Percent Of Reports Research Articles

An approach to evaluate the quality of radiological reports in Head and Neck cancer loco-regional staging: experience of two Academic Hospitals.

To evaluate the quality of the reports of loco-regional staging computed tomography (CT) or magnetic resonance imaging (MRI) in head and neck (H&N) cancer. Consecutive reports of staging CT and MRI of all H&N cancer cases from 2018 to 2020 were collected. We created lists of quality indicators for tumor (T) for each district and for node (N). We marked these as 0 or 1 in the report calculating a report score (RS) and a maximum sum (MS) of each list. Two radiologists and two otolaryngologists in consensus classified reports as low quality (LQ) if the RS fell in the percentage range 0-59% of MS and as high quality (HQ) if it fell in the range 60-100%, annotating technique and district. We evaluated the distribution of reports in these categories. Two hundred thirty-seven reports (97 CT and 140 MRI) of 95 oral cavity, 52 laryngeal, 47 oropharyngeal, 19 hypo-pharyngeal, 14 parotid, and 10 nasopharyngeal cancers were included. Sixty-six percent of all the reports were LQ for T, 66% out of all the MRI reports, and 65% out of all CT reports were LQ. Eight-five percent of reports were HQ for N, 85% out of all the MRI reports, and 82% out of all CT reports were HQ. Reports of oral cavity, oro-nasopharynx, and parotid were LQ, respectively, in 76%, 73%, 100% and 92 out of cases. Reports of staging CT/MRI in H&N cancer were LQ for T description and HQ for N description.

Research Review: Conflicts of Interest (COIs) in autism early intervention research - a meta-analysis of COI influences on intervention effects.

The presence, types, disclosure rates, and effects of conflicts of interest (COIs) on autism early intervention research have not previously been studied. The purpose of this study was to examine these issues. This study is a secondary analysis of a comprehensive meta-analysis of all group-design, nonpharmacological early intervention autism research conducted between 1970 and 2018. We coded reports for the presence/absence of COI statements, the types of COIs that were disclosed, and for 8 types of COIs, including (a) the author developed the intervention, (b) the author is affiliated with a clinical provider, (c) the author is employed by a clinical provider, (d) the author is affiliated with an institution that trains others to use the intervention, (e) the author receives payment or royalties related to the intervention, (f) the study was funded by an intervention provider, (g) the study used a commercially available measure developed by the author, and (h) proceeds of the intervention fund the author's research. Frequencies and proportions were calculated to determine prevalence of COIs and COI disclosures. Meta-analysis was used to estimate summary effects by COI type and to determine if they were larger than for reports with no coded COIs. Seventy percent of reports were coded for≥1 COI, but only~6% of reports contained COI statements fully accounting for all coded COIs. Metaregressions did not detect significant influences of any COI type on summary effects; however, point estimates for each COI type were larger than for reports with no coded COIs. Conflicts of interest are prevalent but under-reported in autism early intervention research. Improved reporting practices are necessary for researcher transparency and would enable more robust examination of the effects of COIs on research outcomes.

PP65 Methods Applied For Systematic Reviews Of Economic Evaluations In Health Technology Assessment

IntroductionWhen making decisions in health care, it is essential to consider economic evidence about an intervention. The objective of this study was to analyze the methods applied for systematic reviews of economic evaluations in Health Technology Assessment (HTA) and to identify common challenges.MethodsWe manually searched the webpages of HTA organizations and included HTA-reports published since 2015. Prerequisites for inclusion were the conduct of a systematic review of economic evaluations in at least one electronic database and the use of the English, German, French, or Spanish language. Methodological features were extracted in standardized tables. We prepared descriptive statistical (e.g., median, range) measures to describe the applied methods. Data were synthesized in a structured narrative way.ResultsEighty-three reports were included in the analysis. We identified inexplicable heterogeneity, particularly concerning literature search strategy, data extraction, assessment of quality, and applicability. Furthermore, process steps were often missing or reported in a nontransparent way. The use of a standardized data extraction form was indicated in one-third of reports (32 percent). Fifty-four percent of authors systematically appraised included studies. In 10 percent of reports, the applicability of included studies was assessed. Involvement of two reviewers was rarely reported for the study selection (43 percent), data extraction (28 percent), and quality assessment (39 percent).ConclusionsThe methods applied for systematic reviews of economic evaluations in HTA and their reporting quality are very heterogeneous. Efforts toward a detailed, standardized guidance for the preparation of systematic reviews of economic evaluations definitely seem necessary. A general harmonization and improvement of the applied methodology would increase their value for decision makers.

Semiautomated System for Nonurgent, Clinically Significant Pathology Results.

Failure of timely test result follow-up has consequences including delayed diagnosis and treatment, added costs, and potential patient harm. Closed-loop communication is key to ensure clinically significant test results (CSTRs) are acknowledged and acted upon appropriately. A previous implementation of the Alert Notification of Critical Results (ANCR) system to facilitate closed-loop communication of imaging CSTRs yielded improved communication of critical radiology results and enhanced adherence to institutional CSTR policies. This article extends the ANCR application to pathology and evaluates its impact on closed-loop communication of new malignancies, a common and important type of pathology CSTR. This Institutional Review Board-approved study was performed at a 150-bed community, academically affiliated hospital. ANCR was adapted for pathology CSTRs. Natural language processing was used on 30,774 pathology reports 13 months pre- and 13 months postintervention, identifying 5,595 reports with malignancies. Electronic health records were reviewed for documented acknowledgment for a random sample of reports. Percent of reports with documented acknowledgment within 15 days assessed institutional policy adherence. Time to acknowledgment was compared pre- versus postintervention and postintervention with and without ANCR alerts. Pathologists were surveyed regarding ANCR use and satisfaction. Acknowledgment within 15 days was documented for 98 of 107 (91.6%) pre- and 89 of 103 (86.4%) postintervention reports (p = 0.2294). Median time to acknowledgment was 7 days (interquartile range [IQR], 3, 11) preintervention and 6 days (IQR, 2, 10) postintervention (p = 0.5083). Postintervention, median time to acknowledgment was 2 days (IQR, 1, 6) for reports with ANCR alerts versus 6 days (IQR, 2.75, 9) for reports without alerts (p = 0.0351). ANCR alerts were sent on 15 of 103 (15%) postintervention reports. All pathologists reported that the ANCR system positively impacted their workflow; 75% (three-fourths) felt that the ANCR system improved efficiency of communicating CSTRs. ANCR expansion to facilitate closed-loop communication of pathology CSTRs was favorably perceived and associated with significant improved time to documented acknowledgment for new malignancies. The rate of adherence to institutional policy did not improve.

VP31 Health Technology Assessment Evidence On E-Health/M-Health Technologies: Fields For Improvement

INTRODUCTION:Evaluation is crucial for integration of e-Health/m-Health applications into healthcare systems and their further sustainability. However, evaluation of these technologies is often challenged by poor quality of research design, lack of common outcome indicators and no consensus on appropriate methodology. Health Technology Assessment (HTA) could offer a sound methodological basis for these evaluations (1). The aim of this study was to look for HTA reports on e-Health/m-Health technologies and to describe their characteristics and analyze transparency, consistency and thoroughness, with the goal to detect fields for improvements.METHODS:A literature search was performed on PubMed, ISI WOS and University of York – Centre for Reviews and Dissemination (CRD) electronic databases, in order to identify reports that had evaluated e-Health/m-Health technologies, published until 1 April 2016. We used the International Network of Agencies for Health Technology Assessment (INAHTA) checklist (2) to evaluate transparency and consistency of included reports. We also assessed thoroughness of reports by checking the presence of the domains suggested by European Network for HTA (EUnetHTA) HTA Core Model (3).RESULTS:Twenty-eight reports published between 1999 and 2015 were included. Most of reports (71.4 percent) were delivered by non-European countries and only 35.7 percent were classified as full reports. E-Health/m-Health technologies from several fields of medicine, mostly cardiology (21.4 percent) and psychiatry (17.9 percent) were evaluated. Policy question was clearly defined in 32.1 percent of reports, whereas ethical (21.4 percent) and legal implications (3.6 percent) were domains with the least presence. With respect to the EUnetHTA Core Model, around 70 percent of reports dealt with effectiveness and economic evaluation, more than 50 percent described health problem and around 40 percent organizational and social aspects. Remaining domains were evaluated in very few reports.CONCLUSIONS:E-Health/m-Health technologies are increasingly present in the field of HTA. Our work identified a number of elements not being included in the available reports. Several reports missed to respond to relevant assessment elements especially ethical, social and organizational implications. There is a need for strengthening and standardizing methods used for the evaluation of these technologies.

Assessing vaccine safety within Ontario's Universal Influenza Immunization Program, 2012-2013 to 2014-2015.

Influenza vaccine is recommended to prevent influenza-related morbidity and mortality. Post-marketing surveillance of adverse events following influenza vaccine is essential to monitor vaccine safety, inform immunization program planning and evaluation, and build confidence in immunization. To summarize adverse events following immunization (AEFIs) reported after receipt of influenza vaccines administered within the Universal Influenza Immunization Program in Ontario. AEFIs following administration of influenza vaccines between September 1, 2012 and August 31, 2015 were extracted from the Integrated Public Health Information System (iPHIS) on September 1, 2015. Events were grouped by provincial surveillance definitions. Reporting rates were calculated using provincial population estimates or net doses distributed as the denominator. The standard World Health Organization definition of serious AEFIs was used. There were 12.1 million doses of influenza vaccine distributed in Ontario and 528 AEFIs reported following influenza vaccines administered over three seasons. The annualized reporting rate was 4.4 per 100,000 doses distributed with a significant decreasing trend over time (p<0.05). The median age was 39.6 years (range six months-96 years); children under four years of age had the highest reporting rate (3.5 per 100,000 population). Disproportionate reporting among females was observed (76.5 percent), most notably in those 18 years and older. The most frequently reported events were injection site reactions (36.2 percent of reports). Others included allergic skin reactions (21.1 percent) and rashes (17.3 percent). Serious AEFIs were rare with a reporting rate of 1.6 per million doses distributed. This assessment found a low rate of reported adverse events following influenza vaccines administered in Ontario. Most reported events were mild and resolved completely. The findings were consistent with the very good safety profile of influenza vaccines.

40-Year Trends in Meal and Snack Eating Behaviors of American Adults

BackgroundUnderstanding changes in profiles of eating behaviors over time may provide insights into contributors to upward trajectories of obesity in the US population. Yet little is known about whether or not characteristics of meal and snack eating behaviors reported by adult Americans have changed over time. ObjectiveTo examine time trends in the distribution of day’s intake into individual meal and snack behaviors and related attributes in the US adult population. DesignThe study was observational with cross-sectional data from national surveys fielded over 40 years. Participants/settingNationally representative dietary data from nine National Health and Nutrition Examination Surveys conducted from 1971-1974 to 2009-2010 (N=62,298 participants aged 20-74 years) were used to describe eating behaviors. Outcomes examinedThe respondent-labeled eating behaviors examined included main meals (breakfast, lunch, and dinner), and snacks (before breakfast, between breakfast and lunch, between lunch and dinner, after dinner, or other). For each eating behavior, percent of reporters, relative contribution to 24-hour energy intake, the clock time of report, and intermeal/snack intervals were examined. Statistical analysisMultivariable logistic and linear regression methods for analysis of complex survey data adjusted for characteristics of respondents in each survey. ResultsOver the 40-year span examined reports of each individual named main meal (or all three main meals) declined, but reports of only two out of three meals or the same meal more than once increased; the percentage of 24-hour energy from snacks reported between lunch and dinner or snacks that displaced meals increased; clock times of breakfast and lunch were later, and intervals between dinner and after-dinner snack were shorter. Changes in several snack reporting behaviors (eg, report of any snack or ≥2 snacks), were significant in women only. ConclusionsSeveral meal and snack eating behaviors of American adults changed over time, with a greater change in snack behaviors of women relative to men.

Clinical Syndrome Associated with Zolpidem Ingestion in Dogs: 33 Cases (January 1998‐July 2000)

Zolpidem is a nonbenzodiazepine hypnotic of the imidazopyridine class that is used to treat insomnia in humans. Zolpidem binds selectively to the benzodiazepine omega‐1 receptor and increases the frequency of chloride channel opening, which results in inhibition of neuronal excitation. A retrospective study was conducted of zolpidem ingestion in dogs that were reported to the ASPCA Animal Poison Control Center (APCC) between January 1998 and July 2000. Data analysis included amount ingested, clinical effects, and time of onset of signs. Thirty‐three reports of zolpidem ingestion in dogs (ranging in age from 5 months to 16 years) were evaluated. Approximate ingested dosages ranged from 0.24 to 21 mg/kg. Clinical signs reported included ataxia (18 dogs; 54.5%), hyperactivity (10 dogs; 30.3%), vomiting (7 dogs; 21.2%), and lethargy (5 dogs; 15.2%), as well as panting, disorientation, nonspecific behavior disorder, and hypersalivation (4 dogs each sign; 12.1%). Other signs reported include tachycardia, tremors, apprehension, vocalization, hypersalivation, weakness, and hyperesthesia. In 85% percent of reports, clinical signs developed within 1 hour and usually resolved within 12 hours. Although central nervous system (CNS) depression is reported as a primary effect of zolpidem in humans and would also be expected in dogs, information obtained from this study indicates that some dogs may exhibit a paradoxical excitation reaction. This effect appears to vary among individual dogs.

Clinical syndrome associated with zolpidem ingestion in dogs: 33 cases (January 1998-July 2000).

Zolpidem is a nonbenzodiazepine hypnotic of the imidazopyridine class that is used to treat insomnia in humans. Zolpidem binds selectively to the benzodiazepine omega-1 receptor and increases the frequency of chloride channel opening, which results in inhibition of neuronal excitation. A retrospective study was conducted of zolpidem ingestion in dogs that were reported to the ASPCA Animal Poison Control Center (APCC) between January 1998 and July 2000. Data analysis included amount ingested, clinical effects, and time of onset of signs. Thirty-three reports of zolpidem ingestion in dogs (ranging in age from 5 months to 16 years) were evaluated. Approximate ingested dosages ranged from 0.24 to 21 mg/kg. Clinical signs reported included ataxia (18 dogs; 54.5%), hyperactivity (10 dogs; 30.3%), vomiting (7 dogs; 21.2%), and lethargy (5 dogs; 15.2%), as well as panting, disorientation, nonspecific behavior disorder, and hypersalivation (4 dogs each sign; 12.1%). Other signs reported include tachycardia, tremors, apprehension, vocalization, hypersalivation, weakness, and hyperesthesia. In 85% percent of reports, clinical signs developed within 1 hour and usually resolved within 12 hours. Although central nervous system (CNS) depression is reported as a primary effect of zolpidem in humans and would also be expected in dogs, information obtained from this study indicates that some dogs may exhibit a paradoxical excitation reaction. This effect appears to vary among individual dogs.

Digital Diffusion in Newsrooms: The Uneven Advance of Computer-Assisted Reporting

A survey of CAR trainers found that half of reporters at respondent newspapers do not routinely use the Internet for research. Trainers estimate that 10 percent of reporters used computers for data analysis.

On the potential cost effectiveness of scientific audits.

The rationale for the routine performance of scientific audits has been previously discussed, and it has been proposed that independent professionals audit scientific data just as certified public accountants in independent public accounting firms audit financial data (1-4). Scientific audits would typically require the examination of data in laboratory notebooks and other work sheets, upon which research publications are based. Examples of such audits have been publicized recently, although these represent audits which have been conducted relatively inefficiently, over periods of several years per audit, and which have only been conducted due to the persistence of whistleblowers suspecting scientific fraud (5, 6). A detailed report has also appeared on the results of an audit of the research activities of a particular individual, where the audit was limited solely to an examination of the research publications themselves for errors and discrepancies (7). It should be emphasized that the purpose of conducting scientific audits is not only to detect fabrication of experimental results but also to monitor presumably more prevalent, non-fraudulent, inappropriate practices, such as misrepresentation of data, inaccurate reporting, and departure from institutional guidelines for handling hazardous materials, working with human subjects, etc. Two concerns which have been raised concerning the performance of scientific audits relate to cost. What would they cost, and who would pay for them? These questions, however, may be turned around. What does it cost not to conduct such audits, and who pays for that? An assumption often made is that science is self-correcting, that sooner or later the truth will be revealed because of the need to replicate experiments of others for independent verification of novel findings (8). Testimony recently presented at a U.S. congressional hearing suggests that the self-correcting manner in which science advances represents a very slow and inefficient process for uncovering scientific fraud (5, 6, 9). Data from a survey of university scientists was also presented, indicating ". . . a reluctance to take prompt, corrective action not only when an investigator suspects another of misconduct but also should the investigator discover flaws in his or her own published reports-whether the flaws were the result of honest error or fraud"; (10). The uncritical acceptance by established scientists that the self-correcting process works compounds the problem. The Editor of Science has written that";. . . 99.9999 percent of reports are accurate and truthful. . ."; (8). If indeed only 0.0001% of published reports were inaccurate or untruthful, there would be little justification for scientific audits. However, congressional testimony from the National Institutes of Health (NIH) revealed that";. . . the NIH Director's office has handled an average of 15-20 allegations and reports of misconduct annually in its extramural programs, which supports the work of approximately 50,000 scientists"; (11). As I shall attempt to demonstrate, since NIH alone receives fraud-related complaints concerning the work of at least 0.03% of scientists it supports in other institutions, and since evidence indicates that the incidence of fraud is considerably greater than 0.03% (10, 12), the need to audit data is justifiable on the basis of being cost effective.