Search Output Research Articles

The role of Cor-Knot in the future of cardiac surgery: A systematic review.

The Cor-Knot automated fastener has been used to eliminate the need for manual knot-tying in cardiac valve surgery for over a decade. We review the current literature pertaining to Cor-Knot and discuss its benefits and shortcomings with respect to cardiac valve surgery. A comprehensive literature search was conducted to identify articles discussing the use of automated fasteners and manually tied knots in the setting of cardiac valve surgery. The search terms used were "heart", "valve surgery", "cardiac", "Cor-Knot", "fastener", "automated fastener", "aortic valve", "mitral valve", "minimally invasive", and "titanium". These terms were used as keywords and, in combination, as MeSH terms to maximize the output of literature searches. Twenty-four relevant articles were identified and reviewed. Current literature provides evidence to support the role of Cor-Knot in facilitating enhanced intraoperative efficacy by reducing total operation times as compared with manual knot-tying. However, studies to date fail to provide evidence for the translation of these intraoperative advantages into improved patient outcomes. Moreover, Cor-Knot is associated with a significant financial burden. A plethora of evidence exists to support the intraoperative advantages provided by Cor-Knot. However, the literature is yet to support its role in facilitating superior clinical outcomes as compared with manual knot tying. Larger high-quality trials and studies are required to provide evidence supporting the ongoing use of Cor-Knot in valve surgery.

LO64: A systematic review of interventions to influence opioid prescribing from the emergency department

Introduction: The opioid crisis has reached epidemic levels in Canada, driven in large part by prescription drug use. Emergency physicians are frequent prescribers of opioids; therefore, the emergency department (ED) represents an important setting for potential intervention to encourage rational and safe prescribing. The objective of this study was to systematically review the literature on interventions aimed to influence opioid prescribing in the ED. Methods: Electronic searches of Medline and Cochrane were conducted and reference lists were hand-searched. All quantitative studies published in English from 2009 to 2019 were eligible for inclusion. Two reviewers independently screened the search output to identify potentially eligible studies, the full texts of which were retrieved and assessed for inclusion. Outcomes of interest included opioid prescribing rate (proportion of ED visits resulting in an opioid prescription at discharge), morphine milligram equivalents per prescription and variability among prescribers. Results: The search strategy yielded 797 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 34 potentially relevant studies were retrieved in full text. Of these, 28 studies were included in the review. The majority (26, 92.9%) of studies were based in the United States and two (7.1%) were from Australia. Four (14.3%) were randomized controlled trials. The interventions were classified into six categories: prescribing guidelines (n = 10), regulation/rescheduling of opioids (n = 6), prescribing data transparency (n = 4), education (n = 4), care coordination (n = 3), and electronic medical record changes (n = 1). The majority of interventions reduced the opioid prescribing rate from the ED (21/28, 75.0%), although regulation/rescheduling of opioids had mixed effectiveness, with 3/6 (50%) studies reporting a small increase in the opioid prescribing rate post-intervention. Education had small yet consistent effects on reducing the opioid prescribing rate. Conclusion: A variety of interventions have attempted to improve opioid prescribing from the ED. These interventions include prescribing guidelines, regulation/rescheduling, data transparency, education, care coordination, and electronic medical record changes. The majority of interventions reduced the opioid prescribing rate; however, regulation/rescheduling of opioids demonstrated mixed effectiveness.

Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis

BackgroundThe effectiveness of female condoms for preventing HIV and sexually transmitted infections (STIs) remains inconclusive. We examined the effects of female condoms on the acquisition of HIV and STIs.MethodsWe searched four databases, two trial registries, and reference lists of relevant publications in October 2018 and updated our search in February 2020. We screened search output, evaluated study eligibility, and extracted data in duplicate; resolving differences through discussion. We calculated the effective sample size of cluster randomised trials using an intra-cluster correlation coefficient of 0·03. Data from similar studies were combined in a meta-analysis. We performed a non-inferiority analysis of new condoms relative to marketed ones using a non-inferiority margin of 3%. We assessed the certainty of evidence using GRADE.ResultsWe included fifteen studies of 6921 women. We found that polyurethane female condoms (FC1) plus male condoms may be as effective as male condoms only in reducing HIV acquisition (1 trial, n = 149 women, RR 0.07, 95%CI 0.00–1.38; low-certainty evidence). However, the use of FC1 plus male condoms is superior to male condoms alone in reducing the acquisition of gonorrhoea (2 trials, n = 790, RR 0.59, 95%CI 0.41–0.86; high-certainty evidence) and chlamydia (2 trials, n = 790, RR 0.67, 95%CI 0.47–0.94; high-certainty evidence). Adverse events and failure rates of FC1 were very low and decreased during follow up. Although the functionality of newer female condoms (Woman’s, Cupid, Pheonurse, Velvet, and Reddy) may be non-inferior to FC2, there were no available studies assessing their efficacy in preventing HIV and STIs.ConclusionThe use of female plus male condoms is more effective than use of male condoms only in preventing STIs and may be as effective as the male condom only in preventing HIV. There is a need for well conducted studies assessing the effects of newer female condoms on HIV and STIs.PROSPERO registration numberCRD42018090710

Deep learning for clustering of continuous gravitational wave candidates

In searching for continuous gravitational waves over very many ($\approx 10^{17}$) templates , clustering is a powerful tool which increases the search sensitivity by identifying and bundling together candidates that are due to the same root cause. We implement a deep learning network that identifies clusters of signal candidates in the output of continuous gravitational wave searches and assess its performance. For loud signals our network achieves a detection efficiency higher than 97\% with a very low false alarm rate, and maintains a reasonable detection efficiency for signals with lower amplitudes, i.e. at $\lesssim$ current upper limit values.

Towards a model for spoken conversational search

Conversation is the natural mode for information exchange in daily life, a spoken conversational interaction for search input and output is a logical format for information seeking. However, the conceptualisation of user–system interactions or information exchange in spoken conversational search (SCS) has not been explored. The first step in conceptualising SCS is to understand the conversational moves used in an audio-only communication channel for search. This paper explores conversational actions for the task of search. We define a qualitative methodology for creating conversational datasets, propose analysis protocols, and develop the SCSdata. Furthermore, we use the SCSdata to create the first annotation schema for SCS: the SCoSAS, enabling us to investigate interactivity in SCS. We further establish that SCS needs to incorporate interactivity and pro-activity to overcome the complexity that the information seeking process in an audio-only channel poses. In summary, this exploratory study unpacks the breadth of SCS. Our results highlight the need for integrating discourse in future SCS models and contributes the advancement in the formalisation of SCS models and the design of SCS systems.

Measuring the potential impact of physical inactivity on worldwide epidemiology of colorectal and breast cancers

Background: Solid evidence has been published in support of a strong association between physical inactivity and enhanced risk of colorectal and breast cancers. This article aims to objectively assess the worldwide epidemiology of physical inactivity-related burden of colorectal and breast cancers. Methods: An electronic search was performed in the Global Health Data Exchange (GHDx) registry, a large database of health-related data, using the keywords “low physical activity” in the category “risk”, combined with “colon and rectum cancer” AND “breast cancer” in the category “cause”. The output of the electronic search was downloaded in comma-separated values (CSV), imported into an Excel file and analyzed. Results: The contribution of physical inactivity on the current burden of disability-adjusted life years (DALYs) and mortality is estimated at 3.44% and 3.64% for colorectal cancer, and at 1.43% and 1.54% for breast cancer, respectively. The impact of physical inactivity on the epidemiologic burden of colorectal cancer is constantly higher in women than in men, whilst it also increases in parallel with the socio-demographic index (SDI) in both types of cancer. The effect of physical inactivity on DALYs and deaths caused by these two malignancies remains substantially stable up to the age of 50 years, but then linearly increases, peaking in the elderly. In multivariable analysis, physical inactivity-related DALYs and deaths for colorectal cancer were independently associated with female sex, older age and higher SDI. Physical inactivity-related DALYs and deaths for breast cancer were also independently predicted by older age and higher SDI. Conclusions: The contribution of physical inactivity to the current burden of colorectal and breast cancer seems higher in the elderly, in people living in middle-to-high SDI countries, and in the female sex as regards colorectal cancer.

Secondhand smoke in childhood: The world-wide burden of a major public health-care problem.

Recent evidence attests that the health-care burden of secondhand smoke is particularly high in the childhood.1-3 Since little information is currently available on the epidemiologic relationship between secondhand smoke on health loss or mortality in childhood to the best of our knowledge, we planned this study to specifically address this question. An electronic search was carried out in Global Health Data Exchange registry, a large database of health-related data maintained by the Institute for Health Metrics and Evaluation,4 using the keywords ‘secondhand smoke’ and ‘all causes’ in the categories ‘DALYs’ (disability-adjusted life years) or ‘deaths’. The database search was then combined with the epidemiologic variables ‘year’ (from 1990 to 2017), ‘age’ (from <1 to 9 years old) and ‘location’ (SDI Regions, where SDI stands for socio-demographic index). The 2017 is the last searchable year in the Global Health Data Exchange registry, and was hence selected for reporting updated information on the adverse health impact of secondhand smoke in childhood world-wide. The output of the electronic search was downloaded in comma-separated values, imported into an Excel file (Microsoft, Redmond, WA, USA) and analysed with Analyse-it (Analyse-it Software Ltd., Leeds, UK). Simple (Pearson's correlation) regression analyses were used for assessing potential associations (and their relative 95% confidence interval (95% CI)) among epidemiologic measures. The study was performed in accordance with the Declaration of Helsinki and under the terms of relevant local legislation. Ethics board approval is unnecessary at the local institution (University Hospital of Verona) for articles based on free scientific databases searches. The values of world-wide childhood DALYs and deaths due to secondhand smoke exposure are currently estimated at 5.65 million (1.0% of all DALYs) and 63 823 (1.1% of all deaths), respectively, the vast majority of which (~75%) is in children aged <1 years. The last 28-year world-wide trend (i.e. between 1990 and 2017) is shown in Figure 1, which reveals that both health loss and mortality due to secondhand smoke have dramatically declined, by approximately 80%, during the last 28 years. The reduction of health loss and deaths has been very similar across age ranges, being comprised between 68 and 81% for DALYs and between 72 and 82% for mortality, respectively. Importantly, an inverse linear relationship can be observed between SDI and both childhood DALYs (r = −0.95; 95% CI −1.00 to −0.44; P = 0.012) or deaths (−0.95; 95% CI −1.00 to −0.43; P = 0.013) due to secondhand smoke. Although continuous exposure to secondhand smoke remains a serious public health-care issue in children, since it may cause or predispose to a vast array of health problems such as premature death, sudden infant death syndrome, respiratory infections and asthma, the results of our investigation are in keeping with those published in other reports, suggesting that passive smoking seems to have significantly declined in the past 40 years world-wide.5 This is most likely the result of effective policies of tobacco control and legislations prohibiting cigarette smoke in public spaces, which have been established and recently reinforced in many countries world-wide.5 The second important finding that has emerged from our analysis is that the burden of secondhand smoke on children heath is dramatically magnified in countries with low socio-economic status, which shall hence be targeted with more aggressive policies aimed at limiting secondhand smoke exposure in highly vulnerable subjects such as neonates and children.

Artificial Bee Colony Optimization Technique Based Speed Control of DC Motor

This work deals with Fractional Order Proportional-Integral-Derivative (FOPID) based controllers designing using Bio-inspired Artificial Bee Colony (ABC) algorithm. The operating principle of bio-inspired optimization techniques are originated from various biological systems. Thus, ABC algorithm works similar to working principle of bees. In this work, second order system model of a DC motor has been considered for speed control of DC motor. The proposed optimization method can be used for higher order approaches, to provide minimum error with efficient system performance. The aim of this research work is to design and tune parameters of FOPID controller, for effective static and dynamic performance. The automatic controller tunning ability for PID is possible using ABC algorithm and fractional order system provides effective solution set for search output parameters of PID.

Barriers to and enablers of uptake of and adherence to antiretroviral therapy in the context of integrated HIV and tuberculosis treatment among adults in sub-Saharan Africa: a protocol for a systematic literature review

IntroductionThe scale-up of integrated Human Immunodeficiency Virus (HIV) and tuberculosis (TB) treatment has been an important intervention to curb the burden of HIV and TB co-infection worldwide. Uptake of and...

Systematic review protocol on Bacillus Calmette-Guerin (BCG) revaccination and protection against tuberculosis

IntroductionTuberculosis (TB) is a disease caused by Mycobacterium tuberculosis (M.TB) and other species of the Mycobacterium tuberculosis complex. Globally, TB is ranked as the ninth leading cause of death and...

Iron stores in pregnant women with sickle cell disease: a protocol for a systematic review and meta-analysis

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD...

Reliability and validity of on-road driving tests in vulnerable adults: a systematic review.

The on-road driving test is considered a ‘gold standard’ evaluation; however, its validity and reliability have not been sufficiently reviewed. This systematic review aimed to map out and synthesize literature regarding on-road driving tests using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Cochrane Library, PubMed, CINAHL, and Web of Science databases were searched from initiation through February 2018. All articles addressing reliability or validity of on-road driving tests involving adult rehabilitation patients were included. The search output identified 513 studies and 36 articles, which were included in the review. The Washington University Road Test/Rhode Island Road Test, performance analysis of driving ability, test ride for investigating practical fitness-to-drive, and K-score demonstrated high reliability and validity in regard to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The Washington University Road Test/Rhode Island Road Test and test ride for investigating practical fitness-to-drive were analyzed based on Classical Test Theory techniques, and performance analysis of driving ability and K-score were analyzed based on Item Response Theory techniques. The frequency of studies were Washington University Road Test/Rhode Island Road Test (n=9), Test Ride for Investigating Practical fitness-to-drive (n=8), performance analysis of driving ability (n=4), and K-score (n=1). From the viewpoint of accuracy and generalization, the Washington University Road Test/Rhode Island Road Test, test ride for investigating practical fitness-to-drive, and performance analysis of driving ability were identified as highly qualified concerning on-road driving tests. However, the ability to assess real-world driving depends on various environmental conditions.

Corruption in Anglophone West Africa health systems: a systematic review of its different variants and the factors that sustain them.

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced.

Assessing the methodological quality of systematic reviews of interventions aimed at improving vaccination coverage using AMSTAR and ROBIS checklists

ABSTRACT Introduction: Systematic reviews (SRs) are the backbone of evidence-based health care, but no gold standard exists to assess their methodological quality. Although the AMSTAR tool is accepted for analyzing the quality of SRs, the ROBIS instrument was recently developed. This study compared the capacity of both instruments to capture the quality of SRs of interventions for improving vaccination coverage. Methods: We conducted a comprehensive literature search in the Cochrane Library and PubMed. Two reviewers independently screened the search output, assessed study eligibility, and extracted data from eligible SRs; resolving differences through consensus. We conducted Principal Component Analysis (PCA) in Stata 14 to determine similarities and differences between AMSTAR and ROBIS. Results: A total of 2322 records were identified through the search and 75 full-text publications were assessed for eligibility, of which 57 met inclusion criteria. Using AMSTAR, we found 32%, 60% and 9% of SRs to have high, moderate and low quality, respectively. With ROBIS, we judged 74%, 14% and 12% of SRs to have low, unclear and high risk of bias. PCA showed that SRs with low risk of bias in ROBIS clustered together with SRs having high-quality in AMSTAR, and SRs with high risk of bias in ROBIS clustered with low-quality SRs in AMSTAR. Conclusions: Our findings suggest that there is an association between methodological quality and risk of bias in SRs of interventions focused on improving vaccination coverage. Therefore, either AMSTAR or ROBIS checklists can be used to evaluate methodological quality of SRs in vaccinology.

The strong focus on positive results in abstracts may cause bias in systematic reviews: a case study on abstract reporting bias

BackgroundResearch articles tend to focus on positive findings in their abstract, especially if multiple outcomes have been studied. At the same time, search queries in databases are generally limited to the abstract, title and keywords fields of an article. Negative findings are therefore less likely to be detected by systematic searches and to appear in systematic reviews. We aim to assess the occurrence of this ‘abstract reporting bias’ and quantify its impact in the literature on the association between diesel exhaust exposure (DEE) and bladder cancer.MethodsWe set up a broad search query related to DEE and cancer in general. Full-texts of the articles identified in the search output were manually scanned. Articles were included if they reported, anywhere in the full-text, the association between DEE and bladder cancer. We assume that the use of a broad search query and manual full-text scanning allowed us to catch all the relevant articles, including those in which bladder cancer was not mentioned in the abstract, title or keywords.ResultsWe identified 28 articles. Only 12 of these (43%) had mentioned bladder in their abstract, title or keywords. A meta-analysis based on these 12 detectable articles yielded a pooled risk estimate of 1.10 (95% confidence interval [CI] 0.97–1.25), whereas the meta-analysis based on all 28 articles yielded a pooled estimate of 1.03 (95% CI 0.96–1.11).ConclusionsThis case study on abstract reporting bias shows that (a) more than half of all relevant articles were missed by a conventional search query and (b) this led to an overestimation of the pooled effect. Detection of articles will be improved if all studied exposure and outcome variables are reported in the keywords. The restriction on the maximum number of keywords should be lifted.

Reporting quality of systematic reviews of interventions aimed at improving vaccination coverage: compliance with PRISMA guidelines

ABSTRACT Systematic reviews have become increasingly important for informing clinical practice and policy; however, little is known about the reporting characteristics and quality of SRs of interventions to improve immunization coverage in different settings. The aim of this study was to assess the reporting quality of systematic reviews of interventions aimed at improving vaccination coverage using the recommended Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. PubMed and Cochrane Library were searched to identify SRs of interventions to improve immunization coverage, indexed up to May 2016. Two authors independently screened the search output, assessed study eligibility, and extracted data from eligible SRs using a 27-item data collection form derived from PRISMA. Discrepancies in reviews assessments were resolved by discussion and consensus. A total of 57 reviews were included in this study with a mean percentage of applicable PRISMA items that were met across all studies of 66% (range 19–100%) and median compliance of 70%. 39 out of the 57 reviews were published after the release of the PRISMA statement in 2009. Highest compliance was observed in items related to the “description of rational”, “description of eligibility criteria”, “synthesis of results” and “provision of a general interpretation of the results” (items #3, #6, #14 and #26, respectively). Compliance was poorest in the items “describing summary of evidence” (item 24, 19%), “describing indication of review protocol and registration” (item 5, 26%) and “describing results of risk of bias across studies (item 22, 33%). The overall reporting quality of systematic reviews of interventions to improve vaccination coverage requires significant improvement. There remains a need for additional research targeted at addressing potential barriers to compliance and strategies to improve compliance with PRISMA guideline.

A scoping review of interventions for vaccine stock management in primary health-care facilities

ABSTRACTOne of the challenges facing the success of immunization programs is shortages of vaccines at health facilities, which could result from inadequate vaccine stock management. Several approaches have been designed by countries to improve vaccine stock management. This review summarizes currently available information on interventions for vaccine stock management.We considered both randomized trials and non-randomized studies eligible for inclusion in this review. The following databases were searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization Library Information System, Web of Science, and PDQ-Evidence. We searched the websites of the World Health Organization, Global Alliance for Vaccine and Immunization, PATH’s Vaccine Resources Library, and United Nations Children’s Fund. The reference lists of all the included studies were also searched. Two authors independently screened search outputs, reviewed full texts of potentially eligible articles, evaluated risk of bias, and extracted data; resolving disagreements through consensus.Four studies met our inclusion criteria (three before–after studies and one randomized trial). Three studies were conducted in low- and middle-income countries while one was conducted in Canada (a high-income country). All the studies had various limitations and were classified as having a high risk of bias. Study findings suggest that the use of digital information systems to improve information and stock visibility, coupled with other interventions (such as training of health-care workers on the use of innovative tools and redesign of the supply chain to tackle certain bottlenecks), has the potential to increase vaccine availability, reduce response times, and improve the quality of vaccine records.

Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease: A Systematic Review

BackgroundGlobally, rheumatic heart disease (RHD) is a major contributor to the burden of cardiovascular disease. Major gaps in RHD prevention and treatment have been documented at all levels of health systems in low- and middle-income countries. Task sharing is an approach that could prove effective in remediating bottlenecks in RHD-related care. ObjectivesThis study conducted a systematic review to assess the state of the evidence for the use of task sharing in the diagnosis, prevention, and management of RHD. MethodsGuided by a previously published protocol, we searched various databases using a systematic search strategy including MeSH and free-text terms for (1) group A streptococcus, acute rheumatic fever, and RHD and (2) strategies of task sharing in limited-resource settings. Two investigators independently screened the search outputs, selected the studies, extracted the data, and assessed the risk of bias, resolving discrepancies by discussion and consensus. ResultsThe publications search yielded 212 records, of which 18 articles were deemed as potentially eligible for inclusion. None of the studies, however, met with the inclusion criteria. ConclusionsThere is a lack of evidence for the use of task-sharing approaches in scaling up RHD prevention and treatment services in limited-resource settings. Considering the persistent burden of group A streptococcus, acute rheumatic fever, and RHD in low- and middle-income countries, this work highlights the urgent need to develop and test models of RHD-related care utilizing an evidence-based approach to task sharing. [Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease: A Systematic Review; CRD42017072989].

Vitamin K Dependent Proteins in Kidney Disease.

Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins (VKDPs) act mainly as calcification inhibitors, but their involvement in the onset and progression of CKD are not completely elucidated. This review is an update of the current state of knowledge about the relationship between CKD and four extrahepatic VKDPs: matrix Gla protein, osteocalcin, growth-arrest specific protein 6 and Gla-rich protein. Based on published literature in the last ten years, the purpose of this review is to address fundamental aspects about the link between CKD and circulating VKDPs levels as well as to raise new topics about how the interplay between molecular weight and charge could influence the modifications of circulating VKDPs at the glomerular level, or whether distinct renal etiologies have effect on VKDPs. This review is the output of a systematic literature search and may open future research avenues in this niche domain.

External Learning Strategies and Technological Search Output: Spinout Strategy and Corporate Invention Quality

The strategic management of knowledge spillovers to employee ventures may provide firms with knowledge spill-ins or the potential to learn from the ventures that they have spun out. However, the mechanisms underlying knowledge spill-ins and their importance for external learning in uncertain technology environments have not been examined in detail. This article compares corporate venturing (CV) spinouts that are supported by parent firms with independent employee spinouts as well as other strategies for external learning, such as investments and alliances. An analysis of the patenting activities of leading corporations operating in the information and communication technology industry reveals that, ceteris paribus, when firms recombine unfamiliar knowledge components developed by their CV spinouts, their inventions are associated with higher quality than comparable firms’ inventions that recombine knowledge from the firm’s corporate venture capital portfolio ventures, allies, or employee spinouts. This effect is especially pronounced when CV spinout inventors hold parent-specific technological expertise. The results are robust across several econometric specifications that account for selection and intrinsic differences in external learning strategies. Furthermore, the results indicate that CV spinouts benefit their parent firms by reducing uncertainty relative to other strategic formats for external learning in unfamiliar technological areas. The detailed theoretical and practical implications derived from this research reflect perspectives on technology strategy and corporate renewal.