacter baumannii pneumonia: a randomized controlled trial". Int J Infect Dis 2025; 153:107795. [PMID: 39864499 DOI: 10.1016/j.ijid.2025.107795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2025] [Revised: 01/16/2025] [Accepted: 01/22/2025] [Indexed: 01/28/2025] Open
Affiliation(s)
- Shunsuke Kondo
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.
| | - Takafumi Kubota
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan; Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yasushi Tsujimoto
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan; Oku Medical Clinic, Osaka, Japan; Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
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Shokraneh F. Stop searching and you will find it: Search-Resistant Concepts in systematic review searches. BMJ Evid Based Med 2025; 30:134-137. [PMID: 39107090 DOI: 10.1136/bmjebm-2023-112798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/09/2024]
Affiliation(s)
- Farhad Shokraneh
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Infectious Diseases Data Observatory (IDDO), Oxford, UK
- Institute of Health Informatics, University College London, London, UK
- Department of Evidence Synthesis, Systematic Review Consultants LTD, Oxford, UK
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Huamán-Mendoza AA, do Amaral GCLS, Vilela N, Chuquimez-Ventura CV, Rovai ES, Romito GA, Pannuti CM, Villar CC, Holzhausen M. Potential Biomarkers Indicating Resistance or Resilience in Experimental Peri-Implant Mucositis: A Systematic Review and Meta-Analysis. Clin Oral Implants Res 2025. [PMID: 40078114 DOI: 10.1111/clr.14427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 02/03/2025] [Accepted: 02/23/2025] [Indexed: 03/14/2025]
Abstract
OBJECTIVES To identify changes in immunological, microbiological, and histological biomarkers that may indicate resistance during the induction phase and resilience during the resolution phase of experimental peri-implant mucositis (PiM). MATERIALS AND METHODS The search was performed in MEDLINE, EMBASE, Web of Science, SCOPUS, Cochrane Library, and LILACS databases. Prospective interventional studies assessing biomarkers during experimental PiM were included. The risk of bias was assessed using the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool. Meta-analyses were conducted using random-effects models. The GRADE approach was used to determine the certainty of evidence. RESULTS Eleven out of 6008 studies were included. Clinical parameters (mPI and mGI) effectively characterized the experimental PiM model. Due to methodological variability and conflicting results, a definitive interpretation of microbiological and histological biomarkers was not possible. The meta-analysis revealed that IL-1β and the volume of peri-implant crevicular fluid (PICF) indicated non-resistance during the induction phase. In contrast, TNF-α, IL-6, IL-8, IL-17, MMP-8, and IFN-γ remained stable. Regarding the resolution phase, IL-1β returned to baseline levels (SMD: 1.13; 95% CI: -0.81, 3.06), and the volume of PICF (MD: 0.08; 95% CI: 0.03, 0.13) remained significantly elevated compared to day 0. However, TNF-α, IL-6, IL-8, IL-17, MMP-8, and IFN-γ did not significantly differ from baseline levels. CONCLUSIONS Moderate to very low evidence suggested that the biomarkers IL-1β and the volume of PICF indicated a lack of resistance while suggesting resilience and non-resilience, respectively. The biomarkers TNF-α, IL-6, IL-8, IL-17, MMP-8, and IFN-γ demonstrated resistance and resilience.
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Affiliation(s)
- Aldrin André Huamán-Mendoza
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | | | - Nathalia Vilela
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | | | - Emanuel Silva Rovai
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Giuseppe Alexandre Romito
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Claudio Mendes Pannuti
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Cristina Cunha Villar
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Marinella Holzhausen
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil
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Starke P, Zhang Z, Papmeier H, Pieper D, Mathes T. Analysis of indications for selectively missing results in comparative registry-based studies in medicine: a meta-research study. Res Integr Peer Rev 2025; 10:2. [PMID: 40038835 DOI: 10.1186/s41073-025-00159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 02/10/2025] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND We assess if there are indications that results of registry-based studies comparing the effectiveness of interventions might be selectively missing depending on the statistical significance (p < 0.05). METHODS Eligibility criteria Sample of cohort type studies that used data from a patient registry, compared two study arms for assessing a medical intervention, and reported an effect for a binary outcome. Information sources We searched PubMed to identify registries in seven different medical specialties in 2022/23. Subsequently, we included all studies that satisfied the eligibility criteria for each of the identified registries and collected p-values from these studies. Synthesis of results We plotted the cumulative distribution of p-values and a histogram of absolute z-scores for visual inspection of selectively missing results because of p-hacking, selective reporting, or publication bias. In addition, we tested for publication bias by applying a caliper test. RESULTS Included studies Sample of 150 registry-based cohort type studies. Synthesis of results The cumulative distribution of p-values displays an abrupt, heavy increase just below the significance threshold of 0.05 while the distribution above the threshold shows a slow, gradual increase. The p-value of the caliper test with a 10% caliper was 0.011 (k = 2, N = 13). CONCLUSIONS We found that the results of registry-based studies might be selectively missing. Results from registry-based studies comparing medical interventions should be interpreted very cautiously, as positive findings could be a result from p-hacking, publication bias, or selective reporting. Prospective registration of such studies is necessary and should be made mandatory both in regulatory contexts and for publication in journals. Further research is needed to determine the main reasons for selectively missing results to support the development and implementation of more specific methods for preventing selectively missing results.
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Affiliation(s)
- Paula Starke
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
| | - Zhentian Zhang
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Hannah Papmeier
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
- Evidence Based Practice in Brandenburg: A JBI Affiliated Group, University of Adelaide, Adelaide, Australia
| | - Tim Mathes
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
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Sule NO, Zhang Y, Basta NE. Reporting of Trial Registration Numbers in Publications of Vaccine Randomized Clinical Trials. JAMA Netw Open 2025; 8:e252276. [PMID: 40152864 PMCID: PMC11953748 DOI: 10.1001/jamanetworkopen.2025.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 01/27/2025] [Indexed: 03/29/2025] Open
Abstract
This cross-sectional study assesses reporting of trial registration numbers in vaccine-related randomized clinical trial publications and evaluates whether trial registration was prospective.
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Affiliation(s)
- Naheemot O. Sule
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Yang Zhang
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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11
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Dos Reis INR, Vilela N, Naenni N, Jung RE, Schwarz F, Romito GA, Spin-Neto R, Pannuti CM. Methods for assessing peri-implant marginal bone levels on digital periapical radiographs: a meta-research. Dentomaxillofac Radiol 2025; 54:222-230. [PMID: 39832279 DOI: 10.1093/dmfr/twaf002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 10/24/2024] [Accepted: 11/12/2024] [Indexed: 01/22/2025] Open
Abstract
OBJECTIVES This meta-research assessed methodologies used for evaluating peri-implant marginal bone levels on digital periapical radiographs in randomized clinical trials published between 2019 and 2023. METHODS Articles were searched in four databases. Data on methods for assessing peri-implant marginal bone levels were extracted. Risk of bias assessment was performed. RESULTS During full-text reading, 108 out of 162 articles were excluded. Methodological issues accounted for these exclusions, including the absence of radiograph-type information, the lack of radiographic positioners, the missing anatomical references, and the use of panoramic radiographs or tomography. Fifty-four articles were included, most from Europe (70%) and university-based (74%). Radiographic positioners were specified in 54% of articles. Examiner calibration was unreported in 54%, with 69% lacking details. In 59%, no statistical measure assessed examiner agreement. Blinding was unreported or unused in 50%. Marginal bone level changes were the primary outcome of 61%. Most articles (59.3%) raised "some concerns" regarding bias, while 37% showed a high risk of bias, and only two articles (3.7%) demonstrated a low risk of bias. CONCLUSIONS Several limitations and areas for improvement were identified. Future studies should prioritize protocol registration, standardize radiographic acquisitions, specify examiner details, implement calibration and statistical measures for agreement, introduce blinding protocols, and maintain geometric calibration standards.
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Affiliation(s)
- Isabella Neme Ribeiro Dos Reis
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
- Department of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, CH-8006, Switzerland
| | - Nathalia Vilela
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Nadja Naenni
- Department of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, CH-8006, Switzerland
| | - Ronald Ernest Jung
- Department of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, CH-8006, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, 60323, Germany
| | - Giuseppe Alexandre Romito
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, School of Dentistry, Aarhus University, Aarhus, 31119103, Denmark
| | - Claudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
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Cohn S, Borgstrom E, Driessen A. Not intervening as a form of care: Negotiating medical practices at the end-of-life. Med Anthropol Q 2025; 39:e12881. [PMID: 39190643 PMCID: PMC11878339 DOI: 10.1111/maq.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 07/30/2024] [Indexed: 08/29/2024]
Abstract
Biomedicine is organized around interventions. Despite growing concern about overtreatment in healthcare systems, not intervening can still raise questions about potential negligence and the quality of care. Based on ethnographic fieldwork with palliative care teams in England, we explore the work palliative care specialists do to reduce and sometimes halt interventions for patients at the end-of-life, in a general medical environment that is largely interventionist. We describe how judgments about what is an action or not aren't based on obvious or agreed criteria, but ultimately according to what different actors feel constitutes the best form of care. In other words, the underlying values that shape ideas of care determine how action and inaction are nominated, and not the other way around.
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Affiliation(s)
- Simon Cohn
- Department of Health Services Research and PolicyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Erica Borgstrom
- School of Health, Wellbeing and Social CareThe Open UniversityMilton KeynesUK
| | - Annelieke Driessen
- Department of Health Services Research and PolicyLondon School of Hygiene and Tropical MedicineLondonUK
- Department of AnthropologyUniversity of AmsterdamAmsterdamNetherlands
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Mathieu S, Bouillon-Minois JB, Renard Triché L, Coudeyre E, Ingrid DC, Thomas F, Laporte C, Moisset X, Samalin L, Villatte G, Pereira B. Protocol publication rate and comparison between article, registry and protocol in RCTs. BMC Med Res Methodol 2025; 25:31. [PMID: 39893396 PMCID: PMC11786558 DOI: 10.1186/s12874-025-02471-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/15/2025] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND Increasing transparency in clinical research is crucial to avoid misleading conclusions. Registering clinical trials prior to participant enrolment is mandatory, and the publication of trial protocols could further enhance transparency. However, the impact of protocol publication on primary outcomes (PO) and sample sizes (SS) remains unclear. This study aimed to determine the rates of trial protocol publication and registration for a sample of randomized controlled trials (RCTs) and to compare the consistency of published and registered PO and SS. METHODS A search was conducted in MEDLINE via PubMed® for RCT reports indexed in May and June 2023 across various medical specialties, focusing on general and high-impact factor journals. Data were extracted regarding trial registration, protocol publication, and comparisons were made between PO and SS in articles, registries, and published protocols. RESULTS Out of 1119 references, 589 (52.6%) were RCTs. The corresponding protocol was published for 146 RCTs (24.8%) including 40 over 140 (28.6%) (6 without end date available) after the trial had ended. Sixty-two (42.4%) protocols were published before the trial conclusion, with no significant differences between PO and SS in published protocols and their corresponding articles. Five hundred and twenty-eight (89.6%) RCTs were registered, 225 over 510 (44%) were registered before the study start with no differences in PO and SS between article and registry. Articles published in generalist or high impact factor journals were associated with higher frequencies of published protocols and trial registration and a lower frequency of difference in PO and SS between articles, registries, and published protocols. CONCLUSIONS While publishing trial protocols may enhance transparency in peer-review process, the initial registered protocol alone appears sufficient for ensuring consistency in primary outcomes and sample sizes. Protocol publication does not seem to provide additional significant benefits in terms of outcome reporting.
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Affiliation(s)
- Sylvain Mathieu
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
- CHU Clermont-Ferrand, Neuro-Dol, Université Clermont Auvergne, Inserm, Clermont- Ferrand, France.
- Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, Clermont-Ferrand, 63003, France.
| | | | - Laurent Renard Triché
- Department of Perioperative Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
- CNRS UMR6293, INSERM U1103, Université Clermont Auvergne, Clermont- Ferrand, France
- Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation Assessments (ECSTRRA) Team, INSERM UMR1153, Université Paris Cité, Paris, France
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Hôpital Louise Michel, INRAE, Université Clermont Auvergne, Clermont-Ferrand, France
| | - De Chazeron Ingrid
- Service de Psychiatrie Adulte et d'Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Finotto Thomas
- Department of Perioperative Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Catherine Laporte
- Département de Médecine Générale, Université Clermont Auvergne, UFR de Médecine et Profession paramédicales de Clermont-Ferrand, Clermont-Ferrand, F-63000, France
- Université Clermont Auvergne, CNRS, UMR 6602, Clermont-Ferrand, F-63000, France
| | - Xavier Moisset
- CHU Clermont-Ferrand, Neuro-Dol, Université Clermont Auvergne, Inserm, Clermont- Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, UMR 6602, Clermont-Ferrand, IP, France
| | - Guillaume Villatte
- Clermont Auvergne University, CNRS, SIGMA Clermont, ICCF, Clermont-Ferrand, France
- Department of Orthopaedic Surgery, CHU Montpied Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), 55174 CHU Clermont-Ferrand, Clermont-Ferrand, France
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Zhang B, Bornet A, Yazdani A, Khlebnikov P, Milutinovic M, Rouhizadeh H, Amini P, Teodoro D. A dataset for evaluating clinical research claims in large language models. Sci Data 2025; 12:86. [PMID: 39820357 PMCID: PMC11739414 DOI: 10.1038/s41597-025-04417-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 01/03/2025] [Indexed: 01/19/2025] Open
Abstract
Large language models (LLMs) have the potential to enhance the verification of health claims. However, issues with hallucination and comprehension of logical statements require these models to be closely scrutinized in healthcare applications. We introduce CliniFact, a scientific claim dataset created from hypothesis testing results in clinical research, covering 992 unique interventions for 22 disease categories. The dataset used study arms and interventions, primary outcome measures, and results from clinical trials to derive and label clinical research claims. These claims were then linked to supporting information describing clinical trial results in scientific publications. CliniFact contains 1,970 instances from 992 unique clinical trials related to 1,540 unique publications. When evaluating LLMs against CliniFact, discriminative models, such as BioBERT with an accuracy of 80.2%, outperformed generative counterparts, such as Llama3-70B, which reached 53.6% accuracy (p-value < 0.001). Our results demonstrate the potential of CliniFact as a benchmark for evaluating LLM performance in clinical research claim verification.
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Affiliation(s)
- Boya Zhang
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Alban Bornet
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anthony Yazdani
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Marija Milutinovic
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hossein Rouhizadeh
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Douglas Teodoro
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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15
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Carciumaru TZ, Tang CM, Farsi M, Bramer WM, Dankelman J, Raman C, Dirven CMF, Gholinejad M, Vasilic D. Systematic review of machine learning applications using nonoptical motion tracking in surgery. NPJ Digit Med 2025; 8:28. [PMID: 39809851 PMCID: PMC11733004 DOI: 10.1038/s41746-024-01412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 12/21/2024] [Indexed: 01/16/2025] Open
Abstract
This systematic review explores machine learning (ML) applications in surgical motion analysis using non-optical motion tracking systems (NOMTS), alone or with optical methods. It investigates objectives, experimental designs, model effectiveness, and future research directions. From 3632 records, 84 studies were included, with Artificial Neural Networks (38%) and Support Vector Machines (11%) being the most common ML models. Skill assessment was the primary objective (38%). NOMTS used included internal device kinematics (56%), electromagnetic (17%), inertial (15%), mechanical (11%), and electromyography (1%) sensors. Surgical settings were robotic (60%), laparoscopic (18%), open (16%), and others (6%). Procedures focused on bench-top tasks (67%), clinical models (17%), clinical simulations (9%), and non-clinical simulations (7%). Over 90% accuracy was achieved in 36% of studies. Literature shows NOMTS and ML can enhance surgical precision, assessment, and training. Future research should advance ML in surgical environments, ensure model interpretability and reproducibility, and use larger datasets for accurate evaluation.
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Affiliation(s)
- Teona Z Carciumaru
- Department of Plastic and Reconstructive Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Cadey M Tang
- Department of Plastic and Reconstructive Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mohsen Farsi
- Department of Plastic and Reconstructive Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Chirag Raman
- Department of Pattern Recognition and Bioinformatics, Delft University of Technology, Delft, the Netherlands
| | - Clemens M F Dirven
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Maryam Gholinejad
- Department of Plastic and Reconstructive Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Dalibor Vasilic
- Department of Plastic and Reconstructive Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Fagoni TG, Rafalovich VC, Brozoski MA, Deboni MCZ, de Oliveira NK. Selective outcome reporting concerning antibiotics and third molar surgery. Clin Oral Investig 2025; 29:42. [PMID: 39751942 DOI: 10.1007/s00784-024-06130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Accepted: 12/21/2024] [Indexed: 01/04/2025]
Abstract
OBJECTIVES This study evaluates the selective outcome reporting (SOR) in clinical trials on antibiotic use in third molar surgeries. It explores how SOR may bias results and affect systematic reviews, potentially leading to misinterpretations of intervention efficacy. MATERIALS AND METHODS A search was conducted on "ClinicalTrials.gov", "Brazilian Registry of Clinical Trials", "International Clinical Trials Registry Platform" and "European Union Clinical Trials Register" using the terms "third molar" and "antibiotics" up to December 2024. Two independent researchers selected eligible clinical trials. Data were extracted from registered protocols and corresponding publications. Discrepancies were analyzed using established criteria, and the risk of bias of published articles was assessed with Risk of Bias2. RESULTS Discrepancies between protocols and publications were found in 87.5% of cases, affecting outcomes in 68.7% of studies. SOR significantly influenced results in studies with one or more discrepancies. 75% of studies assess pain post-antibiotic therapy; of those, 50% found significant results. Only 31,25% of studies showed significant reductions in trismus or edema with antibiotic use. The risk of bias varied significantly across studies. CONCLUSIONS The high rate of selective reporting stresses the need for transparent studies to clarify the role of antibiotics in the perioperative period. Researchers should adhere to best clinical practices, including protocol registration, accurate sample size calculations, and precision in reporting. Journals and reviewers must prioritize transparency to reduce bias and improve research quality. CLINICAL RELEVANCE This study emphasizes the impact of SOR in clinical trials using antibiotics in third molar surgery. Clinicians should be more cautious in reading evidence based on randomized clinical trials with SORs.
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Affiliation(s)
- Thalita Guarda Fagoni
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, 05508-000, Brazil
| | - Vanessa Cristina Rafalovich
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, 05508-000, Brazil
| | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, 05508-000, Brazil
| | - Maria Cristina Zindel Deboni
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, 05508-000, Brazil
| | - Natacha Kalline de Oliveira
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, 05508-000, Brazil.
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Krohn M, Rintala A, Immonen J, Sjögren T. The Effectiveness of Therapeutic Exercise Interventions With Virtual Reality on Balance and Walking Among Persons With Chronic Stroke: Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials. J Med Internet Res 2024; 26:e59136. [PMID: 39621381 DOI: 10.2196/59136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 09/29/2024] [Accepted: 10/19/2024] [Indexed: 12/11/2024] Open
Abstract
BACKGROUND Well-targeted balance, walking, and weight-shift training can improve balance capabilities in the chronic phase of stroke. There is an urgent need for a long-term approach to rehabilitation that extends beyond the acute and subacute phases, supporting participation without increasing the demand for health care staff. OBJECTIVE This study aims to evaluate the effectiveness of therapeutic exercise interventions with virtual reality (VR) training on balance and walking at the activity and participation levels in individuals with chronic stroke, compared with control groups receiving no treatment, conventional physical therapy, specific training, similar treatment, or identical treatment without VR. METHODS Studies were searched across 6 databases. The inclusion criteria were as follows: Adults aged 18 years or older with a stroke diagnosis for at least 6 months (population). Therapeutic exercises within a VR environment, using VR glasses or interactive games (intervention). Control groups without the use of VR (including no treatment, conventional physical therapy, specific training, similar treatment without VR, or identical treatment without the additional use of VR; comparison). We evaluated the Berg Balance Scale score, Functional Reach Test performance, Activities-specific Balance Confidence Scale score, Six-minute Walk Test, Two-minute Walk Test, 10-meter Walk Test results, and cadence (outcome measures). We investigated randomized controlled trials (study design). A meta-analysis and a meta-regression analysis were conducted to evaluate whether the content of VR interventions or control groups, as well as the level of VR immersion used, was related to balance or walking outcomes. RESULTS A total of 43 randomized controlled trials involving 1136 participants were included in this review. The use of VR training in therapeutic exercise interventions had a large effect on balance (standardized mean difference 0.51, 95% CI 0.29-0.72; P<.001) and a moderate effect on walking (standardized mean difference 0.31, 95% CI 0.09-0.53; P=.006) in individuals with chronic stroke, compared with pooled control groups (no treatment, conventional physical therapy, specific training, similar treatment, or identical treatment without the use of VR). According to the meta-regression findings, the content of VR interventions (P=.52), the type of control groups (P=.79), and the level of VR immersion (P=.82) were not significantly related to the pooled balance or walking outcomes. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was moderate for balance and low for walking. CONCLUSIONS Therapeutic exercise training with VR had a positive, albeit moderate, effect on balance and a low impact on walking at the level of activity (capacity), even in the chronic phase of stroke, without serious side effects. The results are applicable to working-aged stroke rehabilitees who are able to walk without assistance. Further research is needed with defined VR methods and outcomes that assess performance at the level of real-life participation.
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Affiliation(s)
- Maria Krohn
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aki Rintala
- Physical Activity and Functional Capacity Research Group, Faculty of Health Care and Social Services, LAB University of Applied Sciences, Lahti, Finland
| | - Jaakko Immonen
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Kolber MJ, Hill CJ. Clinical trial registry: a necessity beyond journal requirements. Physiother Theory Pract 2024; 40:2743-2744. [PMID: 39445361 DOI: 10.1080/09593985.2024.2418200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Affiliation(s)
| | - Cheryl J Hill
- Nova Southeastern University, Fort Lauderdale, FL, USA
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Mongin D, Buitrago-Garcia D, Capderou S, Agoritsas T, Gabay C, Courvoisier DS, Iudici M. Prospective registration of trials: where we are, why, and how we could get better. J Clin Epidemiol 2024; 176:111586. [PMID: 39481460 DOI: 10.1016/j.jclinepi.2024.111586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 10/15/2024] [Accepted: 10/24/2024] [Indexed: 11/02/2024]
Abstract
OBJECTIVES Transparent trial conduct requires prospective registration of a randomized controlled clinical trial (RCT) before the enrollment of the first participant. We aimed to (1) estimate the proportion of RCTs that are prospectively registered and analyze the time trends and factors linked to registration timing and (2) assess the reasons for nonadherence to prospective registration and explore ways to improve compliance. We studied trials published in rheumatology as a case study. STUDY DESIGN AND SETTING We searched for RCTs in rheumatology published between 2009 and 2022. We conducted a multivariable logistic regression to identify factors associated with prospective trial registration. We sent a survey to investigators of trials not prospectively registered, asking about reasons for nonadherence and potential solutions. RESULTS We identified 1093 RCTs; 453 (41.4%) were not prospectively registered. Of these, 130 (11.9%) were not registered and 323 (29.5%) were retrospectively registered. Prospective registration increased by 3% annually (P < .001), with 13.3% (2 of 15) trials registered in 2009 to 73.2% (112 of 153) in 2022. In journals supporting the International Committee of Medical Journals Editors recommendations, 16% of trials published in 2022 were not prospectively registered. Prospective registration was associated with a larger sample size, multinational recruitment, and publication in higher impact journals. Investigators reported lack of knowledge or organizational problems as key reasons for retrospective registration. They suggested linking ethical approval to trial registration to ensure prospective registration. CONCLUSION Despite significant improvement, adherence to prospective registration remains unsatisfactory in rheumatology. Targeted strategies for journal editors, health-care professionals, and researchers may help improve trial registration. PLAIN LANGUAGE SUMMARY Randomized controlled clinical trials are a research type where people are randomly assigned to different treatments to see which works best. These treatments can include drugs, surgery, medical devices, or changes in behavior. The results obtained in RCTs are essential for the advance of medicine and for making medical decisions. Randomized controlled clinical trials need to be conducted in a transparent way to provide trustworthy information and avoid misleading findings. A key aspect of transparency is registering the study details and plan in a public repository before the trial starts. This not only requires researchers to plan their study in advance but also enables the scientific community to track any change in how the study is conducted. Although registration of RCTs is recommended, it is not compulsory. Questions remain about researchers' compliance with prospective registration, and the factors that may affect it. In the present study, we systematically studied the registration practices of rheumatology RCTs published between 2009 and 2022. We reviewed how the trials were registered and used a statistical method (multivariable logistic regression) to determine what factors were linked to whether a trial was registered before it started. We also sent a questionnaire to researchers who either did not register or retrospectively registered their study, asking for their suggestions on how to improve adherence to proper registration practices. We found 1093 trials, of which 453 (41.4%) were not registered before they started. Among these, 130 (11.9%) were never registered and 323 (29.5%) were retrospectively registered. Trials with a larger number of participants, those involving recruiting centers from multiple countries, and those published in more prestigious journals were more likely to be registered in advance and adhere to transparency recommendations. Researchers who did not register their trial before it started reported that lack of awareness and organizational issues as the main reasons for not following these recommendations. They suggested that connecting ethical approval to trial registration could be a solution for ensuring adequate registration. We found that even though trial registration has improved in recent years, a considerable number of rheumatology trials are still not registered before they start. Based on our findings, we think that focusing on strategies for journal editors, health-care professionals, and researchers could help increase the number of properly registered trials.
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Affiliation(s)
- Denis Mongin
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Diana Buitrago-Garcia
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Sami Capderou
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, Department of Medicine, University Hospitals of Geneva, Geneva, Switzerland; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; MAGIC Evidence Ecosystem Foundation, Oslo, Norway
| | - Cem Gabay
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Michele Iudici
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
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Silva S, Singh S, Kashif S, Ogilvie R, Pinto RZ, Hayden JA. Many randomized trials in a large systematic review were not registered and had evidence of selective outcome reporting: a metaepidemiological study. J Clin Epidemiol 2024; 176:111568. [PMID: 39424205 DOI: 10.1016/j.jclinepi.2024.111568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 09/10/2024] [Accepted: 10/09/2024] [Indexed: 10/21/2024]
Abstract
OBJECTIVES The primary objectives were to describe characteristics of trial registration in the chronic low back pain (CLBP) field and assess the association of trial registration status (registered vs unregistered, prospectively registered vs retrospectively registered) with risk of bias, sufficient sample size, quality of reporting, and treatment effect estimates. Secondary objectives were to describe trial registration consistency with the final report and assess its association with risk of bias, sufficient sample size, and treatment effect estimates. STUDY DESIGN AND SETTING A cross-sectional metaepidemiological study of trials included in a large Cochrane review on exercise treatments for CLBP. We extracted relevant trial and registration information and assessed trials' risk of bias using the Cochrane Risk of Bias 1 tool. We performed descriptive analyses, logistic regressions, and subgroup meta-analyses. RESULTS We included 361 trials, of which 23.3% were prospectively registered. Registered trials had lower risk of bias (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.5, 0.7) and higher reporting quality (OR 1.6; 95% CI 1.4, 1.8) than unregistered trials. Prospectively registered trials were more likely to have low risk of reporting bias (OR 2.7; 95% CI 1.2, 6.5) and higher quality of reporting (OR 1.3; 95% CI 1.1, 1.6) than retrospectively registered trials. Trial registration status was not associated with effect estimates. Among prospectively registered trials, 64.3% clearly defined primary outcome(s) in their registration, 58.3% had consistent sample sizes, and 22.6% had no evidence of selective outcome reporting. Trials that clearly defined primary outcome(s) were more likely to report larger effect estimates for pain intensity (mean difference -15.8; 95% CI -22.7, -8.9 vs -6.0; 95% CI -10.6, -1.5; Q = 6.7, P = .01), although the difference was small, the 95% CIs overlapped, and no difference was found for functional limitations. CONCLUSION A small proportion of trials in the CLBP field were registered prospectively and many presented registration inconsistencies. Registered trials tend to have lower risk of bias and higher quality of reporting. Policies are needed to improve prospective registration and registration consistency in the field. PLAIN LANGUAGE SUMMARY Prospective trial registration is the practice of documenting the planned methods of a randomized controlled trial on a publicly available online platform (ie, website) before enrolling participants. Medical journals require trialists to prospectively register their trials to encourage the conduct of high-quality research and reduce the chance of trialists changing their research plan to report only positive or significant results (known as selective outcome reporting). We investigated whether trialists within the chronic low back pain field were registering their trials, and whether they followed their registered research plan.We used data from a large systematic review of 456 trials that tested the effectiveness of exercise as a treatment for chronic low back pain. We assessed each trials' registration status and whether prospectively registered trials had inconsistencies between their registered research plan and their research conduct (eg, evidence of selective outcome reporting). We also looked at the association among trial registration with trials' quality of reporting (ie, a marker of research transparency), risk of bias (ie, a marker of research quality), and the amount of low back pain improvement reported by the trials (ie, effect estimates).We found that less than 25% of trials were prospectively registered, and many had inconsistencies between their registered research plan and their research conduct. Overall, registered trials had lower risk of bias and higher quality of reporting. However, trial registration status and selective outcome reporting were not associated with effect estimates (the amount of back pain improvement reported by trials). Our findings highlight the need for trialists and journals to better follow trial registration guidelines and policies in the chronic low back pain field. Knowledge users should be cautious when consuming information from unregistered trials as they appear to be more likely to have quality concerns.
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Affiliation(s)
- Samuel Silva
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada; Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
| | - Sareen Singh
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada; Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Shazia Kashif
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Rafael Z Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; School of Health Sciences, University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Jill A Hayden
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
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Wang Y, Guo F, Chen X, Yu R, Qin D, Hua F. Selective outcome reporting among randomized controlled trials published in leading dental journals: A research-on-research study. J Dent 2024; 151:105448. [PMID: 39489327 DOI: 10.1016/j.jdent.2024.105448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 10/30/2024] [Accepted: 11/01/2024] [Indexed: 11/05/2024] Open
Abstract
OBJECTIVES To study the prevalence and manifestation of selective outcome reporting (SOR) among randomized controlled trials (RCTs) published in leading dental journals, and to explore the association between SOR and potentially related factors. METHODS We hand-searched RCTs published in the leading dental journals between 2018 and 2023. RCTs with registrations and defined primary outcomes were included, and their relevant characteristics were extracted for analysis. Discrepancies between publication and corresponding registration were compared regarding primary outcome and other study characteristics. The generalized estimating equation model was applied to identify factors associated with SOR. RESULTS Two hundred and seventy trials were included. SOR was identified in 51.5% (n = 139) of the included RCTs with the discrepancy in the assessment timing of the primary outcome as the most common manifestation (n = 86, 31.9%). Substantial discrepancies were observed regarding sample size (n = 148, 54.8%) and source of funding (n = 105, 38.9%). Sample size [odds ratio (OR) 0.61, 95% confidence interval (CI) 0.40 to 0.92], timing of registration (OR 2.10, 95% CI 1.03 to 4.31), and discrepancy in follow-up length (OR 32.01, 95% CI 11.80 to 86.83) were identified as statistically significant factors associated with SOR. CONCLUSIONS SOR was prevalent among RCTs in leading dental journals. Researchers and other stakeholders should be aware of this reporting issue and make joint efforts to improve the outcome reporting quality. CLINICAL SIGNIFICANCE The findings of this research-on-research study indicate a substantial presence of SOR in the field of dentistry. Such bias can potentially mislead readers and distort the pooled effect estimates in evidence synthesis, ultimately influencing clinical decision-making.
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Affiliation(s)
- Yutong Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Feiyang Guo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Xiyuan Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Rongkang Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Danchen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
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22
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Matvienko-Sikar K, O'Shea J, Kennedy S, Thomas SD, Avery K, Byrne M, McHugh S, O' Connor DB, Saldanha IJ, Smith V, Toomey E, Dwan K, Kirkham JJ. Selective outcome reporting in trials of behavioural health interventions in health psychology and behavioural medicine journals: a review. Health Psychol Rev 2024; 18:824-838. [PMID: 38923431 DOI: 10.1080/17437199.2024.2367613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
Selective outcome reporting can result in overestimation of treatment effects, research waste, and reduced openness and transparency. This review aimed to examine selective outcome reporting in trials of behavioural health interventions and determine potential outcome reporting bias. A review of nine health psychology and behavioural medicine journals was conducted to identify randomised controlled trials of behavioural health interventions published since 2019. Discrepancies in outcome reporting were observed in 90% of the 29 trials with corresponding registrations/protocols. Discrepancies included 72% of trials omitting prespecified outcomes; 55% of trials introduced new outcomes. Thirty-eight percent of trials omitted prespecified and introduced new outcomes. Three trials (10%) downgraded primary outcomes in registrations/protocols to secondary outcomes in final reports; downgraded outcomes were not statistically significant in two trials. Five trials (17%) upgraded secondary outcomes to primary outcomes; upgraded outcomes were statistically significant in all trials. In final reports, three trials (7%) omitted outcomes from the methods section; three trials (7%) introduced new outcomes in results that were not in the methods. These findings indicate that selective outcome reporting is a problem in behavioural health intervention trials. Journal- and trialist-level approaches are needed to minimise selective outcome reporting in health psychology and behavioural medicine.
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Affiliation(s)
| | - Jen O'Shea
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Siobhan D Thomas
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Kerry Avery
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Molly Byrne
- School of Psychology, University of Galway, Galway, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Ian J Saldanha
- Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Valerie Smith
- School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Elaine Toomey
- School of Nursing & Midwifery, University College Galway, Galway, Ireland
| | - Kerry Dwan
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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23
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Tran AV, Dennis B, Rashid M, Fitzgerald K, Jones G, Magana K, Modi J, Magee T, Ward S, Hughes G, Ford AI, Vassar M. Assessing the Uptake of the Lung Cancer Core Outcome Set: A Cross-Sectional Analysis. JTO Clin Res Rep 2024; 5:100713. [PMID: 39502497 PMCID: PMC11532957 DOI: 10.1016/j.jtocrr.2024.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 11/08/2024] Open
Abstract
Introduction A core outcome set (COS) helps standardize outcome measurements across clinical trials. Although lung cancer is the leading cause of cancer-related deaths, research exploring COS implementation across lung cancer trials remains limited. We aim to analyze the uptake of the lung cancer COS and identify potential gaps in COS adherence. Methods On June 26, 2023, we conducted a cross-sectional analysis of clinical trials that evaluated lung cancer interventions. Our sample consisted of studies registered on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform between September 2011 and June 2023. In a masked and duplicate fashion, investigators extracted data regarding trial characteristics and COS adoption. An interrupted time series analysis was conducted to evaluate the adherence of lung cancer COS before and after its publication. Results Of the 626 observed trials, we found no overall significant difference in lung cancer COS uptake pre- and post-publication (0.01%, 95% confidence interval: -0.16% to 0.19%, p=0.85). The most frequently measured outcomes were "overall survival" (91.69%%) and "treatment-related mortalities" (54.69%). Health-related quality of life questionnaires were typically used to evaluate outcomes in the "Degree of health" domain (49.20%). Outcomes related to "time from diagnosis to treatment" (0%), "place of death" (0.16%), and "duration of time spent in the hospital at the end of life" (1.60%) were rarely measured. Conclusions Despite the advantages of COS implementation, adherence across lung cancer clinical trials remains alarmingly low-which could compromise data reliability and patient care. Our findings showcase these inconsistencies and emphasize the need for proactive approaches to improve uptake.
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Affiliation(s)
- Andrew V. Tran
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Brody Dennis
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Matthew Rashid
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Kyle Fitzgerald
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Garrett Jones
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Kimberly Magana
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Jay Modi
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Trevor Magee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Shaelyn Ward
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Alicia Ito Ford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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24
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Junkin JC, Vraa D, Young JL, Rhon DI. Assessing the transparency in reporting of clinical trials investigating manual therapy interventions for low back pain: A methodological review. J Eval Clin Pract 2024; 30:1594-1602. [PMID: 38973108 DOI: 10.1111/jep.14078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
RATIONALE Low back pain (LBP) is a common condition with a significant societal burden. Manual therapy is an effective treatment for LBP and recommended in clinical practice guidelines. While the quantity of literature supporting the use of manual therapy is large, the methodological quality and transparency of this collective work are unclear. AIMS AND OBJECTIVES Explore the transparency in reporting of clinical trials assessing manual therapy interventions in patients with LBP by comparing planned components in the trial registration with what was reported in the published manuscript. METHODS Three databases were searched to identify trials assessing the treatment effect of manual therapy for LBP from January 2005 to May 2023. Studies were included if the manual therapy consisted of thrust manipulations, mobilizations or muscle energy techniques. RESULTS From 4462 studies initially identified, 167 studies remained in the final review after title, abstract and full-text review. Only 87 (52.1%) of the 167 studies were registered (n = 57 prospectively and n = 30 retrospectively). Primary outcomes in the publications were identical to the registration in 54 (62.1%) of the registered trials. Secondary outcomes in the publication were identical to the registration in 27 (31.0%) of the registered trials. The CONSORT reporting guideline was referenced in only 19 (21.8%) trials. Multiple discrepancies between registration and publication were noted for primary and secondary outcomes. All trials had eligibility criteria in the registration that matched their corresponding manuscript, while only four (4.6%) trial registrations addressed any type of statistical analysis plan. CONCLUSION Approximately half of the trials were not registered. Of those registered, only half were registered prospectively. Substantial discrepancies existed between registered and published outcomes that were never addressed by the authors, raising questions about potential bias. Transparency can be improved through more stringent requirements during manuscript submission to journals, and better reporting of the rationale for discrepancies between registration and publication.
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Affiliation(s)
- Jennifer C Junkin
- Department of Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Derek Vraa
- Department of Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Jodi L Young
- Department of Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Department of Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
- Department of Rehabilitation Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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25
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Shang BH, Yang FH, Lin Y, Bialka S, van Rensburg DCJ, Tonelli AR, Islam SMS, Kawagoe I, Rhéaume C, Zhang KP. Discrepancies between pre-specified and reported primary outcomes: A cross-sectional analysis of randomized controlled trials in gastroenterology and hepatology journals. PLoS One 2024; 19:e0305027. [PMID: 39576822 PMCID: PMC11584078 DOI: 10.1371/journal.pone.0305027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 11/09/2024] [Indexed: 11/24/2024] Open
Abstract
BACKGROUND Previous research has raised concerns regarding inconsistencies between reported and pre-specified outcomes in randomized controlled trials (RCTs) across various biomedical disciplines. However, studies examining whether similar discrepancies exist in RCTs focusing on gastrointestinal and liver diseases are limited. This study aimed to assess the extent of discrepancies between registered and published primary outcomes in RCTs featured in journals specializing in gastroenterology and hepatology. METHODS We retrospectively retrieved RCTs published between January 1, 2017 and December 31, 2021 in the top three journals from each quartile ranking of the 2020 Journal Citation Reports within the "Gastroenterology and Hepatology" subcategory. We extracted data on trial characteristics, registration details, and pre-specified versus published primary outcomes. Pre-specified primary outcomes were retrieved from the World Health Organization's International Clinical Trials Registry Platform. Only trials reporting specific primary outcomes were included in analyzing primary outcome discrepancies. We also assessed whether there was a potential reporting bias that deemed to favor statistically significant outcomes. Statistical analyses included chi-square tests, Fisher's exact tests, univariate analyses, and logistic regression. RESULTS Of 362 articles identified, 312 (86.2%) were registered, and 79.8% of the registrations (249 out of 312) were prospective. Among the 285 trials reporting primary outcomes, 76 (26.7%) exhibited at least one discrepancy between registered and published primary outcomes. The most common discrepancies included different assessment times for the primary outcome (n = 32, 42.1%), omitting the registered primary outcome in publications (n = 21, 27.6%), and reporting the registered secondary outcomes as primary outcomes (n = 13, 17.1%). Univariate analyses revealed that primary outcome discrepancies were lower in the publication year 2020 compared to year 2021 (OR = 0.267, 95% CI: 0.101, 0.706, p = 0.008). Among the 76 studies with primary outcome discrepancies, 20 (26.3%) studies were retrospectively registered, and 32 (57.1%) of the prospectively registered trials with primary outcome discrepancies showed statistically significant results. However, no significant differences were found between journal quartiles regarding primary outcome consistency and potential reporting bias (p = 0.14 and p = 0.28, respectively). CONCLUSIONS This study highlights the disparities between registered and published primary outcomes in RCTs within gastroenterology and hepatology journals. Attention to factors such as the timing of primary outcome assessments in published trials and the consistency between registered and published primary outcomes is crucial. Enhanced scrutiny from journal editors and peer reviewers during the review process is necessary to ensure the reliability of gastrointestinal and hepatic trials.
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Affiliation(s)
- Bing-Han Shang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Fang-Hui Yang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Yao Lin
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Szymon Bialka
- Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Adriano R. Tonelli
- Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Caroline Rhéaume
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Canada
| | - Kai-Ping Zhang
- Editorial Office, AME Publishing Company, Hong Kong, China
- Clinical Research Institute, Medical College, Nantong University, Nantong, China
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26
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Tornhammar P, Julner A, Al Moosawi N, Wicksell E, Lim CE, Andersson DP, Ueda P. Completion and reporting of COVID-19 clinical trials registered on ClinicalTrials.gov during the first 6 months of the pandemic: cohort study. BMJ Open 2024; 14:e085906. [PMID: 39542470 PMCID: PMC11575289 DOI: 10.1136/bmjopen-2024-085906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, numerous clinical trials were initiated. Although concerns were raised regarding the quality of the trials, the eventual research output yielded from the trials remains unknown. The objective of this study was to include all clinical trials registered on ClinicalTrials.gov during the first 6 months of the pandemic and assess if and where their results had been reported, their completion and discontinuation rates, achieved enrolment and changes made to the primary outcome after trial registration. METHODS We included all interventional studies related to COVID-19 first registered on ClinicalTrials.gov between 1 January 2020 and 1 July 2020. We systematically searched for trial results, reported through 15 May 2023, in scientific publications, preprints and ClinicalTrials.gov. We assessed the achieved trial enrolment, trial discontinuation (reaching <90% of target enrolment), and whether the primary outcome had been changed as compared with the initial protocol registration. RESULTS The 775 clinical trials included in the analysis planned to enrol 238 933 (median (IQR) 120 (60, 304) patients; 355 (46%) of the trials had reported results, and 283 (36%) were published in a scientific journal. In the reported trials, the total enrolment was 95 332 (median (IQR) 105 (45, 222) patients. 186 (24%) trials were completed, and 169 (22%) trials were discontinued, with slow recruitment being the most stated reason for discontinuation (9% of all trials, although 30% of the discontinued trials did not report a reason). 117 (33%) of the reported trials had changed their primary outcome. In total, 157 (20%) trials were completed and published in a scientific journal, of which 105 enrolled ≥100 patients and 103 had not changed the primary outcome. 63 completed and published trials enrolled ≥100 patients and had not changed the primary outcome. CONCLUSIONS Most clinical trials of COVID-19 registered at ClinicalTrials.gov during the first 6 months of the pandemic remained unreported or had been discontinued. Many of the trials whose results had been reported enrolled few patients and changed the primary outcome after trial registration.
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Affiliation(s)
- Per Tornhammar
- Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden
- Department of Medicine Huddinge H7, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Alexander Julner
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Nader Al Moosawi
- Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Elin Wicksell
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Carl-Emil Lim
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Daniel Peter Andersson
- Department of Medicine Huddinge H7, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Endocrinology, Karolinska University Hospital, Huddinge, Sweden
| | - Peter Ueda
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
- Centre for Diabetes, Academic Specialist Centre, Region Stockholm, Stockholm, Sweden
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27
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Wang X, Long Y, Zhang N, Wang X, Guo Q, Deng Y, Huang J, Du L. Impact of selective reporting bias on stroke trials: potential compromise in evidence synthesis - A cross-sectional study. BMC Med Res Methodol 2024; 24:255. [PMID: 39468435 PMCID: PMC11514957 DOI: 10.1186/s12874-024-02381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 10/21/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Accurate reporting of outcomes is crucial for interpreting the results of randomized controlled trials (RCTs). However, selectively reporting outcomes in publications to achieve researchers' anticipated results still occurs frequently. This study aims to investigate the prevalence of selective reporting of outcomes in RCTs on treating acute ischemic stroke (AIS), identify factors contributing to this issue, and assess its potential impact on the degree and direction of intervention effect. METHODS A search was conducted in MEDLINE, Embase, and the Cochrane Library to collect interventional RCTs on AIS published from 2020 to 2022. Full texts of RCTs were reviewed, and only those reporting International Clinical Trials Registry Platform primary registry numbers were included. Registration information of the RCTs was extracted from the registry platforms and compared with the publications' details to assess the selective reporting of outcomes. Bayesian multilevel logistic regression was used to analyze the reasons behind selective reporting. RESULTS Among the total of 159 AIS RCTs identified, 82 (51.6%) were ultimately included, as they reported registration numbers, which encompassed 819 outcomes. Among them, 72 RCTs (87.8%) and 497 outcomes (60.7%) exhibited selective reporting. Omission-type selective reporting (downgrading, omitting, or ambiguously reporting) accounted for 36.4%, while addition-type selective reporting (upgrading, adding, or altering the measurement scope of outcomes) comprised 63.6%. Omission-type selective reporting correlated with negative results (OR: 7.39; 95% CI: 4.08-13.44), whereas addition-type selective reporting correlated with positive results (OR: 2.07; 95% CI: 1.34-3.26) and publication in journals that are not in the top quartile of the Journal Citation Reports (OR: 2.48; 95% CI: 1.15-5.38). CONCLUSIONS Registered interventional AIS RCTs still face significant issues regarding selective reporting of outcomes. Therefore, it is necessary to further evaluate the influence of selective reporting bias on the positive results obtained from individual AIS RCTs and the systematic reviews based on these RCTs.
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Affiliation(s)
- Xinyao Wang
- General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Youlin Long
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Na Zhang
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xinyi Wang
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
| | - Qiong Guo
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Ya Deng
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China
| | - Jin Huang
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China.
| | - Liang Du
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, No.37 Guoxuexiang Road, Chengdu City, Sichuan, 610041, People's Republic of China.
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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28
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Xing X, Xu C, Al Amer FM, Shi L, Zhu J, Lin L. Methods for assessing inverse publication bias of adverse events. Contemp Clin Trials 2024; 145:107646. [PMID: 39084407 PMCID: PMC11392622 DOI: 10.1016/j.cct.2024.107646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 06/06/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
In medical research, publication bias (PB) poses great challenges to the conclusions from systematic reviews and meta-analyses. The majority of efforts in methodological research related to classic PB have focused on examining the potential suppression of studies reporting effects close to the null or statistically non-significant results. Such suppression is common, particularly when the study outcome concerns the effectiveness of a new intervention. On the other hand, attention has recently been drawn to the so-called inverse publication bias (IPB) within the evidence synthesis community. It can occur when assessing adverse events because researchers may favor evidence showing a similar safety profile regarding an adverse event between a new intervention and a control group. In comparison to the classic PB, IPB is much less recognized in the current literature; methods designed for classic PB may be inaccurately applied to address IPB, potentially leading to entirely incorrect conclusions. This article aims to provide a collection of accessible methods to assess IPB for adverse events. Specifically, we discuss the relevance and differences between classic PB and IPB. We also demonstrate visual assessment through contour-enhanced funnel plots tailored to adverse events and popular quantitative methods, including Egger's regression test, Peters' regression test, and the trim-and-fill method for such cases. Three real-world examples are presented to illustrate the bias in various scenarios, and the implementations are illustrated with statistical code. We hope this article offers valuable insights for evaluating IPB in future systematic reviews of adverse events.
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Affiliation(s)
- Xing Xing
- Department of Biostatistics, Johns Hopkins University, Maryland, MD, USA
| | - Chang Xu
- Clinical Transformation Center, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Fahad M Al Amer
- Department of Mathematics, College of Science and Arts, Najran University, Najran, Saudi Arabia
| | | | - Jianan Zhu
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, USA
| | - Lifeng Lin
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA.
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29
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Rivero-de-Aguilar A, Pérez-Ríos M, Mascareñas-García M, Ruano-Raviña A, Ross JS, Casal-Acción B, Varela-Lema L. Discrepancies in the results reported for multiple sclerosis clinical trials: A comparison between ClinicalTrials.gov and peer-reviewed journals. Mult Scler 2024; 30:1514-1524. [PMID: 39189062 DOI: 10.1177/13524585241273089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVE We aimed to compare the results of phase III and IV clinical trials examining drugs to treat multiple sclerosis (MS) registered at ClinicalTrials.gov to those published in peer-reviewed journals. METHODS After identifying trials registered at ClinicalTrials.gov, consecutive searches were conducted in PubMed, EMBASE and Google Scholar for matching publications. Information regarding participants and efficacy and safety results was extracted and compared. The degree of consistency was classified as 'concordant', 'discrepant' or 'not comparable'. The Kaplan-Meier method was used to model time to reporting. RESULTS In total, 65 trials were appraised. The median time from completion to reporting was shorter for ClinicalTrials.gov (16.4 vs 27.3 months; p = 0.010). Information availability was generally higher in journals except for serious adverse events (SAEs) (86.2% vs 100.0%, p = 0.029) and their description (78.2% vs 100.0%, p < 0.001). However, 45 trials had at least one reporting discrepancy (69.2%). Three studies omitted one or more primary outcomes in the matching journal publication. Regarding safety results, the lowest consistencies were found for causes of death (60.0%) and description of SAEs (27.9%). CONCLUSION Consulting both ClinicalTrials.gov and journals increases the accessibility to MS clinical trial results. Some data were frequently missing or disagreed between sources, raising concerns about transparency and generalizability of results.
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Affiliation(s)
- Alejandro Rivero-de-Aguilar
- Department of Neurology, University Hospital Complex of Pontevedra, Pontevedra, Spain
- Department of Epidemiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Epidemiology and Public Health, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Marta Mascareñas-García
- Department of Epidemiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Raviña
- Department of Epidemiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Joseph S Ross
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | | | - Leonor Varela-Lema
- Department of Epidemiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Pool L, Ruiz Del Portal Luyten C, van der Pluijm RW, Soentjens P, Hanscheid T, Grobusch MP, Visser BJ. Dissemination and outcome reporting bias in clinical malaria intervention trials: a cross-sectional analysis. Malar J 2024; 23:293. [PMID: 39350104 PMCID: PMC11443699 DOI: 10.1186/s12936-024-05115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 09/18/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Dissemination and outcome reporting biases are a significant problem in clinical research, with far-reaching implications for both scientific understanding and clinical decision-making. This study investigates the prevalence of dissemination- and outcome reporting biases in registered interventional malaria research. METHODS All malaria interventional trials registered on ClinicalTrials.gov from 2010 to 2020 were identified. Subsequently, publications that matched the registration were searched. The primary outcome measures were the percentage of registered studies that resulted in subsequent publication of study results, the concordance between registered outcomes, and reported outcomes. Secondary outcomes were compliance with WHO standards for timely publication (issued in 2017) of summary study results in the respective trial registry (within 12 months of study completion) or peer-reviewed publication (within 24 months of study completion) was evaluated. RESULTS A total of 579 trials were identified on ClinicalTrials.gov, of which 544 met the inclusion criteria. Notably, almost 36.6% of these trials (199/544) were registered retrospectively, with 129 (23.7%) registered after the first patient enrolment and 70 (12.9%) following study completion. Publications were identified for 351 out of 544 registered trials (64.5%), involving 1,526,081 study participants. Conversely, publications were not found for 193 of the 544 registrations (35.5%), which aimed to enrol 417,922 study participants. Among these 544 registrations, 444 (81.6%) did not meet the WHO standard to post summary results within 12 months of primary study completion (the last visit of the last subject for collection of data on the primary outcome), while 386 out of 544 registrations (71.0%) failed to publish their results in a peer-reviewed journal within 24 months of primary study completion. Discrepancies were noted in the reported primary outcomes compared to the registered primary outcomes in 47.6% (222/466) of the published trials, and an even higher discordance rate of 73.2% (341/466 publications) for secondary outcomes. CONCLUSIONS Non-dissemination remains a significant issue in interventional malaria research, with most trials failing to meet WHO standards for timely dissemination of summary results and peer-reviewed journal publications. Additionally, outcome reporting bias is highly prevalent across malaria publications. To address these challenges, it is crucial to implement strategies that enhance the timely reporting of research findings and reduce both non-dissemination and outcome reporting bias.
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Affiliation(s)
- Lydia Pool
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Claire Ruiz Del Portal Luyten
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Rob W van der Pluijm
- Université Paris Cité, G5 Infectious Disease Epidemiology and Analytics, Institut Pasteur, 75015, Paris, France
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | | | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone
- Centre de Recherches Médicales en Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine & Deutsches Zentrum Für Infektionsforschung, University of Tübingen, Tübingen, Germany
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Benjamin J Visser
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium.
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Kwon CS, Chua MMJ, Jetté N, Rolston JD. A knowledge synthesis of health research reporting standards relevant to epilepsy surgery. Epilepsia 2024; 65:2673-2685. [PMID: 38949199 DOI: 10.1111/epi.18047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/08/2024] [Accepted: 06/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Numerous studies have examined epilepsy surgery outcomes, yet the variability in the level of detail reported hampers our ability to apply these findings broadly across patient groups. Established reporting standards in other clinical research fields enhance the quality and generalizability of results, ensuring that the insights gained from studying these surgeries can benefit future patients effectively. This study aims to assess current reporting standards for epilepsy surgery research and identify potential gaps and areas for enhancement. METHODS The Enhancing the Quality and Transparency of Health Research (EQUATOR) repository was accessed from inception to April 27, 2023, yielding 561 available reporting standards. Reporting standards were manually reviewed in duplicate independently for applicability to epilepsy and/or neurosurgery research. The reporting standards had to cover the following aspects in human studies: (1) reporting standards for epilepsy/epilepsy surgery and (2) reporting standards for neurosurgery. Disagreements were resolved by a third author. The top five neurosurgery, neurology, and medicine journals were also identified through Google Scholar's citation index and examined to determine the relevant reporting standards they recommended and whether those were registered with EQUATOR. RESULTS Of the 561 EQUATOR reporting standards, 181 were pertinent to epilepsy surgery. One was related to epilepsy, six were specific to surgical research, and nine were related to neurological/neurosurgical research. The remaining 165 reporting standards were applicable to research across various disciplines and included but were not limited to CONSORT (Consolidated Standards of Reporting Trails), STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). None of these required reporting factors associated with epilepsy surgery outcomes, such as duration of epilepsy or magnetic resonance imaging findings. SIGNIFICANCE Reporting standards specific to epilepsy surgery are lacking, reflecting a gap in standards that may affect the quality of publications. Improving this gap with a set of specific reporting standards would ensure that epilepsy surgery studies are more transparent and rigorous in their design.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurology, Epidemiology, and Neurosurgery and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Melissa M J Chua
- Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathalie Jetté
- Department of Clinical Neurosciences and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - John D Rolston
- Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Lan RH, Paranjpe I, Saeed M, Perez MV. Characteristics of contemporary atrial fibrillation clinical trials and their association with industry sponsorship. Heart Rhythm 2024; 21:1517-1523. [PMID: 38453036 DOI: 10.1016/j.hrthm.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Industry sponsorship is an important source of funding for atrial fibrillation (AF) clinical trials, the implications of which have not been analyzed. OBJECTIVE The purpose of this study was to determine the characteristics of contemporary AF clinical trials and to evaluate their association with funding source. METHODS We systematically assessed all completed AF trials registered in the ClinicalTrials.gov database between conception to October 31, 2023, and extracted publicly available information including funding source, trial size, demographic distribution, intervention, location, and publication status. Trial characteristics were compared using the Wilcoxon rank-sum test and Fisher exact test for continuous and categorical variables, respectively. RESULTS Of the 253 clinical trials assessed, 171 (68%) reported industry funding. Industry funding was associated with a greater median number of patients enrolled (172 vs 80; P <.001), publication rate (56.7% vs 42.7%; P = .04), probability of being product-focused (48.0% vs 24.4%; P <.001), and multicontinental recruitment location (25.2% vs 2.4%; P <.001) when compared to nonindustry-funded trials. However, industry funding was not associated with a significant difference in median impact factor (7.7 vs 7.7; P = .723). The overall proportion of industry-funded trials did not change over time (P = 1). CONCLUSION Industry-funded clinical trials in AF often are larger, more frequently published, multicontinental, and product-focused. Industry funding was found to be associated with significant differences in study enrollment and publication metrics.
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Affiliation(s)
- Roy H Lan
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Ishan Paranjpe
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Mohammad Saeed
- Department of Cardiology, Texas Heart Institute, Houston, Texas; Center for Cardiac Arrhythmias and Electrophysiology, Texas Heart Institute, Houston, Texas
| | - Marco V Perez
- Cardiovascular Institute, Stanford University, Stanford, California; Stanford Center for Inherited Cardiovascular Disease, Stanford, California; Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
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Mac Eochagain C, Power R, Sam C, Gonzalez-Senac NM, Walsh D, Roy M, Battisti NML. Inclusion, characteristics, and reporting of older adults in FDA registration studies of immunotherapy, 2018-2022. J Immunother Cancer 2024; 12:e009258. [PMID: 39209450 PMCID: PMC11367347 DOI: 10.1136/jitc-2024-009258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 09/04/2024] Open
Abstract
Immune checkpoint inhibitors (ICI) have transformed the management of cancer, particularly for older adults, who constitute a majority of the global cancer patient population. This study aimed to assess the inclusion, characteristics, and reporting of older adults enrolled in Food and Drug Administration (FDA) registration clinical trials of ICI between 2018 and 2022. Clinical trials of ICI leading to an FDA approval in solid tumor oncology between 2018 and 2022 were included. Primary study reports and all available secondary publications were assessed. The availability and completeness of older subgroup data for protocol-defined clinical efficacy endpoints, health-related quality of life (HRQOL) and toxicity outcomes, and baseline characteristics were assessed according to predefined criteria which categorized reporting completeness hierarchically in relation to the availability of published data, including effect size, sample size, and measures of precision. 53 registration trials were included, involving a total of 37,094 participants. Most trials (64.2%) were of ICI combination therapy. 42.3% of patients were aged≥65 years; 11.1% were aged≥75. No trials specified an upper age limit for eligibility. 98.1% of trials excluded patients with European Cooperative Oncology Group performance status>1. 87.2% of primary efficacy endpoints and 17.9% of secondary efficacy endpoints were reported completely for older adults. Five studies (9.4%) reported baseline characteristics, three (6.1%) reported HRQOL assessments, and four (7.5%) reported toxicity outcomes completely among older subgroups. No trials conducted baseline geriatric assessments or reported geriatric-specific symptoms or quality of life scales. This analysis highlights significant deficits in the enrollment and reporting of older subgroups in pivotal trials of ICI therapy. The findings highlight an urgent need for improved reporting and inclusion standards in clinical trials of ICI to better inform treatment decisions for older adults.
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Affiliation(s)
- Colm Mac Eochagain
- Department of Medical Oncology, Trinity St James' Cancer Institute, Dublin, Ireland
| | - Robert Power
- Department of Medical Oncology, Trinity St James' Cancer Institute, Dublin, Ireland
| | - Christine Sam
- H Lee Moffitt Cancer Center and Research Center, Tampa, Florida, USA
| | - Nicolas M Gonzalez-Senac
- Geriatrics Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain
- Biopathology of Aging Group, Instituto de Investigacion Sanitaria Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Darren Walsh
- Department of Medical Oncology, Waterford University Hospital, Waterford, Ireland
| | - Mukul Roy
- Department of Radiation Oncology, Jaslok Hospital and Research Centre, Mumbai, India
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Gonçalves MPMBB, do Prado-Silva L, Sant'Ana AS. Emergent methods for inactivation of Cronobacter sakazakii in foods: A systematic review and meta-analysis. Int J Food Microbiol 2024; 421:110777. [PMID: 38909488 DOI: 10.1016/j.ijfoodmicro.2024.110777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/24/2024] [Accepted: 05/31/2024] [Indexed: 06/25/2024]
Abstract
Cronobacter sakazakii is a potentially pathogenic bacterium that is resistant to osmotic stress and low aw, and capable of persisting in a desiccated state in powdered infant milks. It is widespread in the environment and present in various products. Despite the low incidence of cases, its high mortality rates of 40 to 80 % amongst neonates make it a microorganism of public health interest. This current study performed a comparative assessment between current reduction methods applied for C. sakazakii in various food matrices, indicating tendencies and relevant parameters for process optimization. A systematic review and meta-analysis were conducted, qualitatively identifying the main methods of inactivation and control, and quantitatively evaluating the effect of treatment factors on the reduction response. Hierarchical clustering dendrograms led to conclusions on the efficiency of each treatment. Review of recent research trend identified a focus on the potential use of alternative treatments, with most studies related to non-thermal methods and dairy products. Using random-effects meta-analysis, a summary effect-size of 4-log was estimated; however, thermal methods and treatments on dairy matrices displayed wider dispersions - of τ2 = 8.1, compared with τ2 = 4.5 for vegetal matrices and τ2 = 4.0 for biofilms. Meta-analytical models indicated that factors such as chemical concentration, energy applied, and treatment time had a more significant impact on reduction than the increase in temperature. Non-thermal treatments, synergically associated with heat, and treatments on dairy matrices were found to be the most efficient.
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Affiliation(s)
| | - Leonardo do Prado-Silva
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Brazil
| | - Anderson S Sant'Ana
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Brazil.
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Sandbank M, Bottema-Beutel K, Syu YC, Caldwell N, Feldman JI, Woynaroski T. Evidence-b(i)ased practice: Selective and inadequate reporting in early childhood autism intervention research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1889-1901. [PMID: 38345030 PMCID: PMC11301951 DOI: 10.1177/13623613241231624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
LAY ABSTRACT When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better.
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Affiliation(s)
| | | | - Ya-Cing Syu
- The University of North Carolina at Chapel Hill, USA
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Lee KS, Prevedello DM. Systematic reviews and meta-analyses in neurosurgery Part II: a guide to designing the protocol. Neurosurg Rev 2024; 47:360. [PMID: 39060698 DOI: 10.1007/s10143-024-02555-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 06/22/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024]
Abstract
Despite clearly established guidelines, recent audits have found the conduct and reporting of systematic reviews and meta-analyses (SRMAs) within neurosurgery to be relatively lackluster in methodological rigor and compliance. Protocols of SRMAs allow for planning and documentation of review methods, guard against arbitrary decision-making during the review process, and enable readers to assess for the presence of selective reporting. To aid transparency, authors should provide sufficient detail in their protocol so that the readers could reproduce the study themselves. Development of our guideline drew heavily from the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) initiative. The objective of this article is not to enumerate every detail of this checklist, but to provide guidance to authors preparing their protocol, with examples, for a systematic review in neurosurgery. Particularly, we emphasize on the PICO framework - population (P), interventions (I), comparators (C), outcomes (O) - which is central to constructing a clinical question, defining the scope of the systematic review, defining and prioritizing the primary outcome, to specifying the eligibility criteria, designing the search strategy, and identifying potential sources of heterogeneity. We encourage our readers to make use of this guideline alongside the PRISMA-P 2015 statement, when drafting and appraising systematic review protocols.
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Affiliation(s)
- Keng Siang Lee
- Department of Neurosurgery, King's College Hospital, London, UK.
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Lee KS, Higgins JP, Prevedello DM. Systematic reviews and meta-analyses in neurosurgery part I: interpreting and critically appraising as a guide for clinical practice. Neurosurg Rev 2024; 47:339. [PMID: 39023639 DOI: 10.1007/s10143-024-02560-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 06/26/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
Neurosurgeons are inundated with the Herculean task to keep abreast with the rapid pace at which clinical research is proliferating. Systematic reviews and meta-analyses (SRMAs) have consequently surged in popularity because when executed properly, they constitute the highest level of evidence, and may save busy neurosurgeons many hours of combing the literature. Well-executed SRMAs may prove instructive for clinical practice, but poorly conducted reviews sow confusion and may potentially cause harm. Unfortunately, many SRMAs within neurosurgery are relatively lackluster in methodological rigor. When neurosurgeons apply the results of an SRMA to patient care, they should start by evaluating the extent to which the employed methods have likely protected against misleading results. The present article aims to educate the reader about how to interpret an SRMA, to assess the potential relevance of its results in the special context of the neurosurgical patient population.
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Affiliation(s)
- Keng Siang Lee
- Department of Neurosurgery, King's College Hospital, London, UK.
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Silva FM, Amorim Adegboye AR, Curioni C, Gomes F, Collins GS, Kac G, Cook J, Ismail LC, Page MJ, Khandpur N, Lamb S, Hopewell S, Saleh S, Kirtley S, Bernardes S, Durão S, Vorland CJ, Lima J, Rebelo F, Cunha Figueiredo AC, Braga Tibaes JR, Tavares M, da Silva Fink J, Maia de Sousa T, Chester-Jones M, Bi D, Naude C, Schlussel M. Reporting completeness of nutrition and diet-related randomised controlled trials protocols. Clin Nutr 2024; 43:1626-1635. [PMID: 38795681 DOI: 10.1016/j.clnu.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND AND AIMS There is a need to consolidate reporting guidance for nutrition randomised controlled trial (RCT) protocols. The reporting completeness in nutrition RCT protocols and study characteristics associated with adherence to SPIRIT and TIDieR reporting guidelines are unknown. We, therefore, assessed reporting completeness and its potential predictors in a random sample of published nutrition and diet-related RCT protocols. METHODS We conducted a meta-research study of 200 nutrition and diet-related RCT protocols published in 2019 and 2021 (aiming to consider periods before and after the start of the COVID pandemic). Data extraction included bibliometric information, general study characteristics, compliance with 122 questions corresponding to items and subitems in the SPIRIT and TIDieR checklists combined, and mention to these reporting guidelines in the publications. We calculated the proportion of protocols reporting each item and the frequency of items reported for each protocol. We investigated associations between selected publication aspects and reporting completeness using linear regression analysis. RESULTS The majority of protocols included adults and elderly as their study population (n = 73; 36.5%), supplementation as intervention (n = 96; 48.0%), placebo as comparator (n = 89; 44.5%), and evaluated clinical status as the outcome (n = 80; 40.0%). Most protocols described a parallel RCT (n = 188; 94.0%) with a superiority framework (n = 141; 70.5%). Overall reporting completeness was 52.0% (SD = 10.8%). Adherence to SPIRIT items ranged from 0% (n = 0) (data collection methods) to 98.5% (n = 197) (eligibility criteria). Adherence to TIDieR items ranged from 5.5% (n = 11) (materials used in the intervention) to 98.5% (n = 197) (description of the intervention). The multivariable regression analysis suggests that a higher number of authors [β = 0.53 (95%CI: 0.28-0.78)], most recent published protocols [β = 3.19 (95%CI: 0.24-6.14)], request of reporting guideline checklist during the submission process by the journal [β = 6.50 (95%CI: 2.56-10.43)] and mention of SPIRIT by the authors [β = 5.15 (95%CI: 2.44-7.86)] are related to higher reporting completeness scores. CONCLUSIONS Reporting completeness in a random sample of 200 diet or nutrition-related RCT protocols was low. Number of authors, year of publication, self-reported adherence to SPIRIT, and journals' endorsement of reporting guidelines seem to be positively associated with reporting completeness in nutrition and diet-related RCT protocols.
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Affiliation(s)
- Flávia Moraes Silva
- Nutrition Department and Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Brazil
| | - Amanda Rodrigues Amorim Adegboye
- Research Centre for Healthcare & Communities, Coventry University, Coventry, UK; Centre for Agroecology, Water and Resilience (CAWR), Coventry University, UK
| | - Cintia Curioni
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | - Fabio Gomes
- Pan-American Health Organisation, World Health Organisation, Washington DC, USA
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil
| | - Jonathan Cook
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, P. O. Box 27272 Sharjah, United Arab Emirates; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Neha Khandpur
- Division of Human Nutrition and Health, Washington University, Department of Nutrition, University of São Paulo, Brazil; Department of Nutrition, Harvard T.H. Chan School of Public Health, USA
| | - Sarah Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Shaima Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, P. O. Box 27272 Sharjah, United Arab Emirates
| | - Shona Kirtley
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Simone Bernardes
- Nutrition Department and Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Brazil
| | - Solange Durão
- Health Systems Research Unit, South African Medical Research Council, South Africa
| | - Colby J Vorland
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, USA
| | | | - Fernanda Rebelo
- Clinical Research Unit, National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Amanda C Cunha Figueiredo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil; Health Science Center, Serra dos Órgãos University Center, Rio de Janeiro, Brazil
| | | | - Marina Tavares
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | | | - Taciana Maia de Sousa
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | - Mae Chester-Jones
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Dongquan Bi
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Celeste Naude
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health. Faculty of Medicine and Health Sciences. Stellenbosch University, Cape Town, South Africa
| | - Michael Schlussel
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
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Morin A, Grondin S. Mindfulness and time perception: A systematic integrative review. Neurosci Biobehav Rev 2024; 162:105657. [PMID: 38583653 DOI: 10.1016/j.neubiorev.2024.105657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Several recent studies have explored the relationships between mindfulness and time perception, an area of research that has become increasingly popular in the last 10-15 years. In this article, we present a systematic integrative review of the evidence on this subject. We also integrate the field's findings into a conceptual framework which considers the multifaceted nature of both mindfulness, and time perception research. To identify the relevant literature, we searched the following databases using relevant keywords: PsycINFO; Medline; EBSCO Host Psychology and Behavioral Sciences Collection; and Web of Science. These searches were last performed on the 4th of May 2022, and additional hand searches were also conducted. To be included, articles had to be in English and contain original data about the potential relationship(s) between mindfulness and time perception. Articles which did not present usable data about the relationship(s) between the variables of interest were excluded. In total, 47 research articles were included in the review (combined sample size of ∼5800 participants). Risks of bias in the selected studies were evaluated using two separate assessment tools designed for this purpose. Through an integrative narrative synthesis, this article reviews how mindfulness may relate to time perception for various reference frames, and for various time perception measures and methods. It also provides new insights by exploring how a wide range of findings can be integrated into a coherent whole, in light of some relevant time perception models and mindfulness theories. Altogether, the reviewed data suggest the existence of complex and multifaceted relationships between mindfulness and time perception, highlighting the importance of considering many factors when planning research or interpreting data in this field. Limitations of the current review include the scarceness of data for certain categories of findings, and the relatively low prevalence of studies with a randomized controlled design in the source literature. This research was partly funded by a grant from the Natural Science and Engineering Research Council of Canada.
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Affiliation(s)
- André Morin
- École de psychologie, Université Laval, Québec, Canada.
| | - Simon Grondin
- École de psychologie, Université Laval, Québec, Canada
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Holtedahl R, Brox JI. Compliance with requirements for registration and reporting of results in trials of mesenchymal stromal cells for musculoskeletal disorders: a systematic review. BMJ Open 2024; 14:e081343. [PMID: 38925685 PMCID: PMC11202644 DOI: 10.1136/bmjopen-2023-081343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE To assess compliance with statutory requirements to register and report outcomes in interventional trials of mesenchymal stromal cells (MSCs) for musculoskeletal disorders and to describe the trials' clinical and design characteristics. DESIGN A systematic review of published trials and trials submitted to public registries. DATA SOURCES The databases Medline, Cochrane Library and McMaster; six public clinical registries. All searches were done until 31 January 2023. ELIGIBILITY CRITERIA Trials submitted to registries and completed before January 2021. Prospective interventional trials published in peer-reviewed journals. DATA EXTRACTION AND SYNTHESIS The first author searched for trials that had (1) posted trial results in a public registry, (2) presented results in a peer-reviewed publication and (3) submitted a pretrial protocol to a registry before publication. Other extracted variables included trial design, number of participants, funding source, follow-up duration and cell type. RESULTS In total 124 trials were found in registries and literature databases. Knee osteoarthritis was the most common indication. Of the 100 registry trials, 52 trials with in total 2 993 participants had neither posted results in the registry nor published results. Fifty-two of the registry trials submitted a protocol retrospectively. Forty-three of the 67 published trials (64%) had registered a pretrial protocol. Funding source was not associated with compliance with reporting requirements. A discrepancy between primary endpoints in the registry and publication was found in 16 of 25 trials. In 28% of trials, the treatment groups used adjuvant therapies. Only 39% of controlled trials were double-blinded. CONCLUSIONS A large proportion of trials failed to comply with statutory requirements for the registration and reporting of results, thereby increasing the risk of bias in outcome assessments. To improve confidence in the role of MSCs for musculoskeletal disorders, registries and medical journals should more rigorously enforce existing requirements for registration and reporting.
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Affiliation(s)
| | - Jens Ivar Brox
- Phys med & rehab, Oslo University Hospital and Medical Faculty, University in Oslo, Oslo, Norway
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Tomioka Y, Yoshimatsu Y, Tsujimoto Y. Reply to: "Efficacy and safety of doxycycline versus iodopovidone for pleurodesis through an intercostal tube in malignant pleural effusions: a randomized trial". Support Care Cancer 2024; 32:453. [PMID: 38909347 DOI: 10.1007/s00520-024-08670-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 06/18/2024] [Indexed: 06/24/2024]
Affiliation(s)
- Yasuaki Tomioka
- Division of Thoracic Surgery, Department of Surgery, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, Hiroshima, 721-8511, Japan.
| | - Yuki Yoshimatsu
- Elderly Care, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Stadium Rd, London, SE18 4QH, UK
- Centre for Exercise Activity and Rehabilitation, School of Human Sciences, University of Greenwich, Avery Hill Rd, London, SE9 2HB, UK
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yasushi Tsujimoto
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Oku Medical Clinic, Shimmori, Osaka, Japan
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
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D'Souza RS, Barrington MJ, Sen A, Mascha EJ, Kelley GA. Systematic reviews and meta-analyses in regional anesthesia and pain medicine (Part II): guidelines for performing the systematic review. Reg Anesth Pain Med 2024; 49:403-422. [PMID: 37945064 DOI: 10.1136/rapm-2023-104802] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 11/12/2023]
Abstract
In Part I of this series, we provide guidance for preparing a systematic review protocol. In this article, we highlight important steps and supplement with exemplars on conducting and reporting the results of a systematic review. We suggest how authors can manage protocol violations, multiplicity of outcomes and analyses, and heterogeneity. The quality (certainty) of the evidence and strength of recommendations should follow the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. It is our goal that Part II of this series provides valid guidance to authors and peer reviewers who conduct systematic reviews to adhere to important constructs of transparency, structure, reproducibility, and accountability. This will likely result in more rigorous systematic reviews being submitted for publication to the journals like Regional Anesthesia & Pain Medicine and Anesthesia & Analgesia.
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Affiliation(s)
- Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, Minnesota, USA
| | - Michael J Barrington
- Department of Anesthesia and Perioperative Pain Medicine, Oregon Health & Sciences University, Portland, Oregon, USA
| | - Ananda Sen
- Departments of Biostatistics and Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Edward J Mascha
- Departments of Quantitative Health Sciences and Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
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Hossaini J, Osmani V, Klug SJ. Behavioral weight loss interventions for people with physical disabilities: A systematic review. Obes Rev 2024; 25:e13722. [PMID: 38332472 DOI: 10.1111/obr.13722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 10/26/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
AIM The aim of this study is to examine which interventions lead to clinically significant weight loss among people with physical disabilities. METHODS We systematically searched three electronic databases (PubMed, Scopus, and CENTRAL) including studies until May 2022 to find randomized controlled trials on behavioral interventions and weight-related outcomes in people with physical disabilities. Pharmacological or surgical interventions were excluded. Study quality was evaluated using the Cochrane Risk of Bias Tool. Interventions were grouped as dietary, physical activity, education/coaching, or multi-component. Mean weight changes, standard deviations, confidence intervals, and effect sizes were extracted or calculated for assessment of the intervention effect. RESULTS Sixty studies involving 6,511 participants were included in the qualitative synthesis. Most studies (n = 32) included multi-component interventions, incorporating dietary and physical activity components. Limited evidence suggests that extensive dietary interventions or long-term multi-component interventions might lead to a clinically relevant weight reduction of at least 5% for older individuals (age > 50) with mild-to-moderate mobility impairments. DISCUSSION Due to the high heterogeneity of studies and low study quality, it can be assumed that the range of applicability of the findings is questionable. Further research should examine younger age groups (i.e., children, adolescents, and adults under 40 years) and compare different settings such as schools, clinics, nursing homes, and assisted living facilities.
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Affiliation(s)
- Jihad Hossaini
- Chair of Social Determinants of Health, School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Munich, Germany
| | - Vanesa Osmani
- Chair of Epidemiology, School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Munich, Germany
| | - Stefanie J Klug
- Chair of Epidemiology, School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Munich, Germany
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Assis Santos VPD, Sendyk DI, Barretto MDDA, Nunes JP, Pannuti CM, Deboni MCZ. Selective outcome reporting in randomized clinical trials using the third molar surgery model. J Craniomaxillofac Surg 2024; 52:755-762. [PMID: 38582673 DOI: 10.1016/j.jcms.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/13/2024] [Indexed: 04/08/2024] Open
Abstract
Selective outcome reporting (SOR) can threaten the validity of results found in clinical trials. Some studies in the literature have analyzed SOR in dentistry, but there is no study that has observed SOR in clinical trials in oral and maxillofacial surgery. Impacted third molar surgery is one of the most used models in clinical trials to study mainly analgesic and anti-inflammatory drug interventions. Our study aimed to evaluate the prevalence of SOR in publications employing the third molar extraction clinical trial model, and to verify whether there was an association between the statistical significance of outcomes and other characteristics that could lead to SOR. A systematic search was performed on the ClinicialTrials.gov platform for randomized clinical trial protocols, using the condition of third molar extraction. The corresponding published articles were sourced in PubMed, Scopus, and Embase databases, and compared with the registered protocols regarding the methodological data, in terms of: sample calculation, primary outcome identification, end-point periods, insertion of new outcomes in the publication, and results of outcomes. 358 protocol records were retrieved; 87 presented their corresponding articles. SOR was identified in 28.74% of the publications, and had a significant relationship with changes in the protocol, insertions of new outcomes, and discrepancies in the types of study. General risk of bias was found to be low. There were associations between SOR and the discrepancies in terms of the type of study, the choice of new outcome, and changes in the history of protocol records. The prevalence of SOR in clinical research using the third molar extraction surgery model is moderate. The quality of the scientific reporting of the results and, consequently, the certainty of evidence relating to the intervention tested can be overstated, increasing the chances of misinterpretation by health professionals.
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Affiliation(s)
| | - Daniel Isaac Sendyk
- Implantology Department, São Leopoldo Mandic Institute and Research Center, Brazil; Stomatology Department, Faculty of Dentistry, University of São Paulo, Brazil
| | | | - Julia Puglia Nunes
- Oral Surgery Department, Faculty of Dentistry, University of São Paulo, Brazil
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Vishwanath N, Cummings OW, Lim J, Kulkarni S, Sobti N, O'Toole D, Bhatt R, Kalliainen LK. Conversion Rate of Abstracts Presented at Plastic Surgery The Meeting From 2010 to 2019: A 10-Year Analysis of Factors for Success. Ann Plast Surg 2024; 92:S298-S304. [PMID: 38556693 DOI: 10.1097/sap.0000000000003792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Presentations are an important means of knowledge generation. Publication of these studies is important for dissemination of findings beyond meeting attendees. We analyzed a 10-year sample of presented abstracts at Plastic Surgery The Meeting and describe factors that improve rate and speed of conversion to peer-reviewed publication. METHODS Abstracts presented between 2010 and 2019 at Plastic Surgery The Meeting were sourced from the American Society of Plastic Surgery Abstract Archive. A random sample of 100 abstracts from each year was evaluated. Abstract information and demographics were recorded. The title or author and keywords of each abstract were searched using a standardized workflow to find a corresponding published paper on PubMed, Google Scholar, and Google. Data were analyzed for trends and factors affecting conversion rate. RESULTS A total of 983 presented abstracts were included. The conversion rate was 54.1%. Residents and fellows constituted the largest proportion of presenters (38.4%). There was a significant increase in medical student and research fellow presenters during the study period (P < 0.001). Conversion rate was not affected by the research rank of a presenter's affiliated institution (β = 1.001, P = 0.89), geographic location (P = 0.60), or subspecialty tract (P = 0.73). US academics had a higher conversion rate (61.8%) than US nonacademics (32.7%) or international presenters (47.1%) (P < 0.001). Medical students had the highest conversion rate (65.6%); attendings had the lowest (45.0%). Research fellows had the lowest average time to publication (11.6 months, P = 0.007). CONCLUSIONS Lower levels of training, factors associated with increased institution-level support, and research quality affect rate and time to publication. These findings highlight the success of current models featuring medical student and research fellow-led projects with strong resident and faculty mentorship.
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Affiliation(s)
- Neel Vishwanath
- From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, RI
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Storman D, Swierz MJ, Mitus JW, Pedziwiatr M, Liang N, Wolff R, Bala MM. Microwave coagulation for liver metastases. Cochrane Database Syst Rev 2024; 3:CD010163. [PMID: 38534000 PMCID: PMC10966940 DOI: 10.1002/14651858.cd010163.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Liver metastases (i.e. secondary hepatic malignancies) are significantly more common than primary liver cancer. Long-term survival after radical surgical treatment is approximately 50%. For people in whom resection for cure is not feasible, other treatments must be considered. One treatment option is microwave coagulation utilising electromagnetic waves. It involves placing an electrode into a lesion under ultrasound or computed tomography guidance. OBJECTIVES To evaluate the beneficial and harmful effects of microwave coagulation versus no intervention, other ablation methods, or systemic treatments in people with liver metastases regardless of the location of the primary tumour. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest date of search was 14 April 2023. SELECTION CRITERIA Randomised clinical trials assessing beneficial or harmful effects of microwave coagulation and its comparators in people with liver metastases, irrespective of the location of the primary tumour. We included trials no matter the outcomes reported. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodological procedures. Our primary outcomes were: all-cause mortality at the last follow-up and time to mortality; health-related quality of life (HRQoL); and any adverse events or complications. Our secondary outcomes were: cancer mortality; disease-free survival; failure to clear liver metastases; recurrence of liver metastases; time to progression of liver metastases; and tumour response measures. We used risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI) to present the results. Two review authors independently extracted data and assessed the risk of bias using the Cochrane RoB 1 tool. We used GRADE methodology to assess the certainty of the evidence. MAIN RESULTS Three randomised clinical trials fulfilled the inclusion criteria. The control interventions differed in the three trials; therefore, meta-analyses were not possible. The trials were at high risk of bias. The certainty of evidence of the assessed outcomes in the three comparisons was very low. Data on our prespecified outcomes were either missing or not reported. Microwave coagulation plus conventional transarterial chemoembolisation (TACE) versus conventional TACE alone One trial, conducted in China, randomised 50 participants (mean age 60 years, 76% males) with liver metastases from various primary sites. Authors reported that the follow-up period was at least one month. The trial reported adverse events or complications in the experimental group only and for tumour response measures. There were no dropouts in the trial. The trial did not report on any other outcomes. Microwave ablation versus conventional surgery One trial, conducted in Japan, randomised 40 participants (mean age 61 years, 53% males) with multiple liver metastases of colorectal cancer. Ten participants were excluded after randomisation (six from the experimental and four from the control group); thus, the trial analyses included 30 participants. Follow-up was three years. The reported number of deaths from all causes was 9/14 included participants in the microwave group versus 12/16 included participants in the conventional surgery group. The mean overall survival was 27 months in the microwave ablation and 25 months in the conventional surgery group. The three-year overall survival was 14% with microwave ablation and 23% with conventional surgery, resulting in an HR of 0.91 (95% CI 0.39 to 2.15). The reported frequency of adverse events or complications was comparable between the two groups, except for the required blood transfusion, which was more common in the conventional surgery group. There was no intervention-related mortality. Disease-free survival was 11.3 months in the microwave ablationgroup and 13.3 months in the conventional surgery group. The trial did not report on HRQoL. Microwave ablation versus radiofrequency ablation One trial, conducted in Germany, randomised 50 participants (mean age 62.8 years, 46% males) who were followed for 24 months. Two-year mortality showed an RR of 0.62 (95% CI 0.26 to 1.47). The trial reported that, by two years, 76.9% of participants in the microwave ablationgroup and 62.5% of participants in the radiofrequency ablation group survived (HR 0.63, 95% CI 0.23 to 1.73). The trial reported no deaths or major complications during the procedures in either group. There were two minor complications only in the radiofrequency ablation group (RR 0.19, 95% CI 0.01 to 3.67). The trial reported technical efficacy in 100% of procedures in both groups. Distant recurrence was reported for 10 participants in the microwave ablation group and nine participants in the radiofrequency ablation group (RR 1.03, 95% CI 0.50 to 2.08). No participant in the microwave ablation group demonstrated local progression at 12 months, while that occurred in two participants in the radiofrequency ablation group (RR 0.19, 95% CI 0.01 to 3.67). The trial did not report on HRQoL. One trial reported partial support by Medicor (MMS Medicor Medical Supplies GmbH, Kerpen, Germany) for statistical analysis. The remaining two trials did not provide information on funding. We identified four ongoing trials. AUTHORS' CONCLUSIONS The evidence is very uncertain about the effect of microwave ablation in addition to conventional TACE compared with conventional TACE alone on adverse events or complications. We do not know if microwave ablation compared with conventional surgery may have little to no effect on all-cause mortality. We do not know the effect of microwave ablation compared with radiofrequency ablation on all-cause mortality and adverse events or complications either. Data on all-cause mortality and time to mortality, HRQoL, adverse events or complications, cancer mortality, disease-free survival, failure to clear liver metastases, recurrence of liver metastases, time to progression of liver metastases, and tumour response measures were either insufficient or were lacking. In light of the current inconclusive evidence and the substantial gaps in data, the pursuit of additional good-quality, large randomised clinical trials is not only justified but also essential to elucidate the efficacy and comparative benefits of microwave ablation in relation to various interventions for liver metastases. The current version of the review, in comparison to the previous one, incorporates two new trials in two additional microwave ablation comparisons: 1. in addition to conventional TACE versus conventional TACE alone and 2. versus radiofrequency ablation.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz J Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy W Mitus
- Department of Surgical Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch; Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Michal Pedziwiatr
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Ning Liang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | | | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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Holst M, Carlisle BG. Trials that turn from retrospectively registered to prospectively registered: a cohort study of "retroactively prospective" clinical trial registration using history data. Trials 2024; 25:189. [PMID: 38486299 PMCID: PMC10938677 DOI: 10.1186/s13063-024-08029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Prospective registration of clinical trials is mandated by various regulations. However, clinical trial registries like ClinicalTrials.gov allow registry entries to be updated at any time, and key study elements, including the start date, may change before the first patient is enrolled. If a trial changes its start date after recruiting began, however, it may indicate a reason for concern. This study aimed to measure the rate of "retroactively prospective" trials. This refers to trials that are originally registered retrospectively, with the start date before the registration date, but that retroactively change their start date to be after the registration date, making them appear as if they were prospectively registered. METHODS We retrieved clinical trial history data for all clinical trials registered on ClinicalTrials.gov with a first registration date in the year 2015 (N = 11,908). Using automated analyses, we determined the timepoints of registration in relation to the start date of the trial over time. For retroactively prospective trials and a set of control trials, we manually checked the accompanying publications to determine which start date they report and whether they report changes to the start date. RESULTS We found 235 clinical trials to be retroactively prospective, comprising 2.0% of all clinical trials in our sample of 11,908 trials. Among the 113 retroactively prospective clinical trials with an accompanying publication, 12 (10.6%) explicitly stated in the publication that they had been prospectively registered. CONCLUSIONS Retroactively prospective trial registration happens in one in 50 trials. While these changes to the start date could be mistakes or legitimate edits based on the most up-to-date information, they could also indicate a retrospectively registered trial that has been made to appear as a prospectively registered trial, which would lead to biases unapparent to reviewers. Our results point to the need for more transparent reporting of changes to a trial's details and have implications for the review and conduct of clinical trials, with our fully automated and freely available tools allowing reviewers or editors to detect these changes. TRIAL REGISTRATION The preregistered protocol of our study is available via https://osf.io/rvq53 . The most recent version of the protocol lists all deviations from the original study plan, including the rationale behind the changes, and additional analyses that were conducted.
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Affiliation(s)
- Martin Holst
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, QUEST Center for Responsible Research, Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.
- Medizinische Hochschule Hannover, Institute for Ethics, History and Philosophy of Medicine, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Benjamin Gregory Carlisle
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, QUEST Center for Responsible Research, Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Present Address: Department of Equity, Ethics and Policy, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, QC, H3A 1G1, Canada
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van Aert RCM, Wicherts JM. Correcting for outcome reporting bias in a meta-analysis: A meta-regression approach. Behav Res Methods 2024; 56:1994-2012. [PMID: 37540470 PMCID: PMC10991008 DOI: 10.3758/s13428-023-02132-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 08/05/2023]
Abstract
Outcome reporting bias (ORB) refers to the biasing effect caused by researchers selectively reporting outcomes within a study based on their statistical significance. ORB leads to inflated effect size estimates in meta-analysis if only the outcome with the largest effect size is reported due to ORB. We propose a new method (CORB) to correct for ORB that includes an estimate of the variability of the outcomes' effect size as a moderator in a meta-regression model. An estimate of the variability of the outcomes' effect size can be computed by assuming a correlation among the outcomes. Results of a Monte-Carlo simulation study showed that the effect size in meta-analyses may be severely overestimated without correcting for ORB. Estimates of CORB are close to the true effect size when overestimation caused by ORB is the largest. Applying the method to a meta-analysis on the effect of playing violent video games on aggression showed that the effect size estimate decreased when correcting for ORB. We recommend to routinely apply methods to correct for ORB in any meta-analysis. We provide annotated R code and functions to help researchers apply the CORB method.
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Affiliation(s)
- Robbie C M van Aert
- Department of Methodology and Statistics, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Jelte M Wicherts
- Department of Methodology and Statistics, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
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D'Souza RS, Barrington MJ, Sen A, Mascha EJ, Kelley GA. Systematic Reviews and Meta-analyses in Regional Anesthesia and Pain Medicine (Part II): Guidelines for Performing the Systematic Review. Anesth Analg 2024; 138:395-419. [PMID: 37942964 DOI: 10.1213/ane.0000000000006607] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
In Part I of this series, we provide guidance for preparing a systematic review protocol. In this article, we highlight important steps and supplement with exemplars on conducting and reporting the results of a systematic review. We suggest how authors can manage protocol violations, multiplicity of outcomes and analyses, and heterogeneity. The quality (certainty) of the evidence and strength of recommendations should follow the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. It is our goal that Part II of this series provides valid guidance to authors and peer reviewers who conduct systematic reviews to adhere to important constructs of transparency, structure, reproducibility, and accountability. This will likely result in more rigorous systematic reviews being submitted for publication to the journals like Regional Anesthesia & Pain Medicine and Anesthesia & Analgesia .
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Affiliation(s)
- Ryan S D'Souza
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, Minnesota
| | - Michael J Barrington
- Department of Anesthesia and Perioperative Pain Medicine, Oregon Health & Sciences University, Portland, Oregon
| | - Ananda Sen
- Departments of Biostatistics and Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Edward J Mascha
- Departments of Quantitative Health Sciences and Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia
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Cobey KD, Alayche M, Saba S, Barnes NY, Ebrahimzadeh S, Alarcón E, Hibbert B, Moher D. Cardiology researchers' practices and perceived barriers to open science: an international survey. Open Heart 2024; 11:e002433. [PMID: 38233041 PMCID: PMC10806507 DOI: 10.1136/openhrt-2023-002433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE Open science is a movement and set of practices to conduct research more transparently. Implementing open science will significantly improve public access and supports equity. It also has the potential to foster innovation and reduce duplication through data and materials sharing. Here, we survey an international group of researchers publishing in cardiovascular journals regarding their perceptions and practices related to open science. METHODS We identified the top 100 'Cardiology and Cardiovascular Medicine' subject category journals from the SCImago journal ranking platform. This is a publicly available portal that draws from Scopus. We then extracted the corresponding author's name and email from all articles published in these journals between 1 March 2021 and 1 March 2022. Participants were sent a purpose-built survey about open science. The survey contained primarily multiple choice and scale-based questions for which we report count data and percentages. For the few text-based responses we conducted thematic content analysis. RESULTS 198 participants responded to our survey. Participants had a mean response of 6.8 (N=197, SD=1.8) on a 9-point scale with endpoints, not at all familiar (1) and extremely familiar (9), when indicating how familiar they were with open science. When asked about where they obtained open science training, most participants indicated this was done on the job self-initiated while conducting research (n=103, 52%), or that they had no formal training with respect to open science (n=72, 36%). More than half of the participants indicated they would benefit from practical support from their institution on how to perform open science practices (N=106, 54%). A diversity of barriers to each of the open science practices presented to participants were acknowledged. Participants indicated that funding was the most essential incentive to adopt open science. CONCLUSIONS It is clear that policy alone will not lead to the effective implementation of open science. This survey serves as a baseline for the cardiovascular research community's open science performance and perception and can be used to inform future interventions and monitoring.
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Affiliation(s)
- Kelly D Cobey
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Mohsen Alayche
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Saba
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Nana Yaa Barnes
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Health Sciences University of Ottawa, Ottawa, Ontario, Canada
| | | | - Emilio Alarcón
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - David Moher
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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