Recruitment Sources Research Articles

Success and failure factors of patient recruitment for industry-sponsored clinical trials and the role of the electronic health records—a qualitative interview study in the Nordic countries

BackgroundPatient recruitment for clinical trials is challenging—only approximately one third of all trials recruit their participants as planned. The pharmaceutical industry’s views on recruitment success have not been comprehensively investigated, although the industry globally conducts almost one third of all clinical drug trials. This study explored patient recruitment success and failure factors and the role of electronic health records (EHR) in the recruitment of trial participants in the Nordic countries.MethodsA descriptive qualitative interview study was conducted with 21 representatives of the pharmaceutical industry or contract research organizations operating in Finland, Sweden, Denmark, and Norway. The interviews covered 34 clinical pre-market drug trials. Qualitative data were analyzed using inductive content analysis.ResultsFour main categories were derived to represent both success and failure factors, whereas a fifth category represented only failure factors: (1) sponsor-related (protocol and trial preparation and feasibility evaluations), (2) site/investigator-related (access to patients, motivation, commitment and resources), (3) patient-related recruitment factors (medical need, patients’ role in their care and attitudes towards trials), (4) Sponsor—sites—patients collaboration factors, and (5) start-up related factors. EHR was the most important source of recruitment, utilized in 29 out of 34 trials discussed. Revision of the legislation regulating the secondary use of EHR was highlighted as the most effective measure to facilitate the use of EHR in recruitment of trial participants.ConclusionsThe industry representatives recognized quite well their own role in contributing to the success or failure of the recruitment: to facilitate recruitment of trial participants, many obstacles can be avoided with better trial preparation and proper feasibility evaluations. As access to patients represents one of the key success or failure factors of recruitment, and as the EHR is regarded the main source of searching for and finding patients, the development of EHR utilization appears to represent a powerful tool to improve patient recruitment.

A national recruitment strategy for HIV-serodiscordant partners living in Canada for the Positive Plus One study: a mixed-methods study

BackgroundWith the recent shift in focus to addressing HIV risk within relationships and couple-based interventions to prevent HIV transmission, successful recruitment of individuals involved in HIV-serodiscordant relationships is crucial. This paper evaluates methods used by the Positive Plus One (PP1) study to recruit and collect data on a diverse national sample of dyads and individuals involved in current or past HIV-serodiscordant relationships, discusses the strengths and limitations of the recruitment approach, and makes recommendations to inform the interpretation of study results and the design of future studies.MethodsPP1 used a multi-pronged approach to recruit adults involved in a current or past HIV-serodiscordant relationship in Canada from 2016 to 2018 to complete a survey and an interview. Upon survey completion, index (first recruited) partners were invited to recruit their primary current HIV-serodiscordant partner. We investigated participant enrollment by recruitment source, participant-, relationship-, and dyad-level sociodemographic characteristics, missing data, and correlates of participation for individuals recruited by their partners.ResultsWe recruited 613 participants (355 HIV-positive; 258 HIV-negative) across 10 Canadian provinces, including 153 complete dyads and 307 individuals who participated alone, and representing 460 HIV-serodiscordant relationships. Among those in current relationships, HIV-positive participants were more likely than HIV-negative participants to learn of the study through an ASO staff member (36% v. 20%, p < 0.001), ASO listserv/newsletter (12% v. 5%, p = 0.007), or physician/staff at a clinic (20% v. 11%, p = 0.006). HIV-negative participants involved in current relationships were more likely than HIV-positive participants to learn of the study through their partner (46% v. 8%, p < 0.001). Seventy-eight percent of index participants invited their primary HIV-serodiscordant partner to participate, and 40% were successful. Successful recruitment of primary partners was associated with longer relationship duration, higher relationship satisfaction, and a virally suppressed HIV-positive partner.ConclusionsOur findings provide important new information on and support the use of a multi-pronged approach to recruit HIV-positive and HIV-negative individuals involved in HIV-serodiscordant relationships in Canada. More creative strategies are needed to help index partners recruit their partner in relationships with lower satisfaction and shorter duration and further minimize the risk of “happy couple” bias.

Strategies to Identify and Recruit Women at High Risk for Breast Cancer to a Randomized Controlled Trial of Web-based Decision Support Tools.

We describe five strategies to identify and successfully recruit a large cohort of racially/ethnically diverse high-risk women from multiple sources to a randomized controlled trial evaluating interventions to increase chemoprevention uptake. Findings could inform recruitment efforts for future breast cancer prevention trials to increase recruitment yield of high-risk women.

Application of Due Process in Recruitment and Selection of Personnel into the Federal Civil Service. Part 2

This study was conducted to investigate the constraint to the effective application of due process in the recruitment and selection of personnel into the federal civil service. Four objectives and four research questions guided the study. A sampling technique was used in carrying out the work. A total number of three hundred (300) respondents were used for the study. The instruments for data collection were a questionnaire and observation checklist. Three hundred (300) copies of the questionnaire were distributed to the staff of the Federal Civil Service Commission (FCSC), Abuja and two hundred and seventy-six (276) were returned representing a 92% return rate. The frequency table and Mean were the statistical measures employed for the data analysis. The findings revealed that there were no strategies or methods of recruitment and selection of staff into the federal civil service. However, the findings also revealed that practices such as political interference and corruption during recruitment and selection in federal civil service tend to undermine the principle of due process. Based on the findings, it was recommended that the federal civil service commission should formulate sound policies and practices that will minimize the degree of politicization and corruption in the recruitment and selection of staff into the federal civil service; make use of modern sources and techniques of recruitment and selection such as, E-recruitment process and Information Communication Technology (ICT)-based selection resources as their source of recruitment and selection; and develop strategies or methods that will result in the effective application of due process in their recruitment and selection exercises.

Postfire Seedling Establishment of Desert Peach (Prunus fasciculata) and Joshua Tree (Yucca brevifolia) from Simulated Seed Caches in the Mojave Desert

Desert rodents in the western USA cache enormous numbers of seeds. Seed caches represent a reliable, although highly variable, source of seedling recruitment for numerous desert plants. Prefire caching of refractory seeds (i.e., those capable of forming persistent seed banks) is an important source of postfire seedling recruitment, but it is likely that prefire caches of short-lived seeds also may contribute to postfire regeneration. The primary objective of this study was to quantify seedling recruitment from artificial caches of 2 species with short-lived seeds planted after a stand-replacing wildfire in a singleleaf pinyon (Pinus monophylla) forest. I investigated the survival of 180 artificial caches of Yucca brevifolia and Prunus fasciculata. Caches were composed of 2, 4, or 8 seeds. Also, because soils of the burned area have unusually high coarse fragment volumes (59%), I examined, in greenhouse trials, how soil coarse fragment volumes (CFVs) impacted seedling establishment of these 2 species from caches. In greenhouse trials, the number of P. fasciculata seedlings increased with increasing CFVs. In contrast, Y. brevifolia seedling numbers decreased with increasing CFVs. In field transects, 17% of cached P. fasciculata seeds produced seedlings, whereas 12% of Y. brevifolia seeds recruited seedlings in the first year postfire. The advantage of P. fasciculata in greenhouse CFV trials was not replicated in field seedling recruitment. Seedling mortality over the first 3 years postfire was not statistically different among the 3 cache sizes for either species, nor did seedling sizes differ significantly by cache size and survey date. I conclude that, although the overall recruitment from postfire caches was low (12%–17%), prefire caches of short-lived seeds probably recruit postfire seedlings, but only in specific circumstances.

Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the Restore-2 Rehabilitation Trial for gay and bisexual prostate cancer patients.

Sexual minorities are small and under-researched populations that are at disproportionate risk for cancer and poor cancer outcomes. Described as a "hidden population," the principal research challenge has been to develop effective methods to identify and recruit such cancer patients into cancer studies. Online recruitment strategies, as well as targeted clinic recruitment using patient-entered sexual orientation and gender identity data from electronic medical records have potential to transform recruitment, but studies testing the effects of how to recruit using these have not been published. In 2019, we conducted a naturalistic, three-arm, stratified prospective study to compare three recruitment strategies: (a) clinic based recruitment of prostate cancer patients from gay health and urology clinics; (b) directly from the gay community; and (c) online recruitment (through cancer support, sex/dating, and social sites). For each strategy, we estimated time, workload, and direct costs involved. To study how recruitment strategy may affect sampling, we tested for retention rates, demographic and outcome differences across sites. Using these methods, we successfully recruited 401 gay and bisexual prostate cancer patients into a randomized, controlled, 24-month trial testing an online sexual and urinary rehabilitation curriculum tailored for this population. There were seven key results. First, it is possible to recruit substantial numbers of sexual minority men into prostate cancer studies provided online recruitment methods are used. Second, we observed big differences in dropout during study onboarding by recruitment source. Third, within online recruitment, the online sex/dating application (app) was the most successful and efficient, followed by the cancer support site, and then the social networking site. Fourth, while clinics were the cheapest source of recruitment, they were time intensive and low in yield. Fifth, the cancer support site and sex/dating app recruits differed by several characteristics, with the former being more rehabilitation-focused while the latter were younger and more sexually active. Sixth, we found almost no differences in outcomes across the three online recruitment sites. Seventh, because retention in online studies has been a concern, we confirm very low attrition at 3- and 6 months into the trial. For sexual minority cancer research, more research on how to use sexual orientation and gender identity electronic medical record data for clinic-based recruitment is needed. For other small or hard-to-reach populations, researchers should compare and publish online versus offline recruitment strategies.

Business as a source of recruitment of members of the Russian Federal Government in 2000–2021

Business as a source of recruitment of members of the Russian Federal Government in 2000–2021

T2 Protect AD: Achieving a rapid recruitment timeline in a multisite clinical trial for individuals with mild to moderate Alzheimer's disease.

IntroductionThe reporting of approaches facilitating the most efficient and timely recruitment of Alzheimer's disease (AD) patients into pharmacologic trials is fundamental to much‐needed therapeutic progress.MethodsT2 Protect AD (T2), a phase 2 randomized placebo‐controlled trial of troriluzole in mild to moderate AD, used multiple recruitment strategies.ResultsT2 exceeded its recruitment target, enrolling 350 participants between July 2018 and December 2019 (randomization rate: 0.87 randomizations/site/month, or 3‐fold greater than recent trials of mild to moderate AD). The vast majority (98%) of participants were enrolled during a 10‐month window of intense promotion in news media, TV and radio advertisements, and social media. The distribution of primary recruitment sources included: existing patient lists at participating sites (72.3%), news media (12.3%), physician referral (6.0%), word of mouth (3.1%), and paid advertising (2.9%).DiscussionThe rapid recruitment of participants with mild to moderate AD was achieved through a range of approaches with varying success.

Abstract PO-035: Knowledge, motivation, and mental health: Factors associated with adherence to Hepatitis B medication among underserved Asian Americans

Abstract Introduction: Chronic Hepatitis B (CHB) Virus disproportionately affects Asian Americans, where they represent 6% of the total United States (U.S.) population but make up 58% of Hepatitis B Virus (HBV)-linked hepatocellular carcinoma (HCC) cases. HBV is the leading risk factor for developing HCC. Vietnamese and Chinese Americans suffer from disproportionate amounts of HBV infections as they represent foreign born immigrants that have come from countries with endemic HBV levels. The consequences of non-adherence to medication among is increased virological failure and a higher risk of disease progression to CHB leading to conditions such as cirrhosis as well as HCC. Understanding what factors contribute to medication adherence can be crucial for providing appropriate support for maintaining long-term treatment adherence and sustaining a virological response through interventions and strategies for high-risk populations affected by HBV. This study aims to examine the sociodemographic and psychosocial predictors of low versus medium/high adherence to medication among a community-based sample of Chinese and Vietnamese HBV infected patients. Methods: Study participants were comprised of 382 Asian American CHB patients, including 298 (78.01%) Chinese Americans and 84 (21.99%) Vietnamese Americans. Study participants were recruited between March 2019 to March 2020 and were enrolled through multiple recruitment approaches in the Greater Philadelphia Area and New York City regions. This presentation reports data from the study baseline survey with measures that included medication adherence measured by the Morisksy Medication Adherence Scale, knowledge regarding HBV diagnosis, prevention and treatment, motivation of HBV medication treatment, self-efficacy about HBV medication treatment, depression, and socioeconomic status. Multivariable logistic regression model was used, controlling for recruitment source and clustering by site. Results: Multivariable logistic regression analysis revealed that with regards to sociodemographic predictors, living longer in the U.S. (OR=4.46; 95% CI: 1.23, 16.14; p=0.023), and greater English proficiency characterized as speaking English well or very well were associated with greater odds of medium/high medication adherence (OR=0.31; 95% CI: 0.10, 0.89; p=0.030). With regards to psychosocial predictors, greater knowledge about HBV diagnosis, prevention, and treatment was associated with greater odds of medication adherence (OR=1.46; 95% CI: 1.16, 1.83, p=0.025). Additionally, greater depression score was associated with lower odds of medium/high medication adherence (OR=0.88; 95% CI: 0.78, 0.98, p=0.025). Conclusion: The study findings suggested a need for intervention regarding medication treatment and tertiary prevention and management of CHB among underserved Asian Americans. Furthermore, the association between depression and medication adherence suggests the need for psychological interventions to enhance mental health outcomes and quality of life to potentially improve or maintain medication adherence. Citation Format: Aisha Bhimla, Lin Zhu, Wenyue Lu, Sarit Golub, Chibuzo Enemchukwu, Elizabeth Handorf, Yin Tan, Minhhuyen T. Nguyen, Min Qi Wang, Grace X Ma. Knowledge, motivation, and mental health: Factors associated with adherence to Hepatitis B medication among underserved Asian Americans [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-035.

Not out-of-reach: Engaging the older old isolated African Americans with and without MCI

The Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTrials.gov: NCT02871921) is a multi-center randomized, 12-month efficacy study. There is converging evidence that social isolation is a risk factor of cognitive decline and dementia. We hypothesized that increasing social interaction in older adults with normal cognition or mild cognitive impairment (MCI) could improve or sustain cognitive function through internet-based conversational engagement. African Americans (AA) are at higher risk for developing dementia but their participation in clinical trials is low. Objectives: (1) discuss the effective outreach process to recruit urban AA older old adults (mean targeted age of 80+); (2) describe how we retained participants in a yearlong study using technology-based interventions. The most successful outreach and recruitment sources were the voter registration mass mailings and the Healthier Black Elders Research Center. Successful recruitment methods included: hiring diverse staff, compensating participants’ time, and adjusting research protocols for opting out of MRIs and genetic saliva samples. Technology intervention strategies included: providing user-friendly Chromebooks and free internet connections, simple instructions with pictures, vision and hearing correction, and in-home training with technology support backup. During the pandemic, we could assists participants in learning to use the laptop remotely. Over 12,000 subjects were contacted, which led to 39 randomized participants. Our retention rate thus far is over 75%. This demonstrates that AA older adults are reachable, willing to participate in research and able to use communication technology with appropriate supports for long-term sustainable interaction that may improve cognition and health equity.

Relationship Functioning and Gut Microbiota Composition Among Older Adult Couples: Feasibility of Data Collection

An emerging area of research extends work on couple functioning and physical health to gut health, a critical marker of general health and known to diminish with age. As a foray into this area, we conducted a pilot study to determine feasibility of data collection (questionnaires and a stool sample) among older adult couples. Participants were recruited from the community using a variety of methods including social media. Among 41 persons responding with interest across recruitment sources, 32 were contacted for screening. Inclusion criteria were: age 60+, marriage or cohabiting partnership, and English speaking/understanding. Exclusion criteria were a gastrointestinal disorder, receiving enteric nutrition, use of antibiotics (past month), cancer treatment (past 6 months), and a +COVID-19 diagnosis (past 2 months). Among 31 eligible couples, 30 consented. All 60 participants completed questionnaires and provided a stool sample using DNAgenotek’s OMR-200 collection kit, chosen for its ease and because samples can be stored at room temperature for 60 days. Sample characteristics were: M (SD) age = 66.57 (4.78); 53.3% female; 91.7% White; 1.7% Latinx; and 78.3% college-educated. 2 couples were same-sex. 43% reported at least one health condition and 25% reported use of a proton pump inhibitor (which can affect the gut microbiome), though none daily. Relational well-being was moderate-high on average per measures of dyadic adjustment and intimacy. Despite original plans to recruit couples in-person from a retirement community, remote operations were feasible via online assessment and study-coordinated shipping, a necessary yet fruitful shift due to the SARS-CoV-2 pandemic.

Recruiting Diverse Dementia Family Caregivers: What Works for Which Groups?

The purpose of this presentation is to compare success of recruitment methods by race/ethnicity, age, and kinship of dementia family caregivers. We conducted a cross-sectional study and recruited a convenience sample of dementia family caregivers using community-based and online methods. Recruitment success was tracked through survey questions, direct referrals, and community event sign-ups. Using chi-squared statistics, we examined the success of each method by caregiver race/ethnicity, age, and relationship to person with dementia (kinship). There were significant differences in recruitment source based on race/ethnicity, age, and kinship (P<.001). Specifically, referrals and newspaper advertisements were most successful for recruiting older (54 years+), White, non-Hispanic, and spousal or child caregivers; community events and reputable websites for recruiting older, minority, child caregivers; ResearchMatch for recruiting younger, minority, child/grandchild caregivers; and social media for recruiting younger, White, non-Hispanic, and child caregivers. Findings support the importance of implementing tailored methods to reach diverse dementia caregivers.

Application of Due Process in Recruitment and Selection of Personnel into the Federal Civil Service. Part 1

This study was conducted to investigate the constraint to the effective application of due process in the recruitment and selection of personnel into the federal civil service. Four objectives and four research questions guided the study. A sampling technique was used in carrying out the work. A total number of three hundred (300) respondents were used for the study. The instruments for data collection were a questionnaire and observation checklist. Three hundred (300) copies of the questionnaire were distributed to the staff of the Federal Civil Service Commission (FCSC), Abuja and two hundred and seventy-six (276) were returned representing a 92% return rate. The frequency table and Mean were the statistical measures employed for the data analysis. The findings revealed that there were no strategies or methods of recruitment and selection of staff into the federal civil service. However, the findings also revealed that practices such as political interference and corruption during recruitment and selection in federal civil service tend to undermine the principle of due process. Based on the findings, it was recommended that the federal civil service commission should formulate sound policies and practices that will minimize the degree of politicization and corruption in the recruitment and selection of staff into the federal civil service; make use of modern sources and techniques of recruitment and selection such as, E-recruitment process and Information Communication Technology (ICT)-based selection resources as their source of recruitment and selection; and develop strategies or methods that will result in the effective application of due process in their recruitment and selection exercises.

966. ID Fellows Cup: Leveraging Gamification and Social Media to Enhance Clinical Infectious Diseases Education

BackgroundWe hypothesized that we could leverage social media to recruit learners to a gamification-infused ID knowledge competition, and entice them to explore additional online educational resources.MethodsWe created the ID Fellows Cup, a knowledge-based trivia competition, to engage Infectious Diseases fellows. The game was crafted via Kaizen-Education, a software platform developed at the University of Alabama at Birmingham, that uses gamification to engage learners. Multiple choice questions including figures and/or text are presented to learners, followed by detailed teaching explanations. 60 questions emphasizing high-yield concepts were delivered over 4 weeks. Questions were written by fellows and reviewed by faculty at three programs. Elements of gamification (virtual rewards, leaderboards, etc.) were included to enhance engagement. Recruitment strategies included Twitter, program director emails, and peer-to-peer. We measured game statistics and participation. Learners were invited to complete a post-game survey about their experience. ResultsTable 1 shows our game statistics with broad geographic reach including 42 programs. Most fellows matriculated in 2019 or 2020; the number of US ID fellows equaled 17% of those completing ID in-training exam. Recruitment sources included 44% co-fellow, 42% Twitter, and 15% Program Director. Through 20 days with questions, we had 155 daily average users. Overall, fellows answered 11,419 total questions, representing 89% of all released questions. Of 103 responses to post-game survey (table 2) 97% would participate again and all felt the game was a good use of their time. Over 80% of participants reported some engagement with linked resources included in the answer explanations. In general, 78% felt engagement with online resources increased subsequent to participating in the game, including learning about at least one new online resource. ConclusionWe leveraged social media and gamification to effectively engage, and stimulate ID learners to explore additional online educational resources. Technology enriched learning, helps supplement and globalize ID education, making it as diverse and engaging as our field. Disclosures Todd P. McCarty, MD, Cidara (Grant/Research Support)GenMark (Grant/Research Support, Other Financial or Material Support, Honoraria for Research Presentation)T2 Biosystems (Consultant) Prathit A. Kulkarni, M.D., Vessel Health, Inc. (Grant/Research Support)

The association between personality and longitudinal cognitive trajectories is independent of baseline brain variables

AbstractBackgroundPrevious work has shown that select personality and other interpersonal characteristics influence late‐life cognitive outcomes. However, it is not well understood whether these associations are dissociable from the effects of late‐life brain integrity. The current study examines whether personality characteristics are associated with cross‐sectional and longitudinal cognitive variables in a diverse cohort of older adults and whether these associations are independent of brain integrity as measured by structural MRI.Method157 participants (mean age 73.1±6.3 years) from the UC Davis ADC longitudinal Diversity Cohort were evaluated using the Spanish and English Neuropsychological Assessment Scales (SENAS) to assess verbal episodic memory, semantic memory, executive function, and spatial ability. The Big 5 personality measures were used to assess openness, conscientiousness, agreeableness, neuroticism, and extraversion as well as positive affect, sadness, meaning in life, and self‐efficacy. Baseline brain (MRI) variables including total gray matter volume, hippocampus volume and total white matter hyperintensity volume were also measured (n = 131). A parallel process, multi‐level model of the four longitudinal cognitive outcomes yielded intercept and linear slope random effects for each outcome. Slope random effects were highly correlated and summarized by a global slope second order factor. Global slope and individual intercepts were regressed on personality variables, covariates (age, gender, education, race/ethnicity, and recruitment source), and baseline brain variables.ResultPositive affect (p=0.004) and openness to new experience (p=0.009) demonstrated positive associations with longitudinal change in cognition that were independent of baseline brain variables and covariates (Table 2). Other personality variables, including conscientiousness, extraversion, neuroticism, agreeableness, sadness, meaning in life, and self‐efficacy did not demonstrate significant associations with cognitive change. Lower neuroticism and higher conscientiousness were associated with higher spatial ability intercepts, and lower sadness was associated with a higher episodic memory intercept, independent of covariates and brain variables.ConclusionPositive affect and openness are significantly associated with longitudinal cognitive trajectories, independent of demographics and cross‐sectional brain variables, including total gray matter volume, hippocampal volume, and total white matter hyperintensity volume. Future research will help to delineate how individual differences in personality and behavior relate to late‐life brain and cognitive changes.

Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies.

Subjective Cognitive Decline (SCD) in older adults has been identified as a risk factor for dementia, although the literature is inconsistent, and it is unclear which factors moderate progression from SCD to dementia. Through separate meta-analyses, we aimed to determine if SCD increased the risk of developing dementia or mild cognitive impairment (MCI). Furthermore, we examined several possible moderators. Longitudinal studies of participants with SCD at baseline, with data regarding incident dementia or MCI, were extracted from MEDLINE and PsycINFO. Articles were excluded if SCD occurred solely in the context of dementia, MCI, or as part of a specific disease. Pooled estimates were calculated using a random-effects model, with moderator analyses examining whether risk varied according to SCD definition, demographics, genetics, recruitment source, and follow-up duration. Risk of study bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. 46 studies with more than 74,000 unique participants were included. SCD was associated with increased risk of developing dementia (HR = 1.90, 95% CI 1.52-2.36; OR = 2.48, 95% CI 1.97-3.14) and MCI (HR = 1.73, 95% CI 1.18-2.52; OR = 1.83, 95% CI 1.56-2.16). None of the potential moderating factors examined influenced the HR or OR of developing dementia. In contrast, including worry in the definition of SCD, younger age, and recruitment source impacted the OR of developing MCI, with clinic samples demonstrating highest risk. SCD thus represents an at-risk phase, ideal for early intervention, with further research required to identify effective interventions for risk reduction, and cognitive-behavioural interventions for cognitive management. PROSPERO, protocol number: CRD42016037993.

Validity of First-Time Diagnoses of Darier's Disease in the Danish National Patient Registry.

PurposeDarier's disease (DD) is a rare genetic skin disease, characterized by yellow-brown, scaly, crusted papules in seborrheic areas and specific nail changes. This study aimed to validate all first-time diagnoses of DD in Danish National Patient Registry (DNPR). The intent of the study is validation of DNPR for epidemiological and clinical studies on DD.Patients and MethodsWe identified all patients in DNPR who received their first-time diagnosis of DD between January 1, 1977 and December 31, 2018 (International Classification of Diseases [ICD]-8 code 75721 until the end of 1993: ICD-10 code Q828F thereafter). We restricted to diagnoses from departments of dermatology, where these patients are managed. We validated diagnoses against information from medical records, using predefined data extraction sheets and validation criteria. We classified diagnoses as probable when characteristic clinical features were present; confirmed when there was also genetic confirmation, histopathological confirmation and/or positive family history, or rejected (remaining patients). We estimated positive predictive values (PPVs) with 95% confidence intervals (CIs) for diagnoses overall and stratified by ICD classification, sex, age at diagnosis, year of diagnosis, type of diagnosis, and type of contact.ResultsWe identified 277 first-time diagnoses of DD, of which 229 (82.7%) stemmed from departments of dermatology. Medical records were available for 196 (85.6%) of these. The overall PPVs for probable and confirmed DD were 89.3% (95% CI: 84.2–92.9) and 81.1% (95% CI: 75.1–86.0), respectively. The PPV for probable ICD-8 diagnosis (95.8% (95% CI: 82.1–99.5)) was slightly higher than that of probable ICD-10 diagnosis (88.4% (95% CI: 82.7–92.3)).ConclusionThe validity of first-time diagnoses of DD recorded by departments of dermatology in the DNPR is relatively high, making DNPR suitable for epidemiological studies on DD in Denmark, as well as a useful source for recruitment to clinical studies on DD.

Initial Clinical Laboratory Response to COVID-19: A Qualitative Lookback at a Survey of Medical Laboratory Professionals

Introduction/ObjectiveIn this 2020 survey, the co-investigators of this study explored the experiences of medical laboratory professionals (MLPs) and their perceptions of the testing needs of clinical laboratories in the initial response to the COVID-19 pandemic. The responses gathered in this survey highlighted changes in the laboratory workforce and the impact on laboratory operations moving forward.Methods/Case ReportThis cross-sectional, anonymous, web-based survey of MLPs was conducted between April 29, 2020, and May 31, 2020. To recruit participants, ‘invitation to participate’ messages were posted using online forums and social media platforms (i.e. LinkedIn, Twitter). Furthermore, the survey link was shared with professional contacts and laboratory professional groups. The main source of recruitment was the membership of the American Society for Clinical Laboratory Science (ASCLS), which had more than 6,800 active members at the time of the study. Data provided from individuals who provided informed consent was included in the sample. The inclusion criteria for the survey were that participants self-identify as a current employee of a clinical laboratory whose usual employment involved participating in the diagnostic testing and providing of clinical laboratory test results using human specimens. The instrument gathered demographic data about participants and their workplace using 32 closed-ended questions with 8 questions containing branching that allowed for optional open-ended responses. This project was approved by the institutional review board at the University of Kansas Medical Center.Results (if a Case Study enter NA)Notably, there was an overall decrease in clinical laboratory testing and overtime work for laboratorians during the first months of the COVID-19 pandemic. Respondents noted a lack of pay increase during the pandemic; however, some received in-kind gifts and messages of support in recognition of their essential work. MLPs reported better (or unchanged) job satisfaction and morale in their respective workplaces.ConclusionThe response to the testing needs by healthcare facilities and clinical laboratory leadership can influence the job satisfaction of MLPs, perceptions toward their work, and overall morale during the initial phase of the pandemic. Additionally, cost-reducing measures further shaped the perceptions of MLPs while impacting the operational efficiency of clinical laboratories.

Consumer focused education on acetaminophen side effects, inadequate outcomes and weaning for individuals with low back pain: protocol for a feasibility study

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Prescription and over the counter medications, such as paracetamol, account for a significant proportion of the direct and indirect costs in managing low back pain (LBP). Existing research has not only questioned the efficacy of paracetamol use for musculoskeletal conditions such as LBP, but also its safety.&lt;strong&gt; &lt;/strong&gt;No previous study has investigated the feasibility of a pharmacological education tool for individuals using paracetamol to manage their LBP.&lt;strong&gt; &lt;/strong&gt;The aims of this study are to investigate: (1) the acceptability and experience of participants with the pharmacological education tool, (2) feasibility of recruitment, data collection and outcome measure completion, and (3) participant’s willingness to participate in a randomised control trial.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: This will be a single group repeated measures study design recruiting individuals from community organisations. Included participants will be over 18 years, experiencing acute, chronic or recurrent episodes of LBP and self-report consumption of paracetamol for pain relief weekly for at least one month. This study will be open for recruitment from June 2021 to August 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Our findings will inform the feasibility of conducting a larger randomised controlled trial. This study will be judged as feasible to proceed to a full trial based if, 1) recruitment sources are each able to enrol at least 20 participants into the study within three months of initial advertisement, 2) the majority of participants find the study and intervention experience as acceptable, and 3) there is less than 20% of missing data for the primary outcomes, and a minimum of 85% follow-up rate for enrolled participants.&lt;/p&gt;

Recruitment Analysis Of The Cooperative Labor Force In Improving Human Resources

Employment recruits of an organization have not improved the standards of selection so that the resulting workforce does not meet the qualifications for the jobs offered. This phenomenon also applies to cooperatives as business organizations. Co-operatives are one of the forums that are quite developed in increasing their business. Currently, the existing human resources are managed simply, the function of personnel management is charged as Manager as the manager of the cooperative. The recruitment process is the earliest stage in personnel management, so if it is ignored it can disrupt the company's performance.The purposes of this study are 1) To find out the labor recruitment process that has been implemented so far. 2) To find out the existing workforce recruitment process. The method used in this research is descriptive qualitative, namely as a research process that produces qualitative data in the form of written or spoken words from the observed person or actor.The results showed that the recruitment process in cooperatives was carried out in a simple but complete and selective manner. The process includes forecasting work needs, selection, an orientation that is still simple but complete enough and based on criteria, standards, or specifications for the real needs of the existing job or position. Recruitment sources are utilized optimally so that professionalism is established. The cooperative uses criteria in the Indonesian economy, namely in the form of workforce skills which include moral and physical health, reason (good knowledge), education and training, work perfection.