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1.
Contemp Clin Trials Commun ; 41: 101347, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39262904

RESUMEN

Main problem: Chronic kidney disease (CKD) is a progressive condition that affects millions of people worldwide. A standardized core outcome set (COS) was developed for CKD by the International Consortium for Health Outcomes and Measurements in 2019. This study aims to evaluate the frequency of measurement for these outcomes before and after the publication of the COS. Methods: A literature search was done to gather the phase III/IV clinical trials evaluating chronic kidney disease through ClinicalTrials.gov. Data extraction of included studies was completed in a masked, duplicate fashion. The included studies were evaluated for characteristics such as survival, burden of disease, patient-reported health-related quality of life, and treatment modality-specific outcomes. Results: Our results showed that the majority of all COS domains were inadequately measured in CKD clinical trials before and after publication of the COS. Despite the increase in COS measurements following publication, the average percent of COS outcomes measured was less than 40 % per year even after four years. Conclusion: There is a notable deficiency in the complete measurement of COS among all domains both before and after COS publication. We suggest efforts be made to improve the adoption of consistent outcome measures that would benefit the growing population of patients affected by CKD.

3.
Osteoarthritis Cartilage ; 32(6): 713-718, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38403154

RESUMEN

OBJECTIVE: To assess the degree of core outcome set alignment and identify issues with alignment to the 2019 COS among clinical trial registrations focused on knee and/or hip osteoarthritis (OA). METHODS: Our search was performed on registered knee and hip OA randomized controlled trials (RCTs) available on ClinicalTrials.gov and WHO International Clinical Trials Registry Platform. The screening process considered trials registered between 8/2014 and 6/2023. We extracted data on general trial characteristics and the five trial endpoints detailed in the COS (pain, physical function, quality of life, patient global assessment, and adverse events), in a masked and duplicate manner. The frequencies of COS alignment were assessed over time prior to and after COS publication. RESULTS: Of the 10,718 RCTs screened, 481 met inclusion criteria. Most were phase 3 (368/481, 76.51%) and heavily university-funded (184/481, 38.25%). Despite the 2019 COS, no marked enhancement in overall alignment was noted. The outcome 'Pain' exhibited the highest degree of COS alignment (455/481, 94.59%), whereas 'adverse events' lagged behind (89/481, 18.50%). Additionally, trial factors such as 'Continent', 'Funding Type', and 'Recruitment Status' displayed no significant influence on COS alignment. CONCLUSIONS: Despite the acknowledged advantages of using COS in RCTs and the availability of an updated COS, the alignment to these outcomes remains notably low. Significant efforts are needed to encourage broader adoption in future studies on knee and hip OA, with the aim of improving research quality and patient care.


Asunto(s)
Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Estudios Transversales , Calidad de Vida , Evaluación de Resultado en la Atención de Salud
4.
Thromb Res ; 234: 113-119, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38211379

RESUMEN

INTRODUCTION: Clinical trials (CTs) guide clinical practice, but inconsistent outcome reporting presents challenges. To increase comparability, a core outcome set (COS) was created for primary Immune thrombocytopenia (ITP) in 2009 to standardize outcome measurements. We aimed to evaluate uptake of the primary ITP COS in CT registries. MATERIALS & METHODS: Our cross-sectional analysis employed a search string on ClinicalTrials.gov and ICTRP for phase III/IV CTs in June 2023. Inclusion criteria consisted of subjects with primary ITP, study was registered five years before COS publication to June 26, 2023, and assessed effectiveness of interventions. Two investigators extracted data in a masked, duplicate manner. Interrupted time series analysis, ANOVAs, and correlation analyses were conducted to assess the main outcome of COS uptake pre/post COS publication. RESULTS: The search identified 131 eligible trials for data extraction. Altogether, 38.2 % (50/131) followed IWG platelet response guidelines. An alternative platelet count measurement was 50,000 × 109 L, with 46.56 % (61/131) of trials reporting it. The most measured outcome was adverse events (106/131, 80.9 %). Remaining secondary outcomes were measured in <50 % of studies. After COS publication, there was a statistically non-significant 0.03 % (p = 0.50, CI 95 % = [-0.06, 0.13]) 0.03 % (p = 0.50, CI 95 % = [-0.06, 0.13]) increase in the monthly trend of COS-defined outcomes. CONCLUSION: We found a non-significant increase in uptake of the ITP COS since its publication and highlighted the lack of standardization among endpoints within ITP clinical trials. Our analysis highlights the need for heightened awareness and a COS update that acknowledges the variability in clinical trials.


Asunto(s)
Púrpura Trombocitopénica Idiopática , Humanos , Estudios Transversales , Evaluación de Resultado en la Atención de Salud , Recuento de Plaquetas , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Sistema de Registros , Ensayos Clínicos como Asunto
5.
Diabetes Res Clin Pract ; 207: 111085, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38195041

RESUMEN

AIMS: This study analyzed uptake of the core outcome set (COS) for type 1 diabetes (T1D) and trends in its use before and after its development in December 2017. METHODS: On June 26, 2023, ClinicalTrials.gov was systematically searched for T1D randomized controlled trials. The Core Outcome Measures in Effectiveness Trials (COMET) database provided a COS of eight key outcomes for analysis. Included trials were analyzed for COS uptake before and after its release in December 2017 in a masked, duplicate fashion by independent reviewers. We also calculated the proportion of trials that measured the complete COS and assessed the most frequently reported COS outcomes. RESULTS: Of 3,792 originally screened articles, 144 RCTs were included in the final sample. Following COS publication, its use steadily decreased. Within the COS, HbA1c and severe hypoglycemia were most frequently implemented as endpoints; other recommended outcomes were rarely used in the published trials. CONCLUSION: Despite the 2017 T1D COS publication, use has decreased over time. This inconsistency negatively influences evidence-based practices and care. Educating researchers on COS and promoting uptake is crucial. Wider COS adoption in T1D trials could enhance clinical research overall. Further study of barriers and facilitators influencing uptake is essential to support consistent use and reporting.


Asunto(s)
Diabetes Mellitus Tipo 1 , Ensayos Clínicos Controlados Aleatorios como Asunto , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/terapia , Humanos , Estudios Transversales , Evaluación de Resultado en la Atención de Salud , Hemoglobina Glucada/metabolismo , Hemoglobina Glucada/análisis , Hipoglucemia/epidemiología , Hipoglucemia/prevención & control
6.
Am J Drug Alcohol Abuse ; 50(1): 27-41, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-38295346

RESUMEN

Background: Alcohol Use Disorder (AUD) poses a significant health burden on individuals. The burden occurs more frequently in the medically underserved, as well as racial and sexual minority populations. Ameliorating health inequities is vital to improving patient-centered care.Objectives: The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research.Methods: We performed a literature search using the Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017 to 2021 and written in English. The frequencies of each health inequity examined were analyzed, and findings from each included study were summarized.Results: Our sample consisted of 55 studies for analysis. The most common inequity examined was by race/ethnicity followed by sex or gender. The least reported inequities examined were rural under-resourced areas and occupational status. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with AUD.Conclusions: This scoping review highlights the gaps in research on inequities in AUD. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.


Asunto(s)
Alcoholismo , Femenino , Humanos , Alcoholismo/epidemiología , Participación de la Comunidad , Bases de Datos Factuales , Escolaridad , Inequidades en Salud
7.
BJOG ; 131(6): 795-802, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37798815

RESUMEN

OBJECTIVE: Analyse uptake of the core outcome set (COS) within preterm birth (PTB) clinical trials. DESIGN: On 26 June 2023, we conducted a systematic search of phase III/IV trial registry entries regarding PTB interventions via ClinicalTrials.gov and the International Clinical Trial Registry Platform. These trials were analysed for the outcomes measured. SETTING: N/A. SAMPLE: After searching the two databases, 5257 randomised controlled trials (RCTs) were screened, resulting in 92 RCTs for analysis. METHODS: Inclusion criteria were the following: subjects were patients receiving an intervention for PTB, study enrolment began within 5 years prior to publication of PTB COS to 26 June 2023, and evaluated the efficacy of interventions. Authors screened and extracted data in masked, duplicate fashion, then performed an interrupted time series analysis, analysis of variance and correlation analysis. MAIN OUTCOME MEASURES: We extracted outcomes measured by each clinical trial in our sample. Trials were analysed for the percentage of adopted outcomes from PTB COS. RESULTS: After COS publication, there was no significant change in percentage of COS outcomes measured. The most measured outcome was 'offspring mortality' (54.34%, 50/92) and the least measured outcome was 'late neonatal neurodevelopment morbidity' (3.26%, 3/92). Additionally, 22.83% (21/92) of trials measured zero outcomes related to the PTB COS. CONCLUSION: Our results demonstrated no significant change in outcome measurement before or after PTB COS publication. We recommend focusing on both the measurement of outcomes and the assessments that are used.


Asunto(s)
Nacimiento Prematuro , Recién Nacido , Femenino , Humanos , Nacimiento Prematuro/prevención & control , Estudios Transversales , Evaluación de Resultado en la Atención de Salud , Análisis de Series de Tiempo Interrumpido , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Ageing Res Rev ; 91: 102081, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37774933

RESUMEN

BACKGROUND: Parkinson's Disease (PD) affects more than 10 million individuals, with increasing incidence worldwide. As PD's incidence rises, research funding is increasing substantially. PD's core outcome set (COS) provides standardization for PD clinical trial outcomes, improves research quality, and study comparability. Our study aimed to analyze COS uptake rate before and after the PD COS publication. METHODS: We searched ClinicalTrials.gov to retrieve phase III/IV adult PD trials published between 2013 and 2023. Screening for inclusion and data extraction occurred in a masked, duplicate fashion. Trial characteristics and COS uptake rate were extracted from this sample. RESULTS: In our 111 included trials, the COS uptake rate was highest for the 'Walking and Balance' outcome and lowest for the 'Hospital Admissions' outcome. Overall, there was a non-significant monthly increase of 0.26 % (P = 0.266, CI = [-0.20, 0.72]) in "COS-defined outcome" measurement when comparing pre- and post-COS publication. CONCLUSION: Our study found no significant increase in COS uptake in PD clinical trials. We found multiple outcomes to be vastly unmeasured and heterogeneity among the measurement instruments used. These findings complicate standardizing and comparing RCT outcomes. Overcoming these barriers is vital to improving the usefulness of PD research.


Asunto(s)
Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/complicaciones , Ensayos Clínicos Controlados Aleatorios como Asunto , Evaluación de Resultado en la Atención de Salud
9.
Regen Med ; 18(7): 531-542, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37340904

RESUMEN

Aim: Our objectives are: to evaluate the completeness of harms reporting in systematic reviews (SRs) on platelet-rich plasma therapy; to assess the overall methodological quality of the SR using AMSTAR-2 tool; to assess harms reporting overlap in primary studies between SRs. Materials & methods: The authors searched five database systems for relevant literature on platelet rich plasma therapy. The authors screened and extracted in masked, duplicate fashion. Results: All SRs reported less than 50% completeness in harms reporting. The most frequently reported item was harms being stated in the abstract or title (26/103, 25.2%). AMSTAR-2 assessed 96 SRs as 'critically low', 6 SRs as 'low' and 1 'moderate'. Conclusion: Our study highlights that reporting of harms should become more standardized and transparent.


This study looked at how well the negative effects (harms) of platelet-rich plasma therapy are reported in systematic reviews (SRs). The researchers carefully reviewed and extracted data of SRs from different databases. They found that less than 50% of the SRs reported the harms associated with platelet rich plasma therapy. The researchers also used a tool called AMSTAR to assess the value of each of the SRs, and most were found to be 'critically low' reviews. In conclusion, this study highlights the importance of platelet rich plasma therapy negative effect reporting by SRs.


Asunto(s)
Estudios Transversales , Revisiones Sistemáticas como Asunto
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