Knowledge Translation Efforts Research Articles

A decade later: Assessing pregnant women's perspectives on non-invasive prenatal testing (NIPT) in Saudi Arabia

Since its introduction a decade ago, non-invasive prenatal testing (NIPT) has been recognized as a highly accurate and safe screening option for expecting mothers, with its efficacy hinging on awareness, perceptions, and understanding of the test. We surveyed pregnant women in Saudi Arabia between December 2023 and February 2024 to assess the knowledge and acceptability of NIPT among them. A total of 212 pregnant women from various risk levels, socioeconomic statuses, and trimesters participated in the study, which was carried out at King Saud University Medical City (KSUMC) via online forms. This study investigated factors affecting attitudes towards NIPT, including financial burden. Data were analyzed with descriptive statistics and chi-square tests to assess correlations. The survey revealed a significant lack of awareness about NIPT, with 64.6 % of participants unfamiliar with the test and 93.3 % answering knowledge-related questions incorrectly. Although 74.1 % were willing to undergo NIPT if it were free, only 30 % were willing to pay 1500 SAR (400 USD). These findings underscore the need for targeted knowledge translation efforts to enhance awareness and understanding of NIPT among pregnant women, highlighting the importance of addressing financial barriers and increasing educational outreach. Further research and interventions are needed to promote the uptake of NIPT and enhance the quality of antenatal care programs in Saudi Arabia.

Free sugars in the Canadian diet: a research summary and future directions for food policy.

Until recently, most dietary guidelines and related food policies in Canada focused on total sugars, but recent evidence suggests that free sugars are of greater public health concern. Starting in 2017, our research group received federal funding to fill critical gaps related to free sugars and health. In this commentary, we describe our work related to tracking free sugars in the Canadian food supply and simulating the diet and health impacts of product reformulation. We then summarize how our work has influenced policymaking in Canada with examples of our knowledge translation efforts, and provide a future research and policy agenda based on our findings. Overall, there is significant room for Canadian food policies to target free sugars reductions in food and diets to address overconsumption of this nutrient of public health concern.

“So, We Decided to Make a Film”

Researchers in information science and related fields have traditionally focused on published research and syntheses of research findings. While these mechanisms are crucial for knowledge dissemination, we advocate for more innovative knowledge translation and mobilization efforts. To illustrate this, we present a unique case study on the employment-seeking practices of immigrant women in STEM in Canada. This study stands out for its groundbreaking arts-based knowledge deliverables, including an animated film, a novel approach that was instrumental in our knowledge dissemination and translation efforts. We delve into the study, the rationale behind these deliverables, and the significance of this approach for information science professionals.

Bridging the gap between pregnancy loss research and policy and practice: insights from a qualitative survey with knowledge users

BackgroundThe loss of a pregnancy or the death of baby around the time of their birth can have profound impacts on parents, families and staff involved. There is much opportunity to enhance the systematic uptake of evidence-based interventions to enhance service provision, lived experiences and outcomes. Challenges exist to translating pregnancy loss research evidence into policy and practice, however. Pregnancy loss remains a neglected area of research and resourcing and is steeped in stigma. While barriers and facilitators to the use of research evidence by decision-makers in public health and health services are well documented, we aimed to better understand the factors that influence the translation of pregnancy loss research into practice and policy.MethodsWe conducted a qualitative online survey of pregnancy loss research knowledge users in Ireland, identified through our clinical and academic networks, between January and March 2022. The survey comprised ten questions, with three closed questions, informed by the Knowledge Translation Planning Template©. Questions included who could benefit from pregnancy loss research, perceived barriers and facilitators to the use of research evidence and preferred knowledge translation strategies. We analysed data using reflexive thematic analysis.ResultsWe included data from 46 participants in our analysis, from which we generated two central themes. The first—‘End the silence; stigma and inequality around pregnancy loss to enhance awareness and understanding, public health and services and supports’—addresses issues related to the stigma, sensitivities and silence, lack of awareness and understanding, and lack of relevance or priority afforded to pregnancy loss. The second theme—‘Use a range of tailored, accessible approaches to engage a large, diverse range of knowledge users’—highlights the need to use relevant, accessible, and engaging information, resources or materials in knowledge translation efforts, and a variety of tailored approaches to suit different audiences, including materials, workshops/webinars, media, knowledge brokers and champions or opinion leaders.ConclusionsOur analysis provides rich insights into the barriers and facilitators to knowledge translation in the field of pregnancy loss research. We identified key strategies that can be used to inform knowledge translation planning in Ireland, and which have international applicability.

Co-Producing the International Pediatric Oncology Exercise Guidelines (iPOEG) Toolkit with End-Users

The international Pediatric Oncology Exercise Guidelines (iPOEG) support physical activity among children and adolescents affected by cancer. Knowledge translation efforts are needed to ensure that those who will use and/or benefit from the iPOEG have access to it. This mixed-methods study followed co-production principles as guided by an integrated knowledge translation approach within the Knowledge to Action (KTA) Framework, to engage end-users (i.e., professionals and patients/caregivers) to: (1) identify the types of resources needed; (2) co-produce an iPOEG brand; (3) co-produce resources and content; and (4) co-produce dissemination plans to distribute the iPOEG Toolkit (i.e., resources and content). End-users indicated requiring resources such as posters, infographics, social media posts, and videos, and co-created resource content covering quick tips to get active and movement-related education and information. Generated strategies to disseminate the iPOEG Toolkit included: (1) academic presentations; (2) brief education sessions and facilitated discussions to different end-user groups; (3) engaging champions from different end-user groups; (4) emails and email reminders; (5) mainstream news outlets (e.g., newspaper, magazines, or segments on the television [i.e., local news]); and (6) social media. Co-production of the iPOEG Toolkit and dissemination plan were guided by two phases within the KTA framework to build tools that can promote the reach of the iPOEG, ultimately increasing physical activity in this population.

The impact of surgical randomised controlled trials on the management of FAI syndrome: a citation analysis.

To identify and assess the clinical impact of randomised controlled trials (RCTs) assessing the surgical management of femoroacetabular impingement syndrome (FAIS) through a citation analysis. MEDLINE, EMBASE and CENTRAL were searched from inception to April 22, 2023 for RCTs assessing the surgical management of FAIS. Study characteristics were directly abstracted from included trials and citation metrics were obtained from the Clarivate Web of Knowledge database on May 19, 2023. The continuous fragility index (CFI) was calculated for eligible outcomes. Univariate regression models were used to explore correlations between total citations per year and various study characteristics. Ten studies comprising one thousand two hundred ninetypatients were eligible for analysis. Studies were published from 2013 to 2023. Eight countries were represented across various trials with 91% being either North American or European. The mean journal impact factor of published studies was 39.684 (median 2.982; range 1.31-202.73). The mean citation density was 14.17 (range 0.33-48.67). The median CFI was 4.8 (range 1-32.2). Correlation analysis demonstrated strong and statistically significant correlations to study sample size (R = 0.75, p = 0.012), journal impact factor (R = 0.80, p = 0.006) and continuous fragility index (R = 0.95, p = 0.015). Trials assessing the surgical management of FAIS present with a wide range of clinical uptake based on citation density and are published in journals of broadly variable impact factor. Despite promising citation metrics, high-quality evidence on arthroscopy for FAIS is limited to the United States and Europe with an unclear international impact. Future knowledge translation efforts are warranted to maximise the international uptake of evidence regarding arthroscopic management of FAIS. I.

The brief history of complementary, alternative, and integrative medicine terminology and the development and creation of an operational definition

The definition of complementary, alternative, and integrative medicine (CAIM) remains dynamic and complex despite a steady increase in the popularity/usage of CAIM therapies across the globe. A lack of consistency in how these terms are defined remains a challenge for researchers, clinicians, and national and international organizations (e.g., World Health Organization, National Center for Complementary and Integrative Health) alike. In the present article, we provide a brief history of the use of these terminologies, and then outline the process we took to develop and create an operational definition of complementary, alternative, and integrative medicine. Our operational definition is the first to be informed by a systematic search of four quality-assessed information resource types, ultimately yielding 604 unique CAIM therapies. We then developed a single search string for the most common bibliographic databases using the finalized operational definition list of CAIM therapies. These CAIM therapies were searched against the Therapeutic Research Center's “Natural Medicines” database for all 604 therapies, whereby each item's scientific name and/or synonym was included as a keyword or phrase in the search string. While the current definition is not without limitations and ongoing debates still surround the field, this work is arguably a steppingstone towards enabling increased collaboration and communication amongst healthcare clinicians, researchers, and the public. This operational definition provides a foundation for developing well-coordinated research efforts that will assist in the acceptance and understanding of this field, while also focusing on adopting knowledge translation techniques and efforts for further research advancement and use.

Dissemination and implementation of clinical practice guidelines: a longitudinal, mixed-methods evaluation of the Canadian Task Force on Preventive Health Care's knowledge translation efforts.

The Canadian Task Force on Preventive Health Care (task force) develops evidence-based preventive health care guidelines and knowledge translation (KT) tools to facilitate guideline dissemination and implementation. We aimed to determine practitioners' awareness of task force guidelines and KT tools and explore barriers and facilitators to their use. The task force's KT team completed annual evaluations using surveys and interviews with primary care providers in Canada from 2014 to 2020, to assess practitioners' awareness and determinants of use of task force guidelines and tools. We transcribed interviews verbatim and double-coded them using a framework analysis approach. A total of 1284 primary care practitioners completed surveys and 183 participated in interviews. On average, 79.9% of participants were aware of the task force's 7 cancer screening guidelines, 36.2% were aware of the other 6 screening guidelines and 18.6% were aware of the 3 lifestyle or prevention guidelines. Participants identified 13 barriers and 7 facilitators to guideline and KT tool implementation; these were consistent over time. Participants identified strategies at the public and patient, provider and health systems levels to improve uptake of guidelines. Canadian primary care practitioners were more aware of task force cancer screening guidelines than its other preventive health guidelines. Over the 6-year period, participants consistently reported barriers to guideline uptake, including misalignment with patient preferences and other provincial or specialty guideline organizations. Further evaluations will assess tailored strategies to address the barriers identified.

Examining the Preferences and Priorities of Dance Educators for Dance Science Information: A Pilot Study

Introduction: The growing field of dance medicine and science provides dance educators the opportunity to incorporate evidence-based approaches into teaching practices. Incorporating knowledge produced by dance science research into evidence-based practice can improve learning and health outcomes for dance students. Guided by the Knowledge to Action (KTA) Framework, the purpose of this study was to examine the preferences and research priorities of dance educators for receiving, accessing, and implementing dance science knowledge. Methods: Ninety-seven dance educators representing a range of styles, experience, and educational settings completed an online survey. Dance educators responded to questions about the dance science topics they felt were important to their teaching practices, their preferences for receiving dance science information, and areas of dance science that need more research. Results: Responses indicated that dance science was important to participants’ teaching practices although there was variability in which dance science topics were seen as “Absolutely Essential.” Participants reported a preference for receiving dance science information through in-person methods and observations. Variability was also shown in participant responses to statements about the accessibility, format, and applicability of dance science information to teaching practices. Dance educators indicated that the easiest dance science topics to find information about were anatomy, flexibility, biomechanics, and injury prevention; dance educators also identified that more research was needed in mental health and psychology. Conclusion: The findings of this survey provide key considerations for factors such as accessibility, specificity, and resources that are user-friendly to inform future knowledge translation efforts tailored to dance educators.

Traumatic Brain Injury Intensive Evaluation and Treatment Program: Protocol for a Partnered Evaluation Initiative Mixed Methods Study.

The traumatic brain injury (TBI) Intensive Evaluation and Treatment Program (IETP) is an innovative modality for delivering evidence-based treatments in a residential, inpatient format to special operational forces service members and veterans with mild TBI. IETPs provide bundled evidence-based assessment, treatment, referral, and case management in concordance with the existing guidelines for mild TBI and commonly co-occurring comorbidities. To date, there has been no formal characterization or evaluation of the IETP to understand the determinants of implementation across the system of care. The goal of our partnered evaluation initiative (PEI) with an operational partner, the Physical Medicine and Rehabilitation National Program Office, is to facilitate the full implementation of the IETP across all 5 Veterans Health Administration TBI-Centers of Excellence (TBI-COE) and to inform minimum standards while supporting the unique characteristics of each site. This IETP partnered evaluation will describe each of the 5 TBI-COE IETP services and state of implementation to identify opportunities for adaptation and scale, characterize the relationship between patient characteristics and clinical services received, evaluate the outcomes for participants in the IETP, and inform ongoing implementation and knowledge translation efforts to support IETP expansion. In alignment with the goals of the protocol, ineffective treatment components will be targeted for deimplementation. A 3-year concurrent mixed methods evaluation using a participatory approach in collaboration with the operational partner and TBI-COE site leadership will be conducted. Qualitative observations, semistructured focus groups, and interviewing methods will be used to describe IETP, stakeholder experiences and needs, and suggestions for IETP implementation. Quantitative methods will include primary data collection from patients in the IETP at each site to characterize long-term outcomes and patient satisfaction with treatment and secondary data collection to quantitatively characterize patient-level and care system-level data. Finally, data sets will be triangulated to share data findings with partners to inform ongoing implementation efforts. Data collection began in December 2021 and is currently ongoing. The results and deliverables will inform IETP characterization, evaluation, implementation, and knowledge translation. The results of this evaluation seek to provide an understanding of the determinants affecting the implementation of IETPs. Service member, staff, and stakeholder insights will inform the state of implementation at each site, and quantitative measures will provide options for standardized outcome measures. This evaluation is expected to inform national Physical Medicine and Rehabilitation Office policies and processes and knowledge translation efforts to improve and expand the IETP. Future work may include cost evaluations and rigorous research, such as randomized controlled trials. DERR1-10.2196/44776.

Real-World Cost-Effectiveness Analysis: How Much Uncertainty Is in the Results?

Cost-effectiveness analyses of new cancer treatments in real-world settings (e.g., post-clinical trials) inform healthcare decision makers about their healthcare investments for patient populations. The results of these analyses are often, though not always, presented with statistical uncertainty. This paper identifies five ways to characterize statistical uncertainty: (1) a 95% confidence interval (CI) for the incremental cost-effectiveness ratio (ICER); (2) a 95% CI for the incremental net benefit (INB); (3) an INB by willingness-to-pay (WTP) plot; (4) a cost-effectiveness acceptability curve (CEAC); and (5) a cost-effectiveness scatterplot. It also explores their usage in 22 articles previously identified by a rapid review of real-world cost effectiveness of novel cancer treatments. Seventy-seven percent of these articles presented uncertainty results. The majority those papers (59%) used administrative data to inform their analyses while the remaining were conducted using models. Cost-effectiveness scatterplots were the most commonly used method (34.3%), with 40% indicating high levels of statistical uncertainty, suggesting the possibility of a qualitatively different result from the estimate given. Understanding the necessity for and the meaning of uncertainty in real-world cost-effectiveness analysis will strengthen knowledge translation efforts to improve patient outcomes in an efficient manner.

PHYSICAL ACTIVITY, COGNITIVE HEALTH, AND LONGEVITY IN OLDER ADULTHOOD

Abstract Research suggests that physical activity (PA) protects against cognitive impairment in older adulthood; however, the extent to which PA engagement throughout older adulthood influences the simultaneous risk of transitioning to cognitively impaired states and death is unclear. Applying coordinated data analysis across 14 studies, multi-state survival models (MSM) were independently fit to data from fourteen longitudinal studies (NTotal=52,039). PA was synthesized across studies using the metabolic equivalent of task approach. Adjusting for demographics and chronic conditions, meta-analytic results indicated that engaging in more PA was associated with a reduced risk of transitioning from no cognitive impairment to mildly impaired cognitive functioning (HR=0.94, 95%CI’s=0.89,0.99) and death (HR=0.72, 95%CI’s=0.65,0.80). Based on MSM estimates, multinomial regression models computed total life expectancy stratified by national PA recommendations. Meta-analytic results indicate a positive linear effect of PA, such that more PA is associated with longevity. This presentation will include discussion of knowledge translation efforts.

Transdisciplinary Implementation of Heart Rate Monitors During Inpatient Rehabilitation

<h3>Research Objectives</h3> Clinical practice guidelines demonstrate clear benefits of cardiovascular intensity on movement recovery after a neurologic injury, particularly walking recovery. However, research shows a lack of sufficient intensity during inpatient rehabilitation for both physical and occupational therapy sessions. Knowledge translation efforts and implementation of wearable heart rate monitors have been shown to support increased intensity during physical therapy directed interventions. Through a year-long effort, we have investigated the feasibility of implementing transdisciplinary heart rate monitoring informed by the knowledge to action cycle. <h3>Design</h3> 1 year transdisciplinary feasibility study. <h3>Setting</h3> 114 bed inpatient rehabilitation hospital. <h3>Participants</h3> 16 clinicians (9 physical therapists, 6 occupational therapists, 1 recreational therapist). <h3>Interventions</h3> 1 year, 4 phase Multicomponent Knowledge Translation initiative using the Knowledge to Action Cycle Framework. <h3>Main Outcome Measures</h3> -Clinician Participation (session count). Clinician Satisfaction, Clinician Perceived Relevance (summative feedback questionnaire). <h3>Results</h3> This four phase study will end August 2022. The first 13-week phase included 6 therapists (4 PTs, 2 OTs) that engaged in 70 sessions with an average of 5.38 sessions/week. The second phase included 10 therapists (6 PTs, 4 OTs), engaging in 152 sessions, averaging 11.69 sessions/week. The third phase included 13 therapists (8 PTs, 5 OTs), engaging in 436 sessions, averaging 33 sessions/week. The final phase included 16 therapists (9 PTs, 6 OTs, 1 RT), engaging in 503 sessions, averaging 38 sessions/week. In the one year follow up survey responses, 81% of pilot group users reported high satisfaction with heart rate monitor use. Clinician perceived relevance of heart monitor use differed for persons with non-neurological and neurological diagnoses. <h3>Conclusions</h3> Current data suggests that implementation of wearable heart rate monitoring devices for a transdisciplinary inpatient rehab team is feasible and supported by a multicomponent knowledge to action framework. Majority of pilot group participants were very satisfied with participation in heart rate monitoring interventions and highest perceived clinical relevance was for patients with neurological injuries, consistent with clinical practice guideline recommendations. Future studies will expand implementation among onsite clinicians, further investigate barriers of use, and determine optimal interventions for promoting high intensity and specificity within each discipline. <h3>Author(s) Disclosures</h3> None.

Implementation of Subluxation Stimulation Protocol post stroke in Inpatient Rehabilitation setting

<h3>Research Objectives</h3> Glenohumeral subluxation is a common post-stroke complication, affecting up to 80% of patients. Long duration neuromuscular electrical stimulation has been shown to reduce subluxation, decrease shoulder pain, and can improve motor outcomes for the affected extremity. This poster aims to investigate the feasibility of implementing a long duration subluxation stimulation protocol for the hemiparetic upper extremity post stroke while in inpatient rehabilitation. <h3>Design</h3> Feasibility study 12-month period. <h3>Setting</h3> Inpatient rehabilitation hospital. <h3>Participants</h3> 9 occupational therapists serving dedicated stroke unit. <h3>Interventions</h3> 1 year, 2 phase multicomponent knowledge translation interventions. Attended and unattended neuromuscular electrical stimulation to support glenohumeral subluxation for 3 – 6 hours, 5 days a week. <h3>Main Outcome Measures</h3> Number of referring therapists Average number of hours per day of subluxation stimulation <h3>Clinician survey results</h3> barriers, satisfaction, relevance. <h3>Results</h3> Nineteen patients received long duration subluxation stimulation over the course of this year, 13 patients during phase 1 and 7 during phase 2. Phase 1 consisted of 10 months of providing a goal of 3.5 hours of subluxation stimulation for no more than 2 patients per day facilitated by supervised rehabilitation technician. Phase 2 consisted of 2 months of providing a goal of 6 hours for up to 8 patients per day. Data collection during phase 2 shows an average of 4.36 actual stimulation hours per day. Eight of nine occupational therapists who received training (didactic and experiential) on this protocol referred at least 1 patient to this service. After 12 months of participation, all survey respondents reported that they were 'very satisfied' with this protocol and that they 'strongly agree' that this protocol has a positive effect on patient outcomes and is relevant to persons with stroke during inpatient rehabilitation. <h3>Conclusions</h3> Occupational therapists at an inpatient facility demonstrate adoption of a long duration subluxation stimulation protocol when facilitated by a supervised rehabilitation technician. Knowledge translation efforts and innovative service provision techniques have led to increased duration of stimulation and reduced clinician's perceived barriers of conflicting treatment demands and time limitations. <h3>Author(s) Disclosures</h3> None.

Vascular Cognitive Impairment After Mild Stroke: Connectomic Insights, Neuroimaging, and Knowledge Translation.

Contemporary stroke assessment protocols have a limited ability to detect vascular cognitive impairment (VCI), especially among those with subtle deficits. This lesser-involved categorization, termed mild stroke (MiS), can manifest compromised processing speed that negatively impacts cognition. From a neurorehabilitation perspective, research spanning neuroimaging, neuroinformatics, and cognitive neuroscience supports that processing speed is a valuable proxy for complex neurocognitive operations, insofar as inefficient neural network computation significantly affects daily task performance. This impact is particularly evident when high cognitive loads compromise network efficiency by challenging task speed, complexity, and duration. Screening for VCI using processing speed metrics can be more sensitive and specific. Further, they can inform rehabilitation approaches that enhance patient recovery, clarify the construct of MiS, support clinician-researcher symbiosis, and further clarify the occupational therapy role in targeting functional cognition. To this end, we review relationships between insult-derived connectome alterations and VCI, and discuss novel clinical approaches for identifying disruptions of neural networks and white matter connectivity. Furthermore, we will frame knowledge translation efforts to leverage insights from cutting-edge structural and functional connectomics research. Lastly, we highlight how occupational therapists can provide expertise as knowledge brokers acting within their established scope of practice to drive substantive clinical innovation.

Iron surveillance and management in gastrointestinal oncology patients: A national survey of physician practice.

e13644 Background: In 2018, there were an estimated 4.8 million new cases of gastrointestinal (GI) cancers worldwide and 3.4 million related deaths. Iron deficiency (ID) is a frequent complication of GI malignancy that eventually manifests as iron deficiency anemia (IDA). Early recognition and treatment of ID/IDA in GI oncology patients is an important aspect of care. Traditional serum ferritin monitoring and oral iron supplementation hold limited diagnostic and therapeutic value in this population as it may be falsely elevated and confounded by poor absorption and blood loss, respectively. Therefore, we conducted a survey of Canadian physicians to assess disparities in IDA surveillance and management practices in GI cancer patients. Methods: From February 2020 to September 2021, a 20-question electronic survey was sent to Canadian medical oncologists (MO), surgical oncologists (SO), and gastroenterologists (GE). The survey collected information on four domains: demographics, screening practices, treatment practices, and knowledge of the latest guidelines of ID/IDA. Analysis was conducted using descriptive statistics. Results: A total of 108 (55 GE, 19 SO, and 34 MO) of the 872 (12.4%) invited physicians completed the survey. A greater proportion of GE (70.9% compared to 36.8% of SO, and 26.5% of MO) measured baseline iron parameters. Of these, a slight trend of iron parameters were being measured mainly at initial consult (61.5% of GE, 85.7% of SO, and 44.4% of MO), with little continuing surveillance throughout treatment course. Most physicians who measured iron parameters relied on ferritin mainly (82.1% of GE, 100% of SO), while MO were evenly distributed in their evaluation of ferritin (88.9%), serum iron (100%), total iron binding capacity (100%) and iron saturation (88.9%). The majority supplemented iron if ID/IDA was identified prior to systemic/surgical oncologic treatment (94.2% of GE, 85.7% SO, and 66.7% of MO). Of these, parenteral iron was the preferred modality for SO (85.7%), while oral iron was preferred among GE (82.8%) and MO (55.6%). The majority of physicians (81.3%) were not aware of the ASH/ASCO guidelines regarding the use of erythropoiesis stimulating agents in conjunction with parenteral iron supplementation for treatment anemia in this setting (92% of GE, 66.7% of SO, and 80.9% of MO). Conclusions: Results from this Canadian survey suggests a disparity in practice pattern for IDA management between different specialties caring for GI oncology patients. Moreover, there appears to be a gap in knowledge and thus a gap in care surrounding evidence-based IDA management principles which may be contributing to poor clinical outcomes. Focused knowledge translation and exchange efforts are required to improve treatment of ID/IDA in patients with GI cancer nationally.

P-42 Iron surveillance and management in gastrointestinal oncology patients: A national survey of physician practice

In 2018, there were an estimated 4.8 million new cases of gastrointestinal (GI) cancers worldwide and 3.4 million related deaths. Iron deficiency (ID) is a frequent complication of GI malignancy that eventually manifests as iron deficiency anemia (IDA). Early recognition and treatment ofID/IDA in GI oncology patients is an important aspect of care. Traditional serum ferritin monitoring and oral iron supplementation hold limited diagnostic and therapeutic value in this population as it may be falsely elevated and confounded by poor absorption and blood loss, respectively. Therefore, we conducted a survey ofCanadian physicians to assess disparities in IDA surveillance and management practices in GI cancer patients. From February 2020 to September 2021, a 20-question electronic survey was sent to Canadian medical oncologists (MO), surgical oncologists (SO), and gastroenterologists (GE). The survey collected information on four domains: demographics, screening practices, treatment practices, and knowledge of the latest guidelines of ID/IDA. Analysis was conducted using descriptive statistics. A total of 108 (55 GE, 19 SO, and 34 MO) of the 872 (12.4%) invited physicians completed the survey. A greater proportion of GE (70.9% compared to 36.8% of SO, and 26.5% of MO) measured baseline iron parameters. Of these, a slight trend of iron parameters were being measured mainly at initial consult (61.5%of GE, 85.7% of SO, and 44.4% of MO), with little continuing surveillance throughout treatment course. Most physicians who measured iron parameters relied on ferritin mainly (82.1% of GE, 100% of SO), while MO were evenly distributed in their evaluation of ferritin (88.9%), serum iron (100%), total iron binding capacity (100%) and iron saturation (88.9%). The majority supplemented iron if ID/IDA was identified prior to systemic/surgical oncologic treatment (94.2% of GE, 85.7% SO, and 66.7% of MO). Of these, parenteral iron was the preferred modality for SO (85.7%), while oral iron was preferred among GE (82.8%) and MO (55.6%). The majority of physicians (81.3%) were not aware of the ASH/ASCO guidelines regarding the use of erythropoiesis stimulating agents in conjunction with parenteral iron supplementation for treatment anemia in this setting (92% of GE,66.7% of SO, and 80.9% of MO). Results from this Canadian survey suggests a disparity in practice pattern for IDA management between different specialties caring for GI oncology patients. Moreover, there appears to be a gap in knowledge and thus a gap in care surrounding evidence-based IDA management principles which may be contributing to poor clinical outcomes. Focused knowledge translation and exchange efforts are required to improve treatment of ID/IDA in patients with GI cancer nationally.

Mapping outcomes for recovery of consciousness in studies from 1986 to 2020: a scoping review protocol

IntroductionHistorically, heterogeneous outcome assessments have been used to measure recovery of consciousness in patients with disorders of consciousness (DoC) following traumatic brain injury (TBI), making it difficult to compare across...

Improving the patient-reported outcome sections of clinical trial protocols: a mixed methods evaluation of educational workshops

IntroductionFailure to incorporate key patient-reported outcome (PRO) content in trial protocols affects the quality and interpretability of the collected data, contributing to research waste. Our group developed evidence-based training specifically addressing PRO components of protocols. We aimed to assess whether 2-day educational workshops improved the PRO completeness of protocols against consensus-based minimum standards provided in the SPIRIT-PRO Extension in 2018.MethodAnnual workshops were conducted 2011–2017. Participants were investigators/trialists from cancer clinical trials groups. Although developed before 2018, workshops covered 15/16 SPIRIT-PRO items. Participant feedback immediately post-workshop and, retrospectively, in November 2017 was summarised descriptively. Protocols were evaluated against SPIRIT-PRO by two independent raters for workshop protocols (developed post-workshop by participants) and control protocols (contemporaneous non-workshop protocols). SPIRIT-PRO items were assessed for completeness (0 = not addressed, 10 = fully addressed). Mann–Whitney U tests assessed whether workshop protocols scored higher than controls by item and overall.ResultsParticipants (n = 107) evaluated the workshop positively. In 2017, 16/41 survey responders (39%) reported never applying in practice; barriers included role restrictions (14/41, 34%) and lack of time (5/41, 12%). SPIRIT-PRO overall scores did not differ between workshop (n = 13, median = 3.81/10, interquartile range = 3.24) and control protocols (n = 9, 3.51/10 (2.14)), (p = 0.35). Workshop protocols scored higher than controls on two items: ‘specify PRO concepts/domains’ (p = 0.05); ‘methods for handling missing data’ (p = 0.044).ConclusionAlthough participants were highly satisfied with these workshops, the completeness of PRO protocol content generally did not improve. Additional knowledge translation efforts are needed to assist protocol writers address SPIRIT-PRO guidance and avoid research waste that may eventuate from sub-optimal PRO protocol content.

Development and Refinement of the American Occupational Therapy Association's Knowledge Translation Toolkit.

Occupational therapy practitioners are expected to translate promising discoveries from empirical research into routine practice with their clients. However, complex barriers can influence practitioners' knowledge translation (KT) efforts, leading the American Occupational Therapy Association's Evidence-Based Practice (EBP) group to develop the KT Toolkit tailored to the perceived needs of occupational therapists and occupational therapy assistants. To identify common barriers to implementing EBPs and potential strategies to support EBP uptake. Cross-sectional survey. United States. Occupational therapy practitioners. Data underwent descriptive and directed content analysis, the latter of which was guided by the Consolidated Framework for Implementation Research. Occupational therapy survey respondents (N = 818) identified common EBP implementation barriers (e.g., lack of time and resources, difficulty understanding research findings). Initial KT Toolkit content was developed to address these barriers and included resources for searching for, analyzing, and applying evidence in practice. Survey findings have informed the development of the KT Toolkit, which includes resources designed to support occupational therapy practitioners' EBP implementation efforts. This KT Toolkit is available at AOTA.org and will be continuously revised and updated on an ongoing basis. What This Article Adds: Several barriers limit the extent to which occupational therapy practitioners can implement evidence with their client populations. The KT Toolkit is directly informed by practitioner input and provides resources to support practitioners in their efforts to translate knowledge into real-world practice.