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Three years of quality assurance data assessing the performance of over 4000 grant peer review contributions to the Canadian Institutes of health research Project Grant Competition

Facets

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Facets 2023年第1期8卷 1-14页

作者： Ardern, Clare L. Martino, Nadia Nag, Sammy Tamblyn, Robyn Moher, David Mota, Adrian Khan, Karim M. Department of Family Practice University of British Columbia Vancouver BC Canada Sport and Exercise Medicine Research Centre La Trobe University Melbourne VIC Australia Canadian Institutes of Health Research Ottawa ON Canada Department of Medicine and Department of Epidemiology and Biostatistics McGill University Montreal QC Canada Centre for Journalology Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa ON Canada Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis Vancouver BC Canada

The Canadian Institutes of health research (CIHR) commenced a Quality Assurance program in 2019 to monitor the quality of peer review in its Project Grant Competition Peer Review Committees. Our primary aim was to describe the performance of CIHR grant peer reviewers, based on the assessments made by CIHR peer review leaders during the first 3 years of the research Quality Assurance program. All Peer Review Committee Chairs and (or) Scientific Officers who led peer review for CIHR in 2019, 2020, and 2021 completed Reviewer Quality Feedback forms immediately following Peer Review Committee meetings. The form assessed Performance, Future potential, Review quality, Participation,and Responsiveness. We summarised and descriptively synthesised data from assessments conducted after each of the four grant competitions. The performance of peer reviewers on 4438 occasions was rated by Chairs and Scientific Officers. Approximately one in three peer reviewers submitted outstanding reviews or discussed additional applications and one in 10 demonstrated potential as a future Peer Review Committee leader. At most, one in 20 peer reviewers was considered to have not performed adequately with respect to review quality, participation, or responsiveness. There is a need for more research on the processes involved in allocating research grant funding. © 2023 The Crown and authors Ardern, Tamblyn, Moher, and Khan.

关键词： decisions in research funding funding peer review research grant research integrity research personnel

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Impact of pre-existing cardiometabolic diseases on metastatic cancer stage at diagnosis:a prospective multinational cohort study

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Cancer Communications 2024年第5期44卷 593-597页

作者： Anna Jansana Aviane Auguste Marina Kvaskoff Agnès Fournier Emma Fontvieille Laia Peruchet-Noray Carine Biessy Reynalda Cordova Kristina Elin Nielsen Petersen Anne Tjoneland Verena Katzke Rudolf Kaaks Fulvio Ricceri Salvatore Panico Paolo Contiero Maria-Jose Sánchez Jesus Castilla Marta Crous-Bou Alicia Heath Elom Kouassivi Aglago Elisabete Weiderpass Marc James Gunter Pietro Ferrari Elio Riboli Vivian Viallon Heinz Freisling International Agency for Research on Cancer(IARC-WHO) LyonFrance Paris-Saclay University University of Versailles-Saint-Quentin-en-YvelineUniversity Paris-SudFrench National Institute for Health and Medical Research(Inserm)Gustave Roussy“Exposome and Heredity”TeamCESPVillejuifFrance Department of Nutritional Sciences University of ViennaViennaAustria Danish Cancer Society Research Center CopenhagenDenmark Department of Public Health University of CopenhagenCopenhagenDenmark Division of Cancer Epidemiology German Cancer Research CentreHeidelbergGermany Department of Clinical and Biological Sciences University of TurinTurinItaly Unit of Epidemiology Regional Health Service ASL TO3GrugliascoTurinItaly Department of Clinical Medicine and Surgery Federico II UniversityNaplesItaly Environmental Epidemiology Unit Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)-Istituto Nazionale dei TumoriMilanItaly Cancer Registry of Granada Institute for Biosanitary Research of Granada(ibs.GRANADA)GranadaSpain Epidemiology and Control of Chronic Diseases Group Epidemiology and Public Health Networking Biomedical Research CentreMadridSpain Navarra Public Health Institute PamplonaSpain Unit of Nutrition and Cancer Cancer Epidemiology Research ProgramCatalan Institute of Oncology(ICO)-Bellvitge Biomedical Research Institute(IDIBELL)L’Hospitalet de LlobregatBarcelonaSpain Department of Epidemiology Harvard Tseng-Hsi Chan School of Public HealthBostonMassachusettsUSA Department of Epidemiology and Biostatistics School of Public HealthImperial College LondonSt Mary’s CampusNorfolk PlaceLondonUK

Owing to shared risk factors between cardiometabolic diseases(CMDs)and cancer,coupled with population aging,the lifetime risk of an individual developing cancer after a CMD is ***,biological mechanisms such as insulin resistance or inflammation may not only predispose individuals withCMDto an elevated risk of certain types of cancer but also to a diagnosis of cancer at an advanced stage[1,2].

关键词： diagnosis diseases cancer

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Economic costs of alcohol consumption in Thailand,2021

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Global health research and Policy 2023年第1期8卷 27-34页

作者： Chaisiri Luangsinsiri Sitaporn Youngkong Usa Chaikledkaew Oraluck Pattanaprateep Montarat Thavorncharoensap Doctor of Philosophy Program in Social Economicand Administrative PharmacyDepartment of PharmacyFaculty of PharmacyMahidol UniversityBangkokThailand Department of Clinical Pharmacy Faculty of PharmacySrinakharinwirot UniversityNakhon NayokThailand Mahidol University Health Technology Assessment(MUHTA)International Graduate Program Mahidol UniversityBangkokThailand Social and Administrative Pharmacy Excellence Research(SAPER)Unit Department of PharmacyFaculty of PharmacyMahidol University447 Sri-Ayudhaya Rd.RajathewiPhayathaiBangkok 10400Thailand Department of Clinical Epidemiology and Biostatistics Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand

Background Alcohol is one of the leading risk factors contributing to avoidable economic loss *** from the economic cost of alcohol consumption studies play an important role in prioritizing healthcare resource use,supporting policy decisions,and justifying budgets for alcohol *** study aimed to estimate the economic burden associated with alcohol consumption in Thailand in *** Prevalence-based cost of illness methodology was *** following costs were included in the analysis:healthcare costs;cost of law enforcement;cost of property damage due to road traffic accidents;cost of premature mortality;and cost of absenteeism from out-patient hospital visits and *** capital approach was *** costs were presented in Thai baht,*** Alcohol consumption incurred a total estimated economic cost of 165,450.5 million baht,equivalent to 1.02%of Gross Domestic Product(GDP)and 2500 baht per *** of premature mortality was estimated at 157,918.7 million baht and accounted for the largest proportion of the total cost(95.45%).healthcare cost was found to be the second highest share representing 4370.1 million baht(2.7%of the total cost).The number of premature death attributable to alcohol consumption in 2021 was estimated at 22,*** Alcohol continues to impose a substantial economic burden in *** of existing wellformulated alcohol control policies is urgently required to mitigate the economic impact of alcohol consumption in the country.

关键词： Cost-of-illness Economic burden Alcohol Cost Drinking

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Embedding lifestyle interventions into cancer care: has telehealth narrowed the equity gap?

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Journal of the National Cancer Institute - Monographs 2023年第61期2023卷 133-139页

作者： Dennett, Amy M Hirko, Kelly A Porter, Kathleen J Loh, Kah Poh Liao, Yue Yang, Lin Arem, Hannah Sukumar, Jasmine S Salerno, Elizabeth A Allied Health Clinical Research Office Eastern Health Bundoora VIC Australia School of Allied Health Human Services and Sport La Trobe University Bundoora VIC Australia Department of Epidemiology and Biostatistics College of Human Medicine Michigan State University East Lansing MI United States Department of Public Health Sciences School of Medicine University of Virginia Charlottesville VA United States Division of Hematology/Oncology Department of Medicine James P. Wilmot Cancer Institute Rochester NY United States Department of Kinesiology College of Nursing and Health Innovation University of Texas at Arlington Arlington TX United States Department of Cancer Epidemiology and Prevention Research Alberta Health Services Calgary Canada Departments of Oncology and Community Health Sciences Cumming School of Medicine University of Calgary Calgary Canada Healthcare Delivery Research Program MedStar Health Research Institute WA United States Department of Breast Medical Oncology University of Texas MD Anderson Cancer Center Houston TX United States Division of Public Health Sciences Department of Surgery Washington University School of Medicine St Louis MO United States

Lifestyle interventions targeting energy balance (ie, diet, exercise) are critical for optimizing the health and well-being of cancer survivors. Despite their benefits, access to these interventions is limited, especially in underserved populations, including older people, minority populations and those living in rural and remote areas. Telehealth has the potential to improve equity and increase access. This article outlines the advantages and challenges of using telehealth to support the integration of lifestyle interventions into cancer care. We describe 2 recent studies, GO-EXCAP and weSurvive, as examples of telehealth lifestyle intervention in underserved populations (older people and rural cancer survivors) and offer practical recommendations for future implementation. Innovative approaches to the use of telehealth-delivered lifestyle intervention during cancer survivorship offer great potential to reduce cancer burden. © The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: ***@***.

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Varenicline and Lorcaserin for Smoking Cessation and Weight Gain Prevention: A Randomized clinical Trial

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Mayo Clinic Proceedings: Innovations, Quality and Outcomes 2022年第5期6卷 465-474页

作者： Hurt, Ryan T. Croghan, Ivana T. Schroeder, Darrell R. Choi, Doo-Sup Fischer, Karen Fokken, Shawn Ebbert, Jon O. Division of General Internal Medicine Department of Medicine Mayo Clinic Rochester MN Division of Community Internal Medicine Department of Medicine Mayo Clinic Rochester MN Division of Clinical Trials and Biostatistics Department of Qualitative Health Sciences Mayo Clinic Rochester MN Division of Epidemiology Department of Qualitative Health Sciences Mayo Clinic Rochester MN Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic Rochester MN Nicotine Dependence Research Program Mayo Clinic Rochester MN Clinical Research Office Department of Medicine Mayo Clinic Rochester MN

Objective: To evaluate the safety and effectiveness of combination varenicline with lorcaserin in preventing post-cessation weight gain. Participants and Methods: We conducted a randomized (varenicline for 12 weeks + lorcaserin for 24 weeks vs varenicline for 12 weeks + placebo for 24 weeks) phase II clinical study to obtain preliminary data on the safety and effectiveness of combination varenicline and lorcaserin in preventing post-cessation weight gain in overweight and obese smokers. Eighty-four overweight and obese (body mass index [BMI], 27-40 kg/m²) cigarette smokers were randomized before study termination (lorcaserin: n=40;placebo: n=44). The primary outcomes were weight and waist circumference (WC) changes at 12 and 24 weeks in smokers meeting criteria for prolonged smoking abstinence. Results: Thirty-nine participants met criteria for prolonged smoking abstinence at 12 weeks (46%) and 21 at 24 weeks (25%). No significant treatment effect was observed at 12 weeks with lorcaserin compared with placebo (weight difference, −0.7 kg;90% CI, −2.6 to 1.1 kg;P=.51;WC difference, −1.9 cm;90% CI, −4.2 to 0.5 cm;P=.18;or BMI difference, −0.4 kg/m²;90% CI, −1.1 to 0.3 kg/m²;P=.33). No significant treatment effect was observed between lorcaserin at 24 weeks compared with placebo (weight, 1.4 kg;90% CI, −3.8 to 6.7 kg;P=.65;WC, −0.9 cm;90% CI, −5.8 to 4.0 cm;P=.75;or BMI 0.29 kg/m²;90% CI, −1.5 to 2.12 kg/m²;P=.79). Conclusion: Weight gain and WC increases after prolonged smoking abstinence were not reduced using combination varenicline and lorcaserin. The results do not support further research in the obese and weight-concerned smoking population using lorcaserin or similar drugs. Trial Registration: *** Identifier: NCT02412631 © 2022

关键词： BMI body mass index CAMELLIA-TIMI 61 trial Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients – Thrombolysis in Myocardial Infarction 61, trial DM diabetes mellitus FDA Food and Drug Administration GLP-1 RA glucagon like peptide-1 receptor agonist NRT nicotine replacement therapy OR odds ratio PCWG post-cessation weight gain WC waist circumference

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Respiratory syncytial virus vaccine effectiveness among US veterans, September, 2023 to March, 2024: a target trial emulation study

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The Lancet Infectious Diseases 2025年第6期25卷 625-633页

作者： Bajema, Kristina L Yan, Lei Li, Yuli Argraves, Stephanie Rajeevan, Nallakkandi Fox, Alexandra Vergun, Robert Berry, Kristin Bui, David Huang, Yuan Lin, Hung-Mo Hynes, Denise M Lucero-Obusan, Cynthia Schirmer, Patricia Cunningham, Francesca Huang, Grant D Aslan, Mihaela Ioannou, George N Veterans Affairs Portland Health Care System Portland OR United States Division of Infectious Diseases Department of Medicine Oregon Health & Science University Portland OR United States Veterans Affairs Cooperative Studies Program Clinical Epidemiology Research Center Veterans Affairs Connecticut Health Care System West Haven CT United States Department of Biostatistics Yale School of Public Health New Haven CT United States Biomedical Informatics & Data Science Yale School of Medicine New Haven CT United States Department of Internal Medicine Yale School of Medicine New Haven CT United States Seattle Epidemiologic Research and Information Center Veterans Affairs Puget Sound Health Care System Seattle WA United States Research and Development Veterans Affairs Puget Sound Health Care System Seattle WA United States Center of Innovation to Improve Veteran Involvement in Care Veterans Affairs Portland Health Care System Portland OR United States Health Management and Policy College of Health Oregon State University Corvallis OR United States Health Data and Informatics Program Center for Quantitative Life Sciences Oregon State University Corvallis OR United States Public Health National Program Office Veterans Health Administration Palo Alto CA United States Public Health National Program Office Veterans Health Administration Washington DC United States Veterans Affairs Center for Medication Safety—Pharmacy Benefit Management Services Hines IL United States Office of Research and Development Veterans Health Administration Washington DC United States Division of Gastroenterology Veterans Affairs Puget Sound Health Care System and University of Washington Seattle WA United States

Background: New respiratory syncytial virus (RSV) vaccines have been approved in the USA for the prevention of RSV-associated lower respiratory tract disease in adults aged 60 years and older. Information on the real-world effectiveness of these vaccines is needed. Methods: We used electronic health records in the Veterans health Administration to emulate a target trial comparing a single dose of a recombinant stabilised prefusion F protein RSV vaccine versus no vaccination among veterans aged 60 years and older. We matched eligible vaccine recipients with up to four unvaccinated individuals in four monthly nested sequential trials from Sept 1 to Dec 31, 2023. Outcomes were ascertained up to March 31, 2024. The primary outcome was any positive RSV test from day 14 following the matched index date. Secondary outcomes included hospitalisation and emergency department or urgent care encounter occurring within 1 day before or after a positive RSV test. We estimated vaccine effectiveness as 100 × (1 – risk ratio). Findings: We included 146 852 vaccinated individuals matched to 582 936 unique control individuals, weighted equally to represent 146 852 individuals. Across the two groups, 276 039 (94·0%) of 293 704 veterans were male, 17 665 (6·0%) were female, and median age was 75·9 years (IQR 71·7–79·7). Over a median follow-up of 124 days (IQR 102–150), the incidence rate of documented RSV infection was 1·7 (95% CI 1·4–2·1) events per 1000 person-years (88 total events) in the vaccinated group and 7·3 (6·6–8·1) per 1000 person-years in the unvaccinated group (372 total events), and vaccine effectiveness was estimated as 78·1% (72·6–83·5). Among the secondary outcomes, vaccine effectiveness was estimated at 78·7% (72·2–84·8) against RSV-associated emergency department or urgent care encounters, and 80·3% (65·8–90·1) against RSV-associated hospitalisation. Interpretation: RSV vaccination was effective in preventing RSV-related illness, including associated health-care use,

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Disparities in stage at diagnosis for liver cancer in China

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Journal of the National Cancer Center 2023年第1期3卷 7-13页

作者： Tianhao Shan Xianhui Ran Huizhang Li Guoshuang Feng Siwei Zhang Xuehong Zhang Lei Zhang Lingeng Lu Lan An Ruiying Fu Kexin Sun Shaoming Wang Ru Chen Li Li Wanqing Chen Wenqiang Wei Hongmei Zeng Jie He National Central Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital Department of Cancer PreventionInstitute of Cancer Research and Basic Medical SciencesChinese Academy of SciencesHangzhouChina Big Data Center Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Channing Division of Network Medicine Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA Department of Nutrition T.H.Chan School of Public HealthHarvard UniversityBostonUSA China-Australia Joint Research Center for Infectious Diseases School of Public HealthXi’an Jiaotong University Health Science CenterXi’anChina Artificial Intelligence and Modelling in Epidemiology Program Melbourne Sexual Health CentreAlfred HealthMelbourneAustralia Central Clinical School Faculty of MedicineMonash UniversityMelbourneAustralia Department of Epidemiology and Biostatistics College of Public HealthZhengzhou UniversityZhengzhouChina Department of Chronic Disease Epidemiology Yale School of Public HealthYale Cancer CenterNew HavenUSA Department of Thoracic Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background:The stage at diagnosis is a major factor in making treatment strategies and cancer control ***,the stage distribution for liver cancer in China was not well *** this multi-center hospital-based study,we aimed to identify the distribution and factors associated with stage at diagnosis for liver cancer in ***:We included patients diagnosed with primary liver cancer in 13 hospitals of 10 provinces covering various geographic and socioeconomic populations during 2016-2017 in *** stage distribution overall,and by sex and age at diagnosis were *** used logistic regression to identify the factors associated with stage Ⅲ-Ⅳ *** further compared these estimates with data from the ***:We included 2,991 patients with known stage at diagnosis in *** proportion of patients diagnosed with stageⅠ,Ⅱ,Ⅲ,and Ⅳ was 17.5%,25.6%,29.3%,and 27.6%,*** proportion of stage Ⅲ-Ⅳ cases was higher in women[65.1%vs 54.9%,adjusted odds ratio(OR)=1.5,95%CI:1.2,1.8]and those≥60 years(61.6%vs 52.8%,OR=1.4,95%CI:1.2,1.6).We found an increased risk of stage Ⅲ-Ⅳ among drinkers and those without a family history of *** to the USA,our study population had a substantially higher proportion of stage Ⅲ-Ⅳ cases(56.9%vs 45.6%).Conclusion:The disparities in liver cancer stage at diagnosis among different populations within China,and between China and the USA,imply the necessity for improving cancer awareness and early detection for liver cancer in China.

关键词： Liver cancer Stage at diagnosis Disparity China USA

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Key issues for stakeholder engagement in the development of health and healthcare guidelines

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research Involvement and Engagement 2023年第1期9卷 27页

作者： Petkovic, Jennifer Magwood, Olivia Lytvyn, Lyubov Khabsa, Joanne Concannon, Thomas W. Welch, Vivian Todhunter-Brown, Alex Palm, Marisha E. Akl, Elie A. Mbuagbaw, Lawrence Arayssi, Thurayya Avey, Marc T. Marusic, Ana Morley, Richard Saginur, Michael Slingers, Nevilene Texeira, Ligia Ben Brahem, Asma Bhaumik, Soumyadeep Bou Akl, Imad Crowe, Sally Dormer, Laura Ekanem, Comfort Lang, Eddy Kianzad, Behrang Kuchenmüller, Tanja Moja, Lorenzo Pottie, Kevin Schünemann, Holger Tugwell, Peter Bruyère Research Institute Ottawa Canada Faculty of Medicine University of Ottawa Ottawa Canada Interdisciplinary School of Health Sciences University of Ottawa Ottawa Canada McMaster University Hamilton Canada Clinical Research Institute American University of Beirut Medical Center Beirut Lebanon The RAND Corporation and Tufts University School of Medicine Boston MA United States School of Epidemiology and Public Health University of Ottawa Ottawa Canada Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit Glasgow Caledonian University Glasgow United Kingdom Tufts Medical Center Tufts Clinical and Translational Science Institute Boston MA United States Tufts Medical Center Institute for Clinical Research and Health Policy Studies Boston MA United States Department of Internal Medicine American University of Beirut Beirut Lebanon Department of Health Research Methods Evidence and Impact (HEI) McMaster University Hamilton ON Canada Department of Health Research Methods Evidence and Impact McMaster University Hamilton ON Canada Department of Anesthesia McMaster University Hamilton ON Canada Department of Pediatrics McMaster University Hamilton ON Canada Biostatistics Unit Father Sean O’Sullivan Research Centre St Joseph’s Healthcare Hamilton ON Canada Centre for Development of Best Practices in Health (CDBPH) Yaoundé Central Hospital Yaoundé Cameroon Division of Epidemiology and Biostatistics Department of Global Health Stellenbosch University Cape Town South Africa Weill Cornell Medicine –Qatar Doha Qatar Ministry of Health Cross River State Calabar Nigeria Cumming School of Medicine University of Calgary Alberta Health Services Calgary Zone Canada Canadian Council on Animal Care Ottawa Canada Department of Research in Biomedicine and Health Center for Evidence-Based Medicine University of Split School of Medicine Split Croatia Cochrane St Albans House Haymarket London 57-59 United Kingdom Hôpital Montfort Ottawa

Established in 2015, the Multi-Stakeholder Engagement (MuSE) Consortium is an international network of over 120 individuals interested in stakeholder engagement in research and guidelines. The MuSE group is developing guidance for stakeholder engagement in the development of health and healthcare guideline development. The development of this guidance has included multiple meetings with stakeholders, including patients, payers/purchasers of health services, peer review editors, policymakers, program managers, providers, principal investigators, product makers, the public, and purchasers of health services and has identified a number of key issues. These include: (1) Definitions, roles, and settings (2) Stakeholder identification and selection (3) Levels of engagement, (4) Evaluation of engagement, (5) Documentation and transparency, and (6) Conflict of interest management. In this paper, we discuss these issues and our plan to develop guidance to facilitate stakeholder engagement in all stages of the development of health and healthcare guideline development. © 2023, The Author(s).

关键词： Guideline development Patient and public involvement Stakeholder engagement

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Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials (vol 11, pg 453, 2023)

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LANCET RESPIRATORY MEDICINE 2023年第8期11卷 E77-E77页

作者： Amstutz, A. Speich, B. Mentre, F. [a]CLEAR Methods Center Division of Clinical Epidemiology University Hospital Basel Basel Switzerland [b]Department of Clinical Research University Hospital Basel Basel Switzerland [c]Université Paris Cité and Université Sorbonne Paris Nord Inserm IAME Paris France [d]Département d'Épidémiologie Biostatistique et Recherche Clinique Hôpital Bichat AP-HP Paris France [e]Service de Maladies Infectieuses et Tropicales Hôpital Bichat AP-HP Paris France [f]Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital Oslo Norway [g]Department of Anesthesia and Intensive Care Medicine Oslo University Hospital Oslo Norway [h]Department of Pediatrics Faculty of Medicine University of British Columbia Vancouver BC Canada [i]Clinical Trials Research Section Biostatistics Research Branch National Institute of Allergy and Infectious Diseases National Institutes of Health Rockville MD USA [j]Department of Pulmonary and Critical Care Medicine Center of Respiratory Medicine China-Japan Friendship Hospital Beijing China [k]Institute of Respiratory Medicine Chinese Academy of Medical Sciences Beijing China [l]National Clinical Research Center for Respiratory Diseases Beijing China [m]Department of Urology University of Helsinki and Helsinki University Hospital Helsinki Finland [n]Department of Surgery South Karelian Central Hospital Lappeenranta Finland [o]Département des Maladies Infectieuses et Tropicales Hospices Civils de Lyon Lyon France [p]Laboratoire de Virologie Institut des Agents Infectieux de Lyon Centre National de Référence des Virus Respiratoires France Sud Hospices Civils de Lyon Lyon France [q]Legiopath Centre International de Recherche en Infectiologie Inserm 1111 Université Claude Bernard Lyon 1 CNRS UMR5308 École Normale Supérieure de Lyon Univ Lyon Lyon France [r]Cliniques Universitaires de Bruxelles Hôpital Érasme Université Libre de Bruxelles Clinique des Maladies Infectieuses Brussels Belgium [s]Department of Medicine Univers

Background Interpretation of the evidence from randomised controlled trials (RCTs) of remdesivir in patients treated in hospital for COVID-19 is conflicting. We aimed to assess the benefits and harms of remdesivir compared with placebo or usual care in these patients, and whether treatment effects differed between prespecified patient subgroups. Methods For this systematic review and meta-analysis, we searched PubMed, Embase, the Cochrane COVID-19 trial registry, ***, the International clinical Trials Registry Platform, and preprint servers from Jan 1, 2020, until April 11, 2022, for RCTs of remdesivir in adult patients hospitalised with COVID-19, and contacted the authors of eligible trials to request individual patient data. The primary outcome was all-cause mortality at day 28 after randomisation. We used multivariable hierarchical regression—adjusting for respiratory support, age, and enrollment period—to investigate effect modifiers. This study was registered with PROSPERO, CRD42021257134. Findings Our search identified 857 records, yielding nine RCTs eligible for inclusion. Of these nine eligible RCTs, individual data were provided for eight, covering 10 480 patients hospitalised with COVID-19 (99% of such patients included in such RCTs worldwide) recruited between Feb 6, 2020, and April 1, 2021. Within 28 days of randomisation, 662 (12·5%) of 5317 patients assigned to remdesivir and 706 (14·1%) of 5005 patients assigned to no remdesivir died (adjusted odds ratio [aOR] 0·88, 95% CI 0·78–1·00, p=0·045). We found evidence for a credible subgroup effect according to respiratory support at baseline (pinteraction=0·019). Of patients who were ventilated—including those who received high-flow oxygen—253 (30·0%) of 844 patients assigned to remdesivir died compared with 241 (28·5%) of 846 patients assigned to no remdesivir (aOR 1·10 [0·88–1·38]; low-certainty evidence). Of patients who received no oxygen or low-flow oxygen, 409 (9·1%) of 4473 patien

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The impact of hypertension prevention and modification on dementia burden: A systematic review of economic studies

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The journal of prevention of Alzheimer's disease 2025年第1期12卷 100017-100017页

作者： Lan, Marie John-Baptiste, Ava Curran, Cassandra Alemu, Feben W. Avan, Abolfazl Anderson, Kelly K. Ali, Shehzad Epidemiology and Biostatistics Schulich School of Medicine & Dentistry Western University London ON Canada Epidemiology and Biostatistics Schulich School of Medicine & Dentistry Western University London ON Canada London Health Sciences Centre London ON Canada Lawson Health Research Institute London ON Canada Schulich Interfaculty Program in Public Health Western University London ON Canada Department of Anesthesia and Perioperative Medicine Western University London ON Canada Centre for Medical Evidence Decision Integrity and Clinical Impact London ON Canada Epidemiology and Biostatistics Schulich School of Medicine & Dentistry Western University London ON Canada Robarts Research Institute University of Western Ontario London Ontario Canada Epidemiology and Biostatistics Schulich School of Medicine & Dentistry Western University London ON Canada Lawson Health Research Institute London ON Canada Psychiatry Schulich School of Medicine & Dentistry Western University London ON Canada Epidemiology and Biostatistics Schulich School of Medicine & Dentistry Western University London ON Canada Schulich Interfaculty Program in Public Health Western University London ON Canada Centre for Medical Evidence Decision Integrity and Clinical Impact London ON Canada WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity Ottawa Canada Department of Health Sciences University of York York UK Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Ontario Canada Department of Psychology Macquarie University Sydney Australia

AIM: Neurological disorders account for the largest proportion of disability-adjusted life years globally, with dementia being the third leading cause. Hypertension has been identified as a priority, targetable risk factor for dementia. This study aimed to systematically review economic studies that examine the impact of hypertension prevention and control on the costs and outcomes of dementia. METHODS: An electronic literature search was conducted using MEDLINE, EMBASE, Scopus, Web of Science, EconLit, and grey literature sources. The inclusion criteria were: 1) economic evaluation studies, including both full and partial evaluations;2) a primary focus on dementia;and 3) evaluation of the impact of preventing or modifying hypertension on the burden of dementia. The quality of included studies was assessed using the Consensus on health Economic Criteria (CHEC) list. RESULTS: Twelve studies were included in the final review. Four studies were full economic evaluations, while eight were partial evaluations, with one reporting costs and seven reporting the impact on dementia prevalence. Nine studies considered hypothetical reductions in hypertension rate, while three evaluated applied hypertension-related interventions. Hypertension modification was associated with higher life expectancy and a higher average age of dementia onset. Full economic evaluations of specific hypertension modification interventions found that these interventions dominated (i.e. had lower costs and higher quality-adjusted life-years (QALY)) the status quo scenario or had an acceptable incremental cost-effectiveness ratio (ICER). CONCLUSIONS: Hypertension modification has the potential to reduce the burden of dementia in a cost-effective way. However, further economic evaluations of applied interventions are needed to determine real-world feasibility and cost-effectiveness. Copyright © 2024. Published by Elsevier Masson SAS.

关键词： Costs Dementia Economic evaluation Hypertension Prevention

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