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A population-based cohort study defined estimated glomerular filtration rate decline and kidney failure among Canadian immigrants

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Kidney International 2025年第6期107卷 1088-1098页

作者： Olaye, Ida-Ehosa Yu, Chengchun Tuna, Meltem Akbari, Ayub Ramsay, Tim Tanuseputro, Peter Mucsi, Istvan Knoll, Greg A. Sood, Manish M. Hundemer, Gregory L. School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada ICES Ottawa ON Canada Methodological and Implementation Research Program Ottawa Hospital Research Institute University of Ottawa Ottawa ON Canada Division of Nephrology Department of Medicine University of Ottawa Ottawa ON Canada Department of Family Medicine and Primary Care University of Hong Kong Special Administrative Region of China Hong Kong Ajmera Transplant Centre and Division of Nephrology University Health Network Toronto ON Canada Division of Nephrology Department of Medicine University of Toronto Toronto ON Canada

The link between immigrant status, a key social determinant of health, and kidney disease remains uncertain. To evaluate this, we compared incident adverse kidney outcomes between immigrants and non-immigrants using Canadian provincial health administrative data. We conducted a population-based observational cohort study of all adult Ontario residents (immigrants and non-immigrants) with normal baseline kidney function (estimated glomerular filtration rate (eGFR) 70 mL/min/1.73m² or more). Multivariable Cox proportional hazard regression modeling was used to evaluate the relationship between immigrant status and the composite adverse kidney outcome of 40% eGFR decline or kidney failure. The study cohort included 10,440,210 individuals with 22% immigrants and 78% non-immigrants. The mean (Standard Deviation) age and eGFR were 45 (17) years and 102 (16) mL/min/1.73m², respectively. Immigrants experienced a 27% lower hazard for the composite adverse kidney outcome (adjusted hazard ratio 0.73 [95% Confidence Interval 0.72-0.74]) compared to non-immigrants which was primarily driven by 40% eGFR decline. However, immigrants also experienced a 12% lower hazard for incident kidney failure (0.88 [0.84-0.93]) compared to non-immigrants. Results were consistent upon accounting for the competing risk of death and adjusting for baseline albuminuria. As has been demonstrated with other chronic diseases, these novel findings suggest that a “healthy immigrant effect” also extends to kidney disease. Differential kidney disease outcomes were identified among immigrants based on refugee status and world region of origin which may inform health policy decision-making toward targeted screening strategies and more cost-effective resource allocation for immigrant populations. © 2025 International Society of Nephrology

关键词： chronic kidney disease end-stage kidney disease immigrant kidney health refugee social determinants of health

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Priors from Envisioned Posterior Judgments: A Novel Elicitation Approach With Application to Bayesian Clinical Trials

arXiv

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arXiv 2024年

作者： Ouyang, Yongdong Eng, Janice J. Zhan, Denghuang Wong, Hubert The Hospital for Sick Children Toronto Canada Dalla Lana School of Public Health University of Toronto Toronto Canada Methodological and Implementation Research Program Ottawa Hospital Research Institute Canada Department of Physical Therapy University of British Columbia Vancouver Canada Centre for Aging SMART Vancouver Canada School of Population and Public Health University of British Columbia Vancouver Canada Centre for Advancing Health Outcomes St Paul’s Hospital Vancouver Canada

The uptake of formalized prior elicitation from experts in Bayesian clinical trials has been limited, largely due to the challenges associated with complex statistical modeling, the lack of practical tools, and the cognitive burden on experts required to quantify their uncertainty using probabilistic language. Additionally, existing methods do not address prior-posterior coherence, i.e., does the posterior distribution, obtained mathematically from combining the estimated prior with the trial data, reflect the expert’s actual posterior beliefs? We propose a new elicitation approach that seeks to ensure prior-posterior coherence and reduce the expert’s cognitive burden. This is achieved by eliciting responses about the expert’s envisioned posterior judgments under various potential data outcomes and inferring the prior distribution by minimizing the discrepancies between these responses and the expected responses obtained from the posterior distribution. The feasibility and potential value of the new approach are illustrated through an application to a real trial currently underway. © 2024, CC BY-NC-ND.

关键词： Modeling languages

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Healthcare workers' current practices, knowledge/awareness, barriers, and attitudes/perceptions related to pneumococcal vaccination of older adults: A mixed-methods systematic review

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Vaccine 2025年 61卷 127331页

作者： Asia Akther Cassandra Laurie Tara Elton-Marshall Valentina Ly Giorgia Sulis School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada Institute for Mental Health Policy Research Center for Addiction and Mental Health Toronto Ontario Canada University of Ottawa Library Services University of Ottawa Ottawa Ontario Canada Methodological and Implementation Research Program Ottawa Hospital Research Institute Ottawa Ontario Canada

Objectives Despite global efforts, pneumococcal vaccination uptake among older adults remains significantly low. Previous literature suggests that vaccine promotion by healthcare workers plays an essential role in uptake. We conducted a systematic review to examine healthcare workers' current practices, and to identify capability, opportunity, and motivation factors regarding pneumococcal vaccination for older adults. Methods A search of both quantitative and qualitative studies was conducted in MEDLINE, Embase, CINAHL, Global Health, AgeLine, and Scopus databases and in the grey literature to identify relevant published studies from inception to November 2, 2023, with no language restrictions. The Joanna-Briggs Institute methodology for mixed-methods systematic reviews was used (PROSPERO ID: CRD42023480576). Studies conducted on healthcare workers related to pneumococcal vaccination in older adults (65 years and older) were included. The quality of studies was assessed using the Mixed Methods Appraisal Tool for the quantitative and mixed-methods studies and the Critical Appraisal Skills programme Tool for qualitative studies. In addition, we used the convergent integrated and segregated approach to synthesize proportions and relevant themes. Results We included 42 studies (38 quantitative and four qualitative), of which 20 evaluated factors related to current practice, 27 capability, 24 opportunity, and 28 motivations. Our review findings suggest that practices varied considerably. However, most health providers knew about pneumococcal vaccination and had a positive attitude/perception toward it. Common barriers to pneumococcal vaccination in older adults included finances (e.g., high cost to patients/system), logistics (e.g., insufficient time/information), availability of information (e.g., insufficient education/campaigns), patient-related (e.g., hesitancy/refusal), and system factors (e.g., unclear guidelines/recommendations). Conclusions As the aging populatio

关键词： Pneumococcal disease Prevention Immunization Vaccine promotion Evidence synthesis

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Improving the completeness and transparency of protocols and reports of randomized trials: SPIRIT 2025 and CONSORT 2025

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Journal of Clinical Epidemiology 2025年 182卷 111792-111792页

作者： Moher, David Boutron, Isabelle Chan, An-Wen Hopewell, Sally Hróbjartsson, Asbjørn Schulz, Kenneth F. Centre for Journalology Methodological and Implementation Research Program Ottawa Hospital Research Institute School of Epidemiology and Public Health University of Ottawa Ottawa Canada Université Paris Cité and Université Sorbonne Paris Nord Inserm INRAE Centre for Research in Epidemiology and Statistics (CRESS) Paris France Centre D'Epidémiologie Clinique Hôpital Hôtel Dieu Paris France Department of Medicine Women's College Research Institute University of Toronto Toronto Canada Oxford Clinical Trials Research Unit/Centre for Statistics in Medicine University of Oxford Oxford United Kingdom Centre for Evidence-Based Medicine Odense and Cochrane Denmark Department of Clinical Research University of Southern Denmark Odense Denmark Open Patient Data Explorative Network Odense University Hospital Odense Denmark Department of Obstetrics and Gynecology School of Medicine University of North Carolina at Chapel Hill Chapel Hill NC United States

Objectives: To update SPIRIT 2013 and CONSORT 2010 reporting guidelines. Methods: For SPIRIT 2025, a comprehensive review process incorporating scoping reviews, expert consultations, and a Delphi survey led to a revised checklist. CONSORT 2025 underwent a similar update, addressing methodological advancements and user feedback gathered through scoping reviews, expert consultations, and a Delphi survey. Results: Key changes include the addition of two new items, revisions to five, and the deletion or merging of five, alongside a new Open Science section. Emphasis on harm assessment, intervention description, and patient/public involvement has also been strengthened. The SPIRIT 2025 statement provides a 34-item checklist, a schedule diagram, and an expanded checklist with explanations. Similarly, seven new items were added, three revised, and one deleted, with content integrated from existing CONSORT extensions. A new Open Science section was also incorporated. The CONSORT 2025 statement offers a 30-item checklist, a flow diagram, and a detailed explanatory checklist. Conclusion: Both updated statements and explanatory articles aim to enhance transparency and completeness in trial protocols and reporting. Widespread adoption by investigators, funders, ethics committees, journals, and regulators should improve the quality and usability of research, ultimately benefiting patients and others. Plain Language Summary: We have updated two important guidelines, SPIRIT and CONSORT, to make research studies easier to understand and more reliable. We did this by carefully reviewing existing research and getting feedback from experts around the world. The new SPIRIT 2025 guideline has 34 items to help researchers report their study plans clearly. It includes new sections on how to assess potential risks, describe the treatment, and involve patients in the research. We also added a new section about sharing data openly. The new CONSORT 2025 guideline has 30 items to help research

关键词： Completed reports of randomized trials CONSORT 2025 Protocols of randomized trials Reporting guidelines SPIRIT 2025 Transparency

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The urgent need for implementation science to achieve hepatitis C elimination

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The lancet. Gastroenterology & hepatology 2025年第6期10卷 498-502页

作者： Guillaume Fontaine Natalie Taylor Julie Bruneau Nadine Kronfli Christina Greenaway Mia J Biondi Marina B Klein Sahar Saeed Jason Grebely Justin Presseau Ingram School of Nursing Faculty of Medicine and Health Sciences McGill University Montreal QC H3A 2M7 Canada Centre for Clinical Epidemiology Lady Davis Institute for Medical Research Sir Mortimer B Davis Jewish General Hospital CIUSSS West-Central Montreal Montreal QC Canada Centre for Implementation Research Methodological and Implementation Research Program Ottawa Hospital Research Institute Ottawa ON Canada Kirby Institute UNSW Sydney Kensington NSW Australia. Electronic address: guil.fontaine@mcgill.ca. School of Population Health UNSW Sydney Kensington NSW Australia. Research Centre Université de Montréal Hospital Centre Montreal QC Canada Department of Family and Emergency Medicine Université de Montréal Montreal QC Canada. Department of Medicine Division of Infectious Diseases and Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada Centre for Outcomes Research and Evaluation Research Institute of the McGill University Health Centre Montreal QC Canada. Department of Medicine Division of Infectious Diseases and Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada. School of Nursing York University North York ON Canada. Department of Public Health Sciences Queen's University Kingston ON Canada. Kirby Institute UNSW Sydney Kensington NSW Australia. School of Epidemiology and Public Health and School of Psychology University of Ottawa Ottawa ON Canada.

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Randomization procedures in parallel-arm cluster randomized trials in low- and middle-income countries: a review of 300 trials published between 2017-2022

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Journal of clinical epidemiology 2025年 184卷 111825页

作者： Julia F Shaw Cory E Goldstein Thais Mazzetti Anna Armond Yacine Marouf Kyle Lamprecht Eric Tran Sami Abdul Alex J London Charles Weijer Karla Hemming Lawrence Mbuagbaw Mira Johri Rashida Ferrand Shaun Treweek Stuart G Nicholls Monica Taljaard Methodological and Implementation Research Program Ottawa Hospital Research Institute 501 Smyth Rd Ottawa. ON Canada K1H 8L6 School of Epidemiology and Public Health Faculty of Medicine University of Ottawa 75 Laurier Ave E Ottawa. ON Canada K1N 6N5. Electronic address: julishaw@ohri.ca. School of Epidemiology and Public Health Faculty of Medicine University of Ottawa 75 Laurier Ave E Ottawa. ON Canada K1N 6N5. Graduate Program in Dentistry Federal University of Pelotas R. Gonçalves Chaves 457-Centro Pelotas-RS Brazil 96015-560. Metaresearch and Open Science Centre University of Ottawa Heart Institute 40 Ruskin St. Ottawa ON Canada K1Y 4W7. Dalla Lana School of Public Health University of Toronto 27 King's College Cir Toronto ON Canada M5S 1A1. Faculty of Health Sciences University of Ottawa 200 Lees Ave Ottawa ON Canada K1S 5S9. Shulich School of Medicine and Dentistry Western University 1151 Richmond St London ON Canada N6A 5C1. Center for Ethics and Policy Carnegie Mellon University 5000 Forbes Ave Pittsburgh PA 15213. Department of Medicine Western University 1151 Richmond St. N. London ON Canada N6A 3K7 Department of Epidemiology and Biostatistics Western University 1151 Richmond St. N. London ON Canada N6A 3K7 Department of Philosophy Western University 1151 Richmond St. N. London ON Canada N6A 3K7. Institute of Applied Health Research University of Birmingham 97 Vincent Dr Birmingham United Kingdom B15 2SQ. Biostatistics Unit St Joseph's Healthcare 50 Charlton Ave E Hamilton ON Canada L8N 4A6. University of Montreal Hospital Research Centre (CRCHUM) 900 Saint Denis St Montreal QC H2X 0A9 Department of Health Management Evaluation and Policy School of Public Health University of Montreal 7101 Park Ave Montreal QC Canada H3N 1X9. Clinical Research Department London School of Hygiene and Tropical Medicine Keppel Street London United Kingdom WC1E 7HT The Health Research Unit Zimbabwe Biomedical Research and Training Institute

OBJECTIVE:Cluster randomized trials (CRTs) are frequently used to evaluate interventions in low- and middle-income countries (LMICs). Robust execution and transparent reporting of randomization procedures are essential for successful implementation and accurate interpretation of CRTs. Our objectives were to review the quality of reporting and implementation of randomization procedures in a sample of parallel-arm CRTs conducted in LMICs. STUDY DESIGN AND SETTING:We selected a random sample of 300 primary reports of parallel-arm CRTs from a database of 800 CRTs conducted in LMICs between 2017-2022. Data were extracted by two reviewers per trial and summarized using descriptive statistics. RESULTS:Among 300 trials, 192 (64%) reported the method of sequence generation, 213 (71%) reported the type of randomization procedure used, 146 (49%) reported who generated the sequence, 136 (45%) reported whether randomization was implemented by an independent person, and 75 (25%) reported a method of allocation concealment. Among those reporting the methods used, suboptimal methods of randomization were common: 28% did not use a computer, 21% did not use restricted randomization, 58% did not use a statistician to generate the sequence, in 53% the person was not independent from the trial, and 80% did not use central randomization. Public randomization ceremonies were used in 10% of trials as an alternative method of allocation concealment and to reassure participants of fair allocation procedures. CONCLUSION:The conduct and reporting of randomization procedures of CRTs in LMICs is suboptimal. Dissemination of guidance to promote robust implementation of randomization in LMICs is required and future research on the implementation of public randomization ceremonies is warranted.

关键词： CONSORT cluster randomized trial global health methodology public randomization ceremony

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