MEDLINE Journals Research Articles

A Practical Guide to Measuring Optic Disc Size and its Clinical Correlation in Diagnosing Glaucoma for the Eye Care Professional

This study examines the connection between glaucoma and the optic disc, cup, and neuroretinal rim size. The use of a slit-lamp and funduscopy lens as a technique for determining and estimating the optic disc size is particularly emphasized. Through this study, a clinical manual for working clinicians will be developed by summarizing this information and making it easily accessible for in-office use. PubMed, Science Direct, Ovid, Medline journals, and inter-library journals were used to find papers and abstracts of relevant studies for this review. The most common search terms were: procedures for assessing optic disc size, variance in optic disc size between populations, and ophthalmoscopic methods for measuring optic discs. The search period spanned 2020 to 2022. The following criteria were used to determine whether an article should be included or excluded: a critical evaluation of the various methods used to measure the optic disc, the significance of including population-specific variations in the size of the optic disc, and justifications for the relative risk of glaucoma associated with the size of both the optic disc and the optic cup. According to numerous studies, a slit lamp and funduscopy lens can be used to estimate the size of the optic disc. Additionally, this review discovered a weak association between measures taken at a slit lamp and those taken with more exact office tools, including fundus photography. Using fundoscopic technologies is an effective and affordable method for measuring the optic nerve head while retaining a high level of accuracy. These dimensions can be used to divide the sizes of optic discs into three groups: small, average, and large.

Confusing terminology used in the abbreviation of pharmacy journal names.

The lack of commonly agreed terminology in pharmacy field is highly prevalent and may have influence on the relevance and robustness of the area, especially how others see pharmacy literature. Potential consequences of this poor perception of pharmacy field by the National Library of Medicine (NLM) could be the omission of several pharmacy-related Medical Subject Headings (MeSH) or the low indexing rate of pharmacy practice journals in MEDLINE. Journal name abbreviation, under the responsibility of the NLM, is the unambiguous way to identify a journal in bibliographic references and catalogs. The present study investigated the consistency of pharmacy journal abbreviations in the NLM Catalog. For the 290 journals containing any word with the root pharm in their names, a consistent procedure for NLM title abbreviations was found for 27 of the words in journal names but not for the abbreviation "Pharm", which represented several words with very different meanings: pharmaceutical, pharmaceutics, pharmacists, and pharmacy. The use by the NLM of different abbreviation for pharmaceutical and pharmaceutics would increase journal identification clarity.

Mapping of research publications on corona virus disease (COVID-19) in PubMed database

The purpose of this paper is to find out the publications pertaining to “Corona Virus” available in PubMed database. PubMed database provides links to Full Text publications available with publishers and also Free Full Text publications. The data for the study were extracted from Pub Med database using the search term “Corona Virus”. Totally, 18659 publications pertaining to “Corona Virus” during 2010 to 2020 were retrieved. Out of 18659 publications, 57.90% of publications in Full Text with link to publications. The result shows that 89.43% of the publications were available in the form of “Articles” and 98.37% of publiations were listed under “Medline Journals”. Among four subject categories, the highest number of publications has been classified under subject “Cancer”. English is a dominating language, since, 96.78% of publications were published in English.COVID-19 disease is originated only in December 2019, within the very short span of time, the researchers and authors are rapidly involved in various research activities in order to investigate the factors for COVID-19. Perhaps, the research findings are published at regular and interval to speed up the research and also to encourage the researchers.

Mucormycosis of jaws - literature review and current treatment protocols.

Mucormycosis is a modern-day lifestyle disease that has burst into the health-care scenario. It is an opportunistic fungal infection that proliferates into the immunocompromised host by invasion of the fungus into the paranasal sinuses, thereby invading the palate, maxilla, and orbit. Left untreated it invades the cranial components such as cavernous sinus, skull base, and brain. Mucormycosis invades blood vessels, making these infections highly angioinvasive. We reviewed 45 cases of mucormycois of the head-and-neck region from 2010 to 2020 on the basis of electronic search peer-reviewed journals in Medline (PubMed) database. Presenting symptoms, risk factors, history of extraction, and treatment were tabulated and the data were analyzed. The mean age of patients was 53.8 years. 73.93% of patients had diabetes mellitus, 13.63% of patients had no immunocompromised state, and 8.74% of patients had other medical disorders. About 34.78% of cases had a history of extraction prior to manifestation of symptoms. Mucormycosis remains difficult to treat disease with a high mortality rate. At present, the triad of clinician's awareness, appropriate antifungal therapy, and aggressive surgical intervention represents treatment protocols against the disease.

Indexing of the Russian biomedical journals in MEDLINE and PubMed: analysis of the positive and negative experience

The MEDLINE database and PubMed.com web-platform are the world’s best-known and most used sources for search scientific information in biology and medicine. Indexing in MEDLINE and making a journal searchable through PubMed.com is a most powerful tool to promote it worldwide. No other databases, even Scopus and Web of Science, can be compared with MEDLINE in terms of its effect on the readability and availability in web-search results. At the same time, medical and biological journals from Russia have serious problems with the MEDLINE indexation results in an extremely low presence of publications from Russian journals in this database. Over the past decade, the number of Russian journals indexed in MEDLINE has significantly decreased. Present article discusses the main characteristics of the MEDLINE database and PubMed.com, their journal selection process and the reasons for their high importance in scientific journals promotion, as well as the experience of submitting journals for peer review to be indexed in this database. Both positive and negative experience of preparing a journal for indexing in MEDLINE is considered, this can help the editors and publishers of all biology and medicine journals in Russia in solving this task.

Increasing consensus on terminology of Achilles tendon-related disorders

PurposeAims of this study are to evaluate the current terminology and assess the influence of the latest proposals on the terminology used for Achilles tendon-related disorders in both daily practice and literature.Methods(1) All orthopedic surgeons experienced in the field of foot and ankle surgery of the Ankleplatform Study Group were invited to participate in this survey by email. They were requested to fill out a survey on terminology in six typical cases with Achilles tendon-related disorders. (2) A systematic literature search of Achilles tendon-related disorders was performed in eight foot and ankle journals in Medline, Embase (Classic) from 2000 to 2016. All extracted terms were counted and compared to the terminology proposals, based on anatomic location, symptoms, clinical findings and histopathology.Results(1) In total, 141 of the 283 (50%) orthopedic surgeons responded to the survey. In five out of six cases with Achilles tendon-related disorders, the majority gave an answer according to latest proposals. (2) An overview of terminology used for Achilles tendon-related disorders from 2000 to 2016 shows an increase in use of terminology according to the latest proposals based on anatomic location, symptoms, clinical findings and histopathology.ConclusionThe revised terminology for Achilles tendon-related disorders based on anatomic location, symptoms, clinical findings and histopathology is used by the majority of orthopedic surgeons and is increasingly used in the literature. However, the indistinct Haglund eponyms are still frequently used in Achilles tendon-related terminology.Level of evidenceLevel IV.

Journal editors: How do their editing incomes compare?

Background: The work of journal editors is essential to producing high-quality literature, and editing can be a very rewarding career; however, the profession may not be immune to gender pay gaps found in many professions and industries, including academia and clinical medicine. Our study aimed to quantify remuneration for journal editors from core clinical journals, determine if a gender pay gap exists, and assess if there are remuneration differences across publishing models and journal characteristics. Methods: We completed an online survey of journal editors with substantial editing roles including section editors and editors-in-chief, identified from the Abridged Index Medicus "Core Clinical" journals in MEDLINE. We analyzed information on demographics, editing income, and journal characteristics using a multivariable partial proportional odds model for ordinal logistic regression. Results: There were 166 survey respondents (response rate of 9%), which represented editors from 69 of 111 journals (62%). A total of 140 fully completed surveys were analyzed (95 males and 45 females); 50 (36%) editors did not receive remuneration for editorial work. No gender pay gap and no difference in remuneration between editors who worked in subscription-based publishing vs. open access journals were detected. Editors who were not primarily health care providers were more likely to have higher editing incomes (adjusted odds ratio [OR] 2.96, 95% confidence interval [CI] 1.18-7.46). Editors who worked more than 10 hours per week editing earned more than those who worked 10 hours or less per week (adjusted OR 16.7, 95%CI 7.02-39.76). Conclusions: We were unable to detect a gender pay gap and a difference in remuneration between editors who worked in subscription-based publishing and those in open access journals. More than one third of editors surveyed from core clinical journals did not get remunerated for their editing work.

Quality assessment of real-world data repositories across the data life cycle: A literature review.

Data quality (DQ) must be consistently defined in context. The attributes, metadata, and context of longitudinal real-world data (RWD) have not been formalized for quality improvement across the data production and curation life cycle. We sought to complete a literature review on DQ assessment frameworks, indicators and tools for research, public health, service, and quality improvement across the data life cycle. The review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Databases from health, physical and social sciences were used: Cinahl, Embase, Scopus, ProQuest, Emcare, PsycINFO, Compendex, and Inspec. Embase was used instead of PubMed (an interface to search MEDLINE) because it includes all MeSH (Medical Subject Headings) terms used and journals in MEDLINE as well as additional unique journals and conference abstracts. A combined data life cycle and quality framework guided the search of published and gray literature for DQ frameworks, indicators, and tools. At least 2 authors independently identified articles for inclusion and extracted and categorized DQ concepts and constructs. All authors discussed findings iteratively until consensus was reached. The 120 included articles yielded concepts related to contextual (data source, custodian, and user) and technical (interoperability) factors across the data life cycle. Contextual DQ subcategories included relevance, usability, accessibility, timeliness, and trust. Well-tested computable DQ indicators and assessment tools were also found. A DQ assessment framework that covers intrinsic, technical, and contextual categories across the data life cycle enables assessment and management of RWD repositories to ensure fitness for purpose. Balancing security, privacy, and FAIR principles requires trust and reciprocity, transparent governance, and organizational cultures that value good documentation.

Journal editors: How do their editing incomes compare?

Background: The work of journal editors is essential to producing high-quality literature, and editing can be a very rewarding career; however, the profession may not be immune to gender pay gaps found in many professions and industries, including academia and clinical medicine. Our study aimed to quantify remuneration for journal editors from core clinical journals, determine if a gender pay gap exists, and assess if there are remuneration differences across publishing models and journal characteristics. Methods: We completed an online survey of journal editors with substantial editing roles including section editors and editors-in-chief, identified from the Abridged Index Medicus "Core Clinical" journals in MEDLINE. We analyzed information on demographics, editing income, and journal characteristics using a multivariable partial proportional odds model for ordinal logistic regression. Results: There were 166 survey respondents (response rate of 9%), which represented editors from 69 of 111 journals (62%). A total of 140 fully completed surveys were analyzed (95 males and 45 females); 50 (36%) editors did not receive remuneration for editorial work. No gender pay gap and no difference in remuneration between editors who worked in subscription-based publishing vs. open access journals were detected. Editors who were not primarily health care providers were more likely to have higher editing incomes (adjusted odds ratio [OR] 2.96, 95% confidence interval [CI] 1.18-7.46). Editors who worked more than 10 hours per week editing earned more than those who worked 10 hours or less per week (adjusted OR 16.7, 95%CI 7.02-39.76). Conclusions: We were unable to detect a gender pay gap and a difference in remuneration between editors who worked in subscription-based publishing and those in open access journals. More than one third of editors surveyed from core clinical journals did not get remunerated for their editing work.

Journal editors: How do their editing incomes compare?

Background: The work of journal editors is essential to producing high-quality literature, and editing can be a very rewarding career; however, the profession may not be immune to gender pay gaps found in many professions and industries, including academia and clinical medicine. Our study aimed to quantify remuneration for journal editors from core clinical journals, determine if a gender pay gap exists, and assess if there are remuneration differences across publishing models and journal characteristics. Methods: We completed an online survey of journal editors with substantial editing roles including section editors and editors-in-chief, identified from the Abridged Index Medicus “Core Clinical” journals in MEDLINE. We analyzed information on demographics, editing income, and journal characteristics using a multivariable partial proportional odds model for ordinal logistic regression. Results: There were 166 survey respondents (response rate of 9%), which represented editors from 69 of 111 journals (62%). A total of 140 fully completed surveys were analyzed (95 males and 45 females); 50 (36%) editors did not receive remuneration for editorial work. No gender pay gap and no difference in remuneration between editors who worked in subscription-based publishing vs. open access journals were detected. Editors who were not primarily health care providers were more likely to have higher editing incomes (adjusted odds ratio [OR] 2.96, 95% confidence interval [CI] 1.18-7.46). Editors who worked more than 10 hours per week editing earned more than those who worked 10 hours or less per week (adjusted OR 16.7, 95%CI 7.02-39.76). Conclusions: We were unable to detect a gender pay gap and a difference in remuneration between editors who worked in subscription-based publishing and those in open access journals. More than one third of editors surveyed from core clinical journals did not get remunerated for their editing work.

Can database-level MEDLINE exclusion filters in Embase and CINAHL be used to remove duplicate records without loss of relevant studies in systematic reviews? An exploratory study

Objective: To investigate whether using database filters to remove MEDLINE results within Embase (OVID) and CINAHL (EBSCO) would result in fewer records, without leading to any loss of studies included in the final review.
 Methods: We reviewed the included studies from a sample set of 20 Cochrane Reviews, and replicated the search strategies from those reviews in MEDLINE, Embase (both on the OVID platform) and CINAHL (EBSCO). Results were exported to EndNote; then relevant MEDLINE filters were applied within each database, and results were exported again. Filtered results were analysed to determine whether the filtered Embase and CINAHL results excluded relevant studies that were not identified in the original MEDLINE search. 
 Results: Using the “Records from: Embase” filter resulted in no loss of included studies; however, the “Exclude MEDLINE journals” filter in Embase resulted in a failure to retrieve a large number of relevant studies. CINAHL’s filter for MEDLINE records resulted in a very small number of studies being lost.
 Conclusions: The “Records from: Embase” filter may be safely used for deduplication, though as it removes conferences, searchers may also want to review Conference abstracts separately using the Conferences filter. CINAHL’s MEDLINE filter comes with a small risk of filtering out relevant studies, but may be appropriate to use. Though we did not set out to address this question, our results also demonstrate that it is not advisable to rely on an unfiltered search of Embase alone in order to identify all relevant studies.

Negative impacts of the adaptation process linked to local cultural stress levels in immigrants and development of psychiatric disorders: a systematic review and meta-analysis

Background
 Current studies underline and enable the international scientific community to reflect on migrant needs to restart, mostly without fluency in the language from the country of destination, without a way of proving his/her knowledges and abilities, with an incomplete family core, without cultural references that until that moment defined him/her as belonging to a specific group, with defined and meaningful habits, full of symbolic representations.
 Iams
 Conduct an analysis on the implications of migration in refugees’ mental health, and the link between these implications and Post-traumatic Stress Disorder (PTSD).
 Method
 Indexed journals in MEDLINE and LILACS databases hosted in Biblioteca Virtual em Saúde (BVS), as well as papers hosted in Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Periodicals Portal. Searches were carried using the following DeCS descriptors: “Stress Disorders, Post-Traumatic”, "Refugees” e “Mental Health”.
 Results
 The 10 studies included in the present review were carried in Australia, Denmark, Ethiopia, Turkey, Uganda, Israel, South Korea and Papua New Guinea, and were published in 2014 (2), 2015 (6), and 2017 (2). Regarding the subject, 50% of the articles concentrate information regarding PTSD and mental health problems, while the remaining half deals with psychosocial effects of mass conflict on refugees. Meta-analysis concludes that a considerable percentage of refugees suffer from psychiatric disorder, I-squared (variation in ES attributable to heterogeneity) = 96,46%; Estimate of between-study variance Tau^2= 0.02. Test of ES=0 : z= 17.75 p= 0.00.
 Conclusion
 Exposure to traumatic events such as public executions and other extreme acts of violence, murder of family members, family and friends’ death due to starvation, homelessness, are closely related to PTSD prevalence in refugees. Acculturation and family’s prolonged estrangement are predictors of depressive symptoms in refugees and both exposure to a new culture and adaptation to new laws and norms of welcoming countries act as stressors and aggravators of depressive symptoms.

Essential Considerations for Successful Consumer Health Informatics Solutions.

Summary Objectives : To present the breadth and depth of Consumer Health Informatics (CHI) initiatives and in particular, identify areas to further enhance such solutions with the incorporation of advances in artificial intelligence (AI). Methods : A literature review was conducted. Inclusion criteria focused on barriers and facilitators as well as key milestones for CHI over the last 10 years. In addition, significant international initiatives in regions and /or countries and opportunities to incorporate the advances of AI also made up the inclusion criteria. Exclusion criteria included factors that made reach/range of solutions to individuals or groups of individuals less than 50 people. Journals in Medline were accessed as well as the grey literature. Results : 200 papers were identified but this was narrowed to 25 due to repetitions and similarities of the types of solutions presented. From this, it was possible to identify key barriers and facilitators including: socio-political factors, financial factors, infrastructure, as well as levels of health literacy. Conclusions : The relatively nascent domain of CHI has developed and is growing. Full benefits will only be realized when more precision solutions that incorporate AI advances will be designed. The example of RxPredict is provided as a case vignette to illustrate.

Primary outcome switching among drug trials with and without principal investigator financial ties to industry: a cross-sectional study

ObjectivesTo determine the relationship between manufacturer-related financial ties among investigators of published drug trials and rates of discrepant registered and published primary trial outcomes.DesignCross-sectional study.SettingHuman subjects drug trials published in...

Literature review of 86 cases of mandibular ameloblastic carcinoma.

Ameloblastic carcinoma is considered to be a rare epithelial malignant neoplasm of odontogenic origin occurring mainly in the mandible. Ameloblastic carcinoma has been a topic of controversy regarding management from past many years. We reviewed 86 cases of mandibular ameloblastic carcinoma from 1981 to 2014, on the basis of the electronic search of peer-reviewed journals in MEDLINE (PubMed) database. Age, sex, tumor size, treatment delivered, recurrence, metastasis, follow-up period, and dead/alive status are tabulated, and the data are analyzed. The mean age was 43.47 years with standard deviation ± 21.09. The age range was between 15 and 91 years, and male to female ratio was 2.18:1. Knowledge gained from the present review would help in establishing the best therapeutic options for ameloblastic carcinoma, and it also encourages the further reporting of ameloblastic carcinoma.

Impact factor evolution of nursing research journals: 2009 to 2014

BackgroundThe use of bibliometric indicators (impact factor [IF], impact index, h-index, etc.) is now believed to be a fundamental measure of the quality of scientific research output. In this context, the presence of scientific nursing journals in international databases and the factors influencing their impact ratings is being widely analyzed. PurposeThe aim of this study was to analyze the presence of scientific nursing journals in international databases and track the changes in their IF. MethodsA secondary analysis was carried out on data for the years 2009 to 2014 held in the JCR database (subject category: nursing). Additionally, the presence of scientific nursing journals in Medline, CINAHL, Scopus, and SJR was analyzed. DiscussionDuring the period studied, the number of journals indexed in the JCR under the nursing subject category increased from 70 in 2009 (mean IF: 0.99, standard deviation: 0.53) to 115 in 2014 (mean IF: 1.04, standard deviation: 0.42), of which only 70 were listed for the full six years. Although mean IF showed an upward trend throughout this time, no statistically significant differences were found in the variations to this figure. ConclusionAlthough IF and other bibliometric indicators have their limitations, it is nonetheless true that bibliometry is now the most widely used tool for evaluating scientific output in all disciplines, including nursing, highlighting the importance of being familiar with how they are calculated and their significance when deciding the journal or journals in which to publish the results of our research. That said, it is also necessary to consider other possible alternative ways of assessing the quality and impact of scientific contributions.

Segregación de la ropa hospitalaria en origen usada por el paciente: revisión sistemática

Introducción. La segregación y procesamiento de la ropa es un asunto vital tanto para los pacientes como para el recurso humano que labora en los hospitales y centros de salud y que manipula este material. El objetivo fue evaluar la efectividad del personal de enfermería respecto de la segregación de la ropa hospitalaria en origen usada por el paciente, para la prevención de infecciones intrahospitalarias.Método. Se trata de una revisión sistemática, aplicando la metodología recomendada por la Colaboración Cochrane. Para la identificación de los estudios se realizó búsquedas electrónicas en MEDLINE, conferencias en línea, alertas semanales de revistas en BioMed Central (e-mail), EBSCO, Clinical Key, PubMed, Journal of infection, Advance of Nursing, Excelencia.net, Journal of Hospital, Cochrane Library Plus. Después de establecer los criterios de inclusión y exclusión y análisis crítico, se seleccionaron 5 documentos que dieran respuesta a la pregunta clínica.Resultado. La segregación de la ropa debe ser realizada en origen (A-III) y recomiendan que la manipulación de la ropa sucia se debe determinar a nivel local, en consulta con el comité local de control de infecciones.Conclusión. No se pudo determinar la efectividad de la segregación de la ropa en origen realizada por el personal de enfermería en relación con la prevención de infecciones intrahospitalarias.

Cost-Utility Analysis: Sartorius Flap versus Negative Pressure Therapy for Infected Vascular Groin Graft Managment.

Background:Sartorius flap coverage and adjunctive negative pressure wound therapy (NPWT) have been described in managing infected vascular groin grafts with varying cost and clinical success. We performed a cost–utility analysis comparing sartorius flap with NPWT in managing an infected vascular groin graft.Methods:A literature review compiling outcomes for sartorius flap and NPWT interventions was conducted from peer-reviewed journals in MEDLINE (PubMed) and EMBASE. Utility scores were derived from expert opinion and used to estimate quality-adjusted life years (QALYs). Medicare current procedure terminology and diagnosis-related groups codes were used to assess the costs for successful graft salvage with the associated complications. Incremental cost-effectiveness was assessed at $50,000/QALY, and both univariate and probabilistic sensitivity analyses were conducted to assess robustness of the conclusions.Results:Thirty-two studies were used pooling 384 patients (234 sartorius flaps and 150 NPWT). NPWT had better clinical outcomes (86.7% success rate, 0.9% minor complication rate, and 13.3% major complication rate) than sartorius flap (81.6% success rate, 8.0% minor complication rate, and 18.4% major complication rate). NPWT was less costly ($12,366 versus $23,516) and slightly more effective (12.06 QALY versus 12.05 QALY) compared with sartorius flap. Sensitivity analyses confirmed the robustness of the base case findings; NPWT was either cost-effective at $50,000/QALY or dominated sartorius flap in 81.6% of all probabilistic sensitivity analyses.Conclusion:In our cost–utility analysis, use of adjunctive NPWT, along with debridement and antibiotic treatment, for managing infected vascular groin graft wounds was found to be a more cost-effective option when compared with sartorius flaps.

The Role of End-of-Life Issues in the Design and Reporting of Cancer Clinical Trials: A Structured Literature Review.

BackgroundRandomized controlled trials (RCTs) are important sources of information on the benefits and harms patients may expect from treatment options. The aim of this structured literature review by the German Institute for Quality and Efficiency in Health Care was to explore whether and how the end-of-life (EoL) situation of patients with advanced cancer is considered in RCTs investigating anti-cancer treatments.MethodsOur journal pool comprised 19 medical journals, namely five preselected key general medical journals as well as 14 specialist journals (mainly cancer) identified via a scoping search. We systematically searched these journals in MEDLINE to identify RCTs investigating anti-cancer treatments for the following four cancer types: glioblastoma, lung cancer (stage IIIb-IV), malignant melanoma (stage IV), and pancreatic cancer (search via OVID; November 2012). We selected a representative sample of 100 publications, that is, the 25 most recent publications for each cancer type. EoL was defined as a life expectancy of ≤ two years. We assessed the information provided on (1) the descriptions of the terminal stage of the disease, (2) the therapeutic goal (i.e. the intended therapeutic benefit of the intervention studied), (3) the study endpoints assessed, (4) the authors’ concluding appraisal of the intervention’s effects, and (5) the terminology referring to the patients’ EoL situation.ResultsMedian survival was ≤ one year for each of the four cancer types. Descriptions of the terminal stage of the disease were ambiguous or lacking in 29/100 publications. One or more therapeutic goals were mentioned in 51/100 publications; these goals were patient-relevant in 38 publications (survival alone: 30/38; health-related quality of life (HRQoL) or HRQoL and survival: 6/38; symptom control or symptom control and survival: 2/38). Primary endpoints included survival (50%), surrogates (44%), and safety (3%). Patient-reported outcomes (PROs) were assessed in 36/100 RCTs. The implications of treatment-related harms for the patients were discussed in 22/100 appraisals. Terminology referring to the patients’ EoL situation (e.g. “terminal”) was scarce, whereas terms suggesting control of the disease (e.g. “cancer control“) were common.ConclusionsThe EoL situation of patients with advanced cancer should be more carefully considered in clinical trials. Although the investigation and robust reporting of PROs is a prerequisite for informed decision-making in healthcare, they are rarely defined as endpoints and HRQoL is rarely mentioned as a therapeutic goal. Suggestions for improving standards for study design and reporting are presented.

A review of suicide risk assessment instruments and approaches

Abstract Introduction: Conducting an accurate suicide risk assessment (SRA) is no simple task as there are a number of factors that influence an individual's level of suicidality and his/her willingness to share this information. Therefore, it is imperative that practitioners adopt a systematic approach to conducting and documenting the foreseeability that a patient will commit suicide. Methods PubMed was used to search for articles published in MEDLINE journals using the following keywords: suicide, risk assessment, measure, scale. Randomized trials and pilot, proof-of-concept publications investigating the use of specific SRA measurements were included in the review. The scales are described based on the prevailing opinions in psychiatry from the American Psychiatric Association's Textbook of Suicide Assessment and Management (2nd ed., 2012). Results Although various SRA scales exist, experts in the field have repeatedly concluded that there is not any one scale that can predict who will commit suicide to any useful degree. However, when used along with the clinical interview, standardized suicide risk factor components of clinical and research scales remain crucial to gaining information often omitted by patients regarding thoughts and preparation for suicide. A summary of the most widely cited scales and approaches used in SRA is provided. Discussion SRA remains a challenge largely due to the fact that suicidal behavior is multifactorial. As a result, risk formulation is a process that should involve both standardized measures and detailed clinical interviews repeated over time.