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1.
BMC Neurol ; 24(1): 321, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39237894

RESUMEN

BACKGROUND: Neurological disorders have had a substantial rise the last three decades, imposing substantial burdens on both patients and healthcare costs. Consequently, the demand for high-quality research has become crucial for exploring effective treatment options. However, current neurology research has some limitations in terms of transparency, reproducibility, and reporting bias. The adoption of reporting guidelines (RGs) and trial registration policies has been proven to address these issues and improve research quality in other medical disciplines. It is unclear the extent to which these policies are being endorsed by neurology journals. Therefore, our study aims to evaluate the publishing policies of top neurology journals regarding RGs and trial registration. METHODS: For this cross-sectional study, neurology journals were identified using the 2021 Scopus CiteScore Tool. The top 100 journals were listed and screened for eligibility for our study. In a masked, duplicate fashion, investigators extracted data on journal characteristics, policies on RGs, and policies on trial registration using information from each journal's Instruction for Authors webpage. Additionally, investigators contacted journal editors to ensure information was current and accurate. No human participants were involved in this study. Our data collection and analyses were performed from December 14, 2022, to January 9, 2023. RESULTS: Of the 356 neurology journals identified, the top 100 were included into our sample. The five-year impact of these journals ranged from 50.844 to 2.226 (mean [SD], 7.82 [7.01]). Twenty-five (25.0%) journals did not require or recommend a single RG within their Instructions for Authors webpage, and a third (33.0%) did not require or recommend clinical trial registration. The most frequently mentioned RGs were CONSORT (64.6%), PRISMA (52.5%), and ARRIVE (53.1%). The least mentioned RG was QUOROM (1.0%), followed by MOOSE (9.0%), and SQUIRE (17.9%). CONCLUSIONS: While many top neurology journals endorse the use of RGs and trial registries, there are still areas where their adoption can be improved. Addressing these shortcomings leads to further advancements in the field of neurology, resulting in higher-quality research and better outcomes for patients.


Asunto(s)
Políticas Editoriales , Neurología , Publicaciones Periódicas como Asunto , Ensayos Clínicos como Asunto/normas , Ensayos Clínicos como Asunto/métodos , Estudios Transversales , Neurología/normas , Publicaciones Periódicas como Asunto/normas , Guías de Práctica Clínica como Asunto
2.
Heliyon ; 10(15): e35240, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-39161812

RESUMEN

Background: Coronary microvascular dysfunction (CMD) assessed by the index of microcirculatory resistance (IMR) is associated with perioperative myocardial injury (PMI).The angiographically derived index of microcirculatory resistance (caIMR) represents a novel and accurate alternative to IMR. Objective: This study aims to evaluate the predictive ability of caIMR for PMI in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). Methods: Consecutive patients with stable CAD undergoing elective PCI of a single lesion were recruited. caIMR was measured before and after revascularisation, and total creatine kinase-MB (CK-MB) and high-sensitivity troponin T (hsTnT) levels were measured before and within 24 h after PCI. Results: A total of 65 patients were enrolled and 26 patients fulfilled the diagnostic criteria for PMI. Post-PCI caIMR values were significantly higher in the PMI group than in the control group (27.02 ± 3.70 vs. 15.91 ± 3.43U, P < 0.001). Pearson correlation analysis showed that increased post-PCI caIMR values had a significant positive correlation with peak hsTnT (r = 0.803, P < 0.001) and peak CK-MB (r = 0.512, P = 0.001). Multivariate logistic regression analysis showed that post-PCI caIMR was an independent predictor of PMI (OR,1.731; 95 % CI:1.348-2.023; P < 0.001).ROC analysis suggested that the best cut-off value of post-PCI caIMR was 25.17U to diagnose PMI (AUC = 0.951, sensitivity 88.5 %, specificity 97.1 %). During a median follow-up 16 months, patients with PMI had a higher incidence of major adverse cardiovascular events (MACE) (42.31 % vs 5.13 %, P = 0.04). Conclusions: Post-PCI caIMR can accurately predict PMI and clinical outcomes in stable CAD patients undergoing elective PCI, which supports the use of caIMR in clinical practice.

3.
Hum Vaccin Immunother ; 20(1): 2379864, 2024 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-39165083

RESUMEN

This Phase I/IIa open-label, single-arm clinical trial addressing advanced, refractory, metastatic breast cancer was conducted at six medical centers in the United States. We repeated inoculations with irradiated SV-BR-1-GM, a breast cancer cell line with antigen-presenting activity engineered to release granulocyte-macrophage colony-stimulating factor (GM-CSF), with pre-dose low-dose cyclophosphamide and post-dose local interferon alpha. Twenty-six patients were enrolled; 23 (88.5%) were inoculated, receiving a total of 79 inoculations. There were six Grade 4 and one Grade 5 adverse events noted (judged unrelated to SV-BR-1-GM). Disease control (stable disease [SD]) occurred in 8 of 16 evaluable patients; 4 showed objective regression of metastases, including 1 patient with near-complete regressions in 20 of 20 pulmonary lesions. All patients with regressions had human leukocyte antigen (HLA) matches with SV-BR-1-GM; non-responders were equally divided between matching and nonmatching (p = .01, Chi-squared), and having ≥2 HLA matches with SV-BR-1-GM (n = 6) correlated with clinical benefit. Delayed-type hypersensitivity (DTH) testing to candida antigen and SV-BR-1-GM generated positive responses (≥5 mm) in 11 (42.3%) and 13 (50%) patients, respectively. Quantifying peripheral circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAMLs) showed that a drop in CAMLs was significantly correlated with an improvement in progression-free survival (PFS; 4.1 months vs. 1.8 months, p = .0058). Eight of 10 patients significantly upregulated programmed cell death ligand 1 (PD-L1) on CTCs/CAMLs with treatment (p = .0012). These observations support the safety of the Bria-IMT regimen, demonstrate clinical regressions, imply a role for HLA matching, and identify a possible value for monitoring CAMLs in peripheral blood.


Asunto(s)
Neoplasias de la Mama , Ciclofosfamida , Factor Estimulante de Colonias de Granulocitos y Macrófagos , Interferón-alfa , Humanos , Femenino , Persona de Mediana Edad , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Ciclofosfamida/administración & dosificación , Ciclofosfamida/uso terapéutico , Adulto , Anciano , Interferón-alfa/administración & dosificación , Interferón-alfa/uso terapéutico , Metástasis de la Neoplasia , Línea Celular Tumoral , Resultado del Tratamiento , Estados Unidos
4.
5.
Eur J Surg Oncol ; : 108545, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39068044

RESUMEN

INTRODUCTION: There is unmet need in the treatment of ovarian and testicular germ cell tumors (GCTs). This study analyzed registered trials of interventions for GCTs. MATERIALS AND METHODS: We included trials of interventions for GCTs registered on ClinicalTrials.gov by July 29, 2022. We analyzed their interventions, outcome measures and study design. RESULTS: We included 142 trials registrations; 42 (30 %) for ovarian GCTs, 50 (35 %) for testicular GCTs, and 50 (35 %) trials for both. The majority of the trials were completed (56 %) and did not have results available (75 %). Most trials were in Phase 2. Information about the study design were not reported for many analyzed trials. Most trials had a single-group assignment (44 %) and were open-label (68 %). The median planned number of enrolled participants was 43. Most registrations used medicine(s) (87 %), either as a single type of intervention or in combination. The most commonly used type of medicine was chemotherapy (54 %). Primary outcome was not reported in 23 % of registrations, and secondary outcomes were not reported in 35 % of registrations. Overall survival was used in 6 % of registrations as a primary outcome and in 31 % of registrations as a secondary outcome. CONCLUSIONS: Few trials on GCTs were registered on ClinicalTrials.gov, and their number was declining in recent times. Most registrations did not report relevant information about the study design, or results if completed. More effort is needed to foster trials on GCTs, as well as to optimize the management of the registrations and foster the publication of research results.

6.
Contemp Clin Trials ; 144: 107611, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38914310

RESUMEN

BACKGROUND: The three types of evidence-based treatment options for adults with overweight and obesity - behavioral weight management, anti-obesity medications (AOM), and bariatric surgery - are underutilized in the Veterans Health Administration (VHA) system. Our objective in this manuscript is to describe the study protocol for an adequately powered randomized controlled trial (RCT) of a behavioral intervention: TOTAL (Teaching Obesity Treatment Options to Adult Learners) to increase patient uptake of obesity treatment. METHODS: In this multi-site, parallel, RCT, eligible Veterans with a body mass index [BMI] ≥ 27 who had not received obesity treatment within the past 12 months were randomly assigned to TOTAL or usual care. TOTAL involves watching an 18-min video that highlights obesity health risks, pros/cons of all three evidence-based obesity treatments, and expected treatment outcomes. It also includes motivational sessions delivered via televideo at 2 weeks, 6 months, and 12 months after the video (target n = 494 participants). The primary outcome is initiation of behavioral weight management treatment within 18 months of randomization. Secondary outcomes include sustained behavioral weight management treatment, initiation of AOM, bariatric surgery referral, and weight change across 18 months. CONCLUSION: TOTAL, which seeks to increase delivery of weight management treatment within the largest integrated health system in the U.S., combines patient education with motivational interviewing components. If efficacious in this trial, further evaluation of intervention effectiveness and implementation throughout the VHA and other healthcare systems would be warranted.


Asunto(s)
Cirugía Bariátrica , Terapia Conductista , Obesidad , Adulto , Femenino , Humanos , Masculino , Fármacos Antiobesidad/uso terapéutico , Cirugía Bariátrica/métodos , Terapia Conductista/métodos , Índice de Masa Corporal , Entrevista Motivacional/métodos , Obesidad/terapia , Sobrepeso/terapia , Estados Unidos , United States Department of Veterans Affairs , Veteranos , Pérdida de Peso , Programas de Reducción de Peso/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como Asunto
7.
J Nephrol ; 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38837001

RESUMEN

OBJECTIVE: To determine the extent to which nephrology journals recommend and require reporting guideline adherence and clinical trial registration. BACKGROUND: Despite a rising disease burden, research published on chronic kidney disease (CKD) and the field of nephrology has failed to keep pace and is limited. To improve the quality of research in the field of nephrology, reporting guidelines have been developed to minimize such deficits in research quality. However, the extent to which nephrology journals require and use reporting guidelines in addition to clinical trial registration is unknown. METHODS: Sixty-two Nephrology journals were selected through the 2021 Scopus CiteScore tool. Each journal's Instructions for Authors was assessed to determine endorsement of study design-specific reporting guidelines or clinical trial registration. Researchers used R (version 4.2.1) and RStudio to create data summaries of descriptive statistics for nephrology journal reporting guidelines. RESULTS: Clinical trial registration was required by 52% (32/62) of nephrology journals within our sample. The reporting guideline for clinical trials, CONSORT, was required by 17.74% (11/62) of journals. The EQUATOR Network was mentioned by 46.77% (29/62) of journals, while 9.67% (6/62) failed to mention the ICMJE. The reporting guideline for systematic review, PRISMA, was only required by 12.90% (8/62) of journals. When contacting journal editors, 9.67% (6/62) responded and 4.83% (3/62) provided clarifying information. CONCLUSIONS: Reporting guidelines and clinical trial registration are suboptimally required and recommended by nephrology journals. Their adoption may decrease bias and increase research quality. Thus, nephrology journals should consider a more complete endorsement of these safeguards.

8.
Mult Scler Relat Disord ; 87: 105690, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38795594

RESUMEN

BACKGROUND: Patients with Multiple Sclerosis (PwMS) often experience sensory, balance, and gait problems. Impairment in any sensation may increase imbalance and gait disorder in PwMS. This study aimed to (1) compare foot plantar sensations, knee position sense, balance, and gait in PwMS compared to Healthy Individuals (HI) and (2) examine the relationship between plantar sensations, knee position sense, balance, and gait in PwMS. METHODS: Thirty PwMS with mild disability and 10 HI participated in this study. Light touch threshold, two-point discrimination, vibration duration, and knee position sense were examined on the Dominant Side (DS) and Non-Dominant Side (NDS). Balance and spatio-temporal gait analysis were evaluated in all participants. RESULTS: PwMS had higher postural sway with eyes closed on the foam surface, longer swing phase of DS, longer single support phase of NDS, and shorter double support phase of DS compared to HI (p < 0.05). The results of regression analysis showed that the light touch thresholds of the 1st and 5th toes of the DS were associated with postural sway in different sensory conditions (p < 0.05). In contrast, the light touch thresholds of the 1st and 5th toes, two-point discrimination of the heel, vibration duration of the 1st metatarsal head and knee position sense of the NDS, and light touch threshold in the medial arch of both sides were associated with the gait parameters (p < 0.05). CONCLUSION: PwMS, even with mild disabilities needs neurorehabilitation to improve plantar sensation and knee position sense.


Asunto(s)
Esclerosis Múltiple , Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Femenino , Masculino , Adulto , Esclerosis Múltiple/fisiopatología , Esclerosis Múltiple/complicaciones , Persona de Mediana Edad , Pie/fisiopatología , Propiocepción/fisiología , Marcha/fisiología , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/etiología , Rodilla/fisiopatología , Umbral Sensorial/fisiología , Vibración , Índice de Severidad de la Enfermedad
9.
BJGP Open ; 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38806214

RESUMEN

BACKGROUND: Family medicine, vital for patient care but underfunded, prompts an evaluation of how family medicine journals endorse, require, and advocate for reporting guidelines (RGs), clinical trial, and systematic review registration. AIM: Assess endorsement and requirement of RGs, and the stance on clinical trial and systematic review registration in family medicine journals, impacting research quality and transparency. DESIGN & SETTING: A cross-sectional analysis of 43 "Family Practice" journals, identified through the 2021 Scopus CiteScore. Editors-in-Chief were contacted to confirm article types. Data extracted from "instructions to authors" pages focused on RG recommendations, requirements, and trial registration. METHOD: To ensure confidentiality and prevent bias, authors independently extracted data on RG utilisation, adherence, and clinical trial registration provide a overview of research standards. RESULTS: Of 43 journals, the most recommended guidelines were CONSORT (69%), PRISMA (58%), and STROBE (60%). The most required were PRISMA (16%) and CONSORT (11%). Clinical trial registration was recommended or required by 67% of journals. Additionally, 40 out of the 43 (93%) journals cited at least one reporting guideline in their instructions to authors. CONCLUSION: Family medicine journals exhibit varied endorsement and requirement patterns for RGs and clinical trial registration. While guidelines like CONSORT, PRISMA, and STROBE are acknowledged, caution is needed in presuming a direct link to enhanced research quality. A nuanced approach, promoting diverse reporting guidelines and rigorous study registration, is essential for elevating transparency and advancing research standards in family medicine.

10.
Trials ; 25(1): 189, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38486299

RESUMEN

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.


Asunto(s)
Estudios de Cohortes , Humanos , Estudios Prospectivos , Sistema de Registros
11.
Health Policy ; 142: 104991, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38417375

RESUMEN

OBJECTIVES: Since 2017, the UK government has made concerted efforts to ensure the dissemination of clinical trials conducted at public research institutions. This study aims to understand how stakeholders within these institutions responded to these pressures and modified internal policies and processes while identifying best practices and barriers to improved transparency practice. METHODS: Research governance and trial management staff from UK public research institutions (i.e., Universities and NHS Trusts) in England, Scotland and Wales participated in semi-structured interviews. Interviews were analysed using thematic analysis, aided by the framework method. RESULTS: Between November 2020 and July 2021, 14 individual participants were recruited from 11 different institutions. They worked in research governance, administration, and management. Almost universally, new policies and procedures have been established to ensure investigators are aware of, and supported in, fulfilling their transparency commitments, however challenges remain. Trials of medicinal products, as the most closely regulated research, consequently received the most attention. National professional networks aid in sharing knowledge and best practice within this community. CONCLUSIONS: Investment in the institutional governance of transparency is essential to achieving optimal transparency practices. Universities and hospitals share responsibility for ensuring research is performed and reported to regulatory standards. Facing political pressure, public research institutions in the UK have made efforts to improve their transparency practice which can provide key insights for similar efforts elsewhere.


Asunto(s)
Gobierno , Políticas , Humanos , Investigación Cualitativa , Inglaterra , Gales
12.
Autism ; 28(8): 1889-1901, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38345030

RESUMEN

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.


Asunto(s)
Trastorno Autístico , Humanos , Trastorno Autístico/terapia , Preescolar , Niño , Proyectos de Investigación , Investigación Biomédica/normas , Investigación Biomédica/métodos , Sistema de Registros
13.
Rheumatol Int ; 44(5): 909-917, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37861727

RESUMEN

The purpose of this study was to investigate the instructions for authors of rheumatology journals and analyze their endorsement of reporting guidelines and clinical trial registration. Sixty rheumatology journals were selected by a research librarian and an investigator through the 2021 Scopus CiteScore tool. The instructions for authors' subsection of each journal was assessed to determine endorsement of study design-specific reporting guidelines or clinical trial registration. Descriptive statistics were calculated using R (version 4.2.1) and RStudio. Of the 58 journals analyzed, 34 (34/58; 59%) mentioned the EQUATOR Network: an online compendium of best practice reporting guidelines. The most commonly mentioned reporting guidelines were CONSORT with 44 journals (44/58; 75%), and PRISMA with 35 journals (35/58; 60%). The least mentioned guidelines were QUOROM with 56 journals not mentioning the guideline (56/58; 97%), and SRQR with 53 journals not mentioning the guideline (53/57, 93%). Clinical trial registration was required by 38 journals (38/58; 66%) and recommended by 8 journals (8/58; 14%). Our study found that endorsement of reporting guidelines and clinical trial registration within rheumatology journals was suboptimal with great room for improvement. Endorsement of reporting guidelines have shown to not only mitigate bias, but also improve research methodologies. Therefore, we recommend rheumatology journals broadly expand their endorsement of reporting guidelines and clinical trial registration to improve the quality of evidence they publish.


Asunto(s)
Publicaciones Periódicas como Asunto , Reumatología , Humanos , Estudios Transversales , Edición , Bibliometría , Adhesión a Directriz
14.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1026911

RESUMEN

Objective To analyze the registered clinical trials of headache treated by TCM;To discuss the current research status;To provide reference for the optimization of subsequent clinical trial research plans.Methods All clinical trials of headache treated by TCM were retrieved from the ChiCTR and the ClinicalTrials.The retrieval time was from the database establishment to May 22,2023.The general characteristics,study types,intervention measures and outcome indicators of the trials were analyzed respectively.Results A total of 104 registered studies were included,with the number of registered studies increasing since 2004 and reaching a peak in 2020,involving 25 provincial administrative regions or countries and 69 clinical trial institutions;the funding sources were mainly scientific research funds of universities,national finance and local finance.The research type was mainly intervention research;the designing scheme was mainly randomized parallel control study;the high frequency random method was simple random method;45 registered studies used blind methods.Exploratory studies/pre-trials were the most commonly used in the phases of clinical researches.Most of the registered studies were single-center clinical trials with a total sample size of 9 648 patients.The main interventions were acupuncture and oral Chinese medicines.The high frequency outcome indicators included life quality of score,headache attack frequency,headache attack days and headache severity,etc.There were some problems in outcome indicators,such as non-standard,lack of TCM characteristic advantages,and insufficient patient participation.Conclusion The number of registered studies of headache treated by TCM has increased by year,but there are some problems in design elements,such as random method,blind method,number of research centers,sample size and the setting of outcome indicator.

15.
J Clin Transl Sci ; 7(1): e166, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37588679

RESUMEN

Objectives: Assess the extent to which the clinical trial registration and reporting policies of 25 of the world's largest public and philanthropic medical research funders meet best practice benchmarks as stipulated by the 2017 WHO Joint Statement, and document changes in the policies and monitoring systems of 19 European funders over the past year. Design Setting Participants: Cross-sectional study, based on assessments of each funder's publicly available documentation plus validation of results by funders. Our cohort includes 25 of the largest medical research funders in Europe, Oceania, South Asia, and Canada. Interventions: Scoring all 25 funders using an 11-item assessment tool based on WHO best practice benchmarks, grouped into three primary categories: trial registries, academic publication, and monitoring, plus validation of results by funders. Main outcome measures: How many of the 11 WHO best practice items each of the 25 funders has put into place, and changes in the performance of 19 previously assessed funders over the preceding year. Results: The 25 funders we assessed had put into place an average of 5/11 (49%) WHO best practices. Only 6/25 funders (24%) took the PI's past reporting record into account during grant application reviews. Funders' performance varied widely from 0/11 to 11/11 WHO best practices adopted. Of the 19 funders for which 2021(2) baseline data was available, 10/19 (53%) had strengthened their policies over the preceding year. Conclusions: Most medical research funders need to do more to curb research waste and publication bias by strengthening their clinical trial policies.

16.
Appetite ; 188: 106631, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37302414

RESUMEN

The mechanisms underlying the negative associations between pre-pregnancy body mass index (BMI) and exclusive breastfeeding remain poorly understood. Thus, the study aimed to determine whether the negative associations between high pre-pregnancy BMI and exclusive breastfeeding at six weeks postpartum are mediated by components of the capability, opportunity, and motivation behaviour (COM-B) model. In this prospective observational study, we assigned 360 primiparous women to a pre-pregnancy overweight/obese group (n = 180) and a normal-BMI group (n = 180). A structural equation model was designed to study how capabilities (onset of lactogenesis II, perceived milk supply, breastfeeding knowledge, and postpartum depression), opportunities (pro-breastfeeding hospital practices, social influence, social support), and motivations (breastfeeding intention, breastfeeding self-efficacy, and attitudes towards breastfeeding) affected exclusive breastfeeding at six weeks postpartum in groups of women with different pre-pregnancy BMIs. In all, 342 participants (95.0%) possessed complete data. Women with high pre-pregnancy BMI were less likely to exclusively breastfeed at six weeks postpartum than women with a normal BMI were. We observed a significant negative direct effect of high pre-pregnancy BMI on exclusive breastfeeding at six weeks postpartum and a significantly negative indirect effect of high pre-pregnancy BMI via the explanatory mediating variables of capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy) on exclusive breastfeeding at six weeks postpartum. Our findings support certain capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy), partially explaining the negative association between high pre-pregnancy BMI and exclusive breastfeeding outcome. We suggest that interventions aimed at promoting exclusive breastfeeding among women with high pre-pregnancy BMI should address the capacity and motivation factors specific to this population.


Asunto(s)
Lactancia Materna , Motivación , Embarazo , Femenino , Humanos , Índice de Masa Corporal , Madres , Periodo Posparto
17.
Brain Behav Immun ; 111: 352-364, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37150266

RESUMEN

Alzheimer's dementia (AD) is a major contributor to global disability, and effective therapies to modify disease progression are currently lacking. The neuro-inflammatory theory is a potential etiology underlying this neurodegenerative disease. Previous randomized, controlled trials (RCTs) have provided inconclusive results regarding efficacy of omega-3 polyunsaturated fatty acids (PUFAs) regimens, which might provide anti-inflammatory benefits in the management of AD, in improving cognitive function among participants with AD. The objective of this frequentist-model based network meta-analysis (NMA) was to evaluate the potential advantages of omega-3 PUFAs and currently FDA-approved medications for AD on overall cognitive function in AD individuals. The primary outcomes were: (1) changes in cognitive function, and (2) acceptability, which refers to all-cause discontinuation. Additionally, secondary outcomes included quality of life, behavioral disturbances and safety/tolerability, which was assessed through the frequency of any reported adverse event. This NMA included 52 RCTs (6 with omega-3 PUFAs and 46 with FDA-approved medications) involving 21,111 participants. The results showed that long-term high-dose (1500-2000 mg/day) of eicosapentaenoic acid (EPA)-dominant omega-3 PUFAs augmented with anti-oxidants had the highest potential for cognitive improvement among all investigated treatments [standardized mean difference = 3.00, 95% confidence intervals (95 %CIs) = 1.84-4.16]. Compared to placebo, omega-3 PUFAs had similar acceptability [odds ratio (OR) = 0.46, 95 %CIs = 0.04 to 5.87] and safety profiles (OR = 1.24, 95 %CIs = 0.66 to 2.33)o. These findings support the potential neurotherapeutic effects of high dosage EPA-dominant omega-3 PUFAs for the amelioration of cognitive decline in patients with AD. Future large-scale, long-term RCTs should focus on different dosages of EPA-dominant omega-3 PUFAs regimens on improving cognitive dysfunction in patients with AD at different levels of inflammatory status and psychopathology.


Asunto(s)
Enfermedad de Alzheimer , Ácidos Grasos Omega-3 , Humanos , Ácido Eicosapentaenoico/farmacología , Ácido Eicosapentaenoico/uso terapéutico , Enfermedad de Alzheimer/tratamiento farmacológico , Metaanálisis en Red , Ácidos Grasos Omega-3/uso terapéutico , Cognición , Antiinflamatorios/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto
18.
J Shoulder Elbow Surg ; 32(9): 1763-1769, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37224915

RESUMEN

BACKGROUND: Prospective trial registration has become an important means of improving the transparency and reproducibility of randomized controlled trials (RCTs) and is recommended by the Journal of Shoulder and Elbow Surgery (JSES) per the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Herein, we performed a cross-sectional evaluation of RCTs published in JSES from 2010 to present to determine the prevalence of trial registration and consistency of outcome reporting. METHODS: The electronic database PubMed was searched to identify all RCTs on total shoulder arthroplasty (TSA) published in JSES from 2010 to 2022 using the search terms "randomized controlled trial" AND "shoulder" AND "arthroplasty OR replacement." RCTs were considered to be registered if they provided a registration number. For articles that were registered, authors also extracted the registry name, registration date, date of first enrollment, date of last enrollment, and if the primary outcomes reported in the registry were either (1) omitted, (2) newly introduced in the publication, (3) reported as a secondary outcome or vice versa, or (4) varied in timing of assessment compared to the publication. "Early" RCTs were considered those published from 2010 to 2016, whereas "later" RCTs were from 2017 to 2022. RESULTS: Fifty-eight RCTs met inclusion criteria. There were 16 early RCTs and 42 later RCTs. Twenty-three of the 58 (39.7%) studies were registered, with 9 of 22 with an available registry (40.9%) of those being enrolled prior to patient enrollment. Nineteen of the registered studies (82.6%) provided the name of the registry and a registration number. The proportion of later RCTs that were registered was not significantly different from the early RCTs (45.2% vs. 25.0%, P = .232). Seven RCTs (31.8%) had at least 1 inconsistency compared with the registry. The most common discrepancy was the timing of the assessment (ie, follow-up period) reported in the publication vs. the registry. DISCUSSION: Although JSES recommends prospective trial registration, less than half of shoulder arthroplasty RCTs are registered and more than 30% registered trials have at least 1 inconsistency with their registry record. More rigorous review of trial registration and accuracy is necessary to limit bias in published shoulder arthroplasty RCTs.


Asunto(s)
Artroplastía de Reemplazo de Hombro , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Artroplastia , Hombro , Sistema de Registros
19.
Worldviews Evid Based Nurs ; 20(6): 574-581, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37005350

RESUMEN

BACKGROUND: The inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent. AIMS: The aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration. METHODS: We systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions. RESULTS: A total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time. LINKING EVIDENCE TO ACTION: While not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.


Asunto(s)
Publicaciones Periódicas como Asunto , Humanos , Sistema de Registros , Publicaciones
20.
Gastro Hep Adv ; 2(3): 370-379, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36938381

RESUMEN

Background & Aims: Results of randomized clinical trials are often first presented as conference abstracts, but these abstracts may be difficult to find, and trial results included in the abstract may not be followed by subsequent journal publications. In a review of abstracts submitted to eight major medical and surgical conferences in 2017, we identified 237 abstracts reporting primary results of randomized clinical trials accepted for presentation at three major gastroenterology and hepatology conferences. The aims of this new analysis were to determine the publication rate for these abstracts and the proportion of publications that included trial registration numbers in the publication abstract. Methods: Clinical trial registries, PubMed, Europe PMC, and Google Scholar were searched through November 1, 2021, for publications reporting trial results for the selected abstracts. Publications were reviewed to determine if they included a trial registration number and if the registration number was in the abstract. Results: Publications were found for 157 abstracts (66%) within four years of the conference. Publications were found more frequently for the 194 abstracts reporting results of registered trials (144, 74%) than for the 43 abstracts reporting unregistered trials (13, 30%), but only 67% of these 144 publications included the registration number in the publication abstract. Ten unpublished trials had summary results posted on ClinicalTrials.gov. Conclusions: Clinical trial results could be more accessible if all trials were registered, authors included registration numbers in both conference and journal abstracts, and journal editors required the inclusion of registration numbers in publication abstracts for registered clinical trials.

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