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Protocol for a systematic review and systems-based exploration of interventions to reduce medicines wastage 对减少药品浪费的干预措施进行系统性审查和系统性探索的议定书
Pub Date : 2023-12-01 DOI: 10.12688/hrbopenres.13800.1
Áine Harris, Ryan Jayesinghe, Lorna Bonnici West, Derek Stewart, T. Grimes, Patrick Redmond
Introduction A reduction in medicines wastage is an important objective in promoting appropriate use of finite resources. The objective of this systematic review is to both assess the effectiveness of interventions to reduce medicines wastage, and apply a systems based exploration of the factors affecting implementation of interventions. Methods A systematic review will be conducted following PRISMA reporting guidelines. Searches will be performed in Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, PubMed, Science Citation Index, PsycInfo, Scopus, the Cochrane Library, grey literature, and trials registries. Data extraction and critical appraisal will be completed independently by two reviewers. If studies are sufficiently homogenous in terms of design and comparators, we will conduct a meta-analysis. Where this is not possible, we will provide a narrative synthesis of results grouping studies with similar interventions together. The barriers and enablers of the described interventions will then be analysed using the Systems Engineering Initiative in Patient Safety (SEIPS 101) model. Conclusions This review will describe the effectiveness of interventions to reduce medicines wastage and issues associated with their implementation in order to inform policy development and intervention implementation in the future. This will have the potential to reduce both the economic and environmental burden of medicines wastage on the health service. PROSPERO registration CRD42022335848 (12/06/2022)
减少药品浪费是促进合理利用有限资源的一个重要目标。本系统综述的目的是评估减少药物浪费的干预措施的有效性,并对影响干预措施实施的因素进行基于系统的探索。方法按照PRISMA报告指南进行系统评价。检索将在护理和联合健康文献累积索引(CINAHL)、Embase、Medline、PubMed、科学引文索引、PsycInfo、Scopus、Cochrane图书馆、灰色文献和试验注册中进行。数据提取和关键评估将由两名审稿人独立完成。如果研究在设计和比较物方面具有足够的同质性,我们将进行荟萃分析。如果这是不可能的,我们将提供一个叙述性的综合结果,将具有类似干预措施的研究分组在一起。然后将使用患者安全系统工程计划(SEIPS 101)模型分析上述干预措施的障碍和促成因素。本综述将描述减少药物浪费的干预措施的有效性及其实施相关问题,以便为未来的政策制定和干预措施实施提供信息。这将有可能减轻医药浪费给卫生服务造成的经济和环境负担。普洛斯彼罗注册编号42022335848 (12/06/2022)
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引用次数: 0
mHealth clinical decision-making tools for maternal and perinatal health care in Sub-Saharan Africa: A systematic review protocol 用于撒哈拉以南非洲孕产妇和围产期保健的移动保健临床决策工具:系统性审查协议
Pub Date : 2023-11-27 DOI: 10.12688/hrbopenres.13799.1
Gaudensia A. Olomi, L. Cansdale, Simon Woodworth, Rachel Manongi, Pendo Mlay, Karen Yeates, Nicola West, Jane E. Hirst, Christopher Redman, M. Mahande, B. Mmbaga, A. Khashan
Background Mobile health (mHealth) tools are increasingly being used in Sub-Saharan Africa (SSA) to improve the quality of health services. mHealth clinical decision-making tools have several established roles in maternal and perinatal healthcare including health surveillance, data collection and access to guidelines. The adoption of mHealth clinical decision-making tools in low-resource environments like SSA, as well as the lessons learnt from using them, have not yet been determined. As new mHealth technologies are quickly being evaluated and deployed in resource-poor settings, it is crucial to thoroughly analyse what has been accomplished in order to inform implementers and policy makers on the effectiveness of technology in evidence-based practice. Objective This study aims to synthesize the available evidence 1) on the use of mHealth clinical decision-making tools for maternal and perinatal care in SSA, and 2) whether these tools lead to improvements in the quality of maternal and perinatal care in SSA. Methods A systematic review of the literature will be performed to identify publications describing the use mHealth tools for maternal and perinatal clinical decision-making in SSA. PubMed, CINAHL, EMBASE, Global Health and Web of Science will be searched for relevant articles following a predetermined search strategy with no date restrictions. A limited grey literature search will also be carried out. Two independent reviewers will screen the articles. Pre-determined data items will be extracted, and data synthesis carried out using a descriptive approach. Appraisal will be done using the Appraisal of Guidelines Research and Evaluation Health Systems (AGREE-HS) instrument. Conclusions This systematic review protocol for identifying and appraising mHealth clinical decision-making tools in maternal and perinatal care may help to establish best practice for developing and scaling up, thus help to improve care in SSA. Registration PROSPERO (CRD42023452760; 19 August 2023).:
移动医疗临床决策工具在孕产妇和围产期保健中发挥着多种既定的作用,包括健康监测、数据收集和获取指南。在 SSA 等低资源环境中采用移动医疗临床决策工具的情况以及从使用这些工具中汲取的经验教训尚未确定。随着新的移动医疗技术在资源匮乏的环境中迅速得到评估和部署,彻底分析已取得的成果至关重要,以便让实施者和决策者了解技术在循证实践中的有效性。本研究旨在综合现有证据:1)在撒哈拉以南非洲地区使用移动医疗临床决策工具进行孕产妇和围产期保健的情况;2)这些工具是否提高了撒哈拉以南非洲地区孕产妇和围产期保健的质量。方法 将对文献进行系统性综述,以确定描述在 SSA 地区使用移动医疗工具进行孕产妇和围产期临床决策的出版物。将按照预先确定的检索策略在 PubMed、CINAHL、EMBASE、Global Health 和 Web of Science 上检索相关文章,没有日期限制。此外,还将进行有限的灰色文献检索。两名独立审稿人将对文章进行筛选。将提取预先确定的数据项,并采用描述性方法进行数据综合。评估将使用卫生系统指南研究与评估(AGREE-HS)工具进行。结论 该系统综述方案用于确定和评估孕产妇和围产期保健中的移动医疗临床决策工具,有助于确立开发和推广的最佳实践,从而帮助改善撒哈拉以南非洲地区的保健服务。注册 PROSPERO(CRD42023452760;2023 年 8 月 19 日):
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引用次数: 0
Which outcome measurement instruments are used to measure core infant feeding outcomes in children up to 1 year of age? A scoping review protocol 哪些结果测量工具可用于测量1岁以内婴儿喂养的核心结果?范围界定审查协议
Pub Date : 2023-11-27 DOI: 10.12688/hrbopenres.13797.1
K. Matvienko-Sikar, Linda Adair, Lucinda K Bell, C. Birken, Vicki Brown, Darren Dahly, A. Doherty, Rebecca K Golley, Patricia Leahy-Warren, Marian McBride, Elizabeth McCarthy, Andrew W Murphy, Sarah Redsell, C. B. Terwee
Background How, what, and when infants are fed plays a role in the aetiology of childhood obesity. Heterogeneity in how infant feeding outcomes are measured in trials of interventions to prevent childhood obesity limits evidence syntheses and understanding of intervention effectiveness. An infant feeding core outcome set (COS) was previously developed to standardised outcome measurement and reporting. The COS represents what to measure; determining how best to measure these outcomes is the next essential step to improve intervention evaluations. The aim of this scoping review is therefore to identify what outcome measurement instruments have been used in trials, and how they have been used, to measure the core infant feeding outcomes. Methods A scoping review will be conducted. MEDLINE, EMBASE, CINAHL, PsychINFO, the Cochrane Central Register of Controlled Trials, OpenGrey and GreyNet will be searched from inception. Papers are eligible for inclusion if they report trials involving primary data collection that measure and report at least one core infant feeding outcome in infants ≤one year of age. Following searching and screening, eligible studies will be categorised into the following four overarching categories for data extraction, synthesis and write-up: caregiver-related outcomes; diet-related outcomes; feeding environment outcomes; child weight outcomes. Data will be narratively described and presented in tabular format, with findings presented in four separate review papers delineated by the four overarching categories. Discussion This scoping review forms part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study (www.eiascope.com). Evidence from this scoping review on what measurement instruments are used, and how they are used, represents an essential first step in developing recommendations and guidance about how best to measure core infant feeding outcomes for childhood obesity prevention. This can improve evidence syntheses and understanding of what infant feeding interventions are most effective for childhood obesity prevention.
背景婴儿的喂养方式、内容和时间在儿童肥胖症的病因中起着重要作用。在对预防儿童肥胖的干预措施进行试验时,对婴儿喂养结果的测量方法存在差异,这限制了对证据的综合分析和对干预效果的理解。以前曾开发过一套婴儿喂养核心结果集(COS),以实现结果测量和报告的标准化。COS 代表了要测量的内容;确定如何最好地测量这些结果是改进干预评估的下一个关键步骤。因此,本范围综述旨在确定试验中使用了哪些结果测量工具,以及如何使用这些工具来测量婴儿喂养的核心结果。方法 将进行范围界定综述。从一开始就将检索 MEDLINE、EMBASE、CINAHL、PsychINFO、Cochrane 对照试验中央登记册、OpenGrey 和 GreyNet。如果论文报告的试验涉及原始数据收集,并测量和报告了至少一项一岁以下婴儿喂养的核心结果,则符合纳入条件。经过搜索和筛选后,符合条件的研究将分为以下四大类进行数据提取、综合和撰写:护理人员相关结果;饮食相关结果;喂养环境结果;儿童体重结果。将对数据进行叙述性描述,并以表格形式呈现,研究结果将按照四个总体类别分别撰写成四篇综述论文。讨论 本范围界定综述是儿童肥胖症预防标准化测量(SCOPE)研究的一部分 (www.eiascope.com)。本范围界定综述提供了有关使用哪些测量工具以及如何使用这些工具的证据,这是就如何最好地测量预防儿童肥胖的核心婴儿喂养结果提出建议和指导的重要第一步。这可以提高证据的综合水平,并加深对哪些婴儿喂养干预措施对预防儿童肥胖最有效的理解。
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引用次数: 0
Age of first self-harm act in childhood and adolescence: A scoping review protocol. 儿童和青少年首次自我伤害行为的年龄:范围界定审查协议。
Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13764.2
Daisy Wiggin, Elaine McMahon, Fiona McNicholas, Eve Griffin

Background: Self-harm in youth is associated with adverse outcomes for many. The age of first self-harm is not often reported in the literature and there is considerable heterogeneity in how it is reported and in the methods used to estimate it. The objective of this study will be to examine the age of first self-harm act in childhood and adolescence and to identify the research methods used to assess this.

Methods: This scoping review will follow JBI guidance. Five electronic databases, Medline, PsycInfo, CINAHL Plus, Embase, and Web of Science will be searched from inception. Grey literature will be searched via Google Scholar. Studies reporting the age of first act of self-harm in young people aged 17 years and younger are of interest. Any study design and methodology will be eligible for inclusion. Included studies may use any self-harm definition, any measures used to assess self-harm and the age of the first act. The focus can be in any context, including health services presenting or community samples. Title and abstract screening and full text screening will be carried out by two reviewers independently. The data extraction tool will be piloted by two reviewers independently, included studies will undergo data extraction by one reviewer and this will be checked by a second, independent reviewer.

Results: The resulting data will be presented using descriptive statistics, in tabular format, and accompanied with a narrative presentation of results. The results of this study will be distributed by publication in an academic journal.

背景:青少年自残与许多人的不良后果有关。首次自我伤害的年龄在文献中并不常见,而且在报告方式和估算方法上也存在相当大的差异。本研究的目的是探讨儿童和青少年首次自我伤害行为的年龄,并确定用于评估这一年龄的研究方法:本次范围界定审查将遵循 JBI 指南。将从一开始就检索 Medline、PsycInfo、CINAHL Plus、Embase 和 Web of Science 这五个电子数据库。灰色文献将通过谷歌学术进行搜索。报告 17 岁及以下青少年首次自我伤害行为年龄的研究将受到关注。任何研究设计和方法均可纳入。纳入的研究可以使用任何自我伤害定义、任何用于评估自我伤害的方法以及首次行为的年龄。研究重点可以是在任何情况下,包括医疗服务机构或社区样本。标题和摘要筛选以及全文筛选将由两名审稿人独立完成。数据提取工具将由两名审稿人独立试用,纳入的研究将由一名审稿人进行数据提取,并由第二名独立审稿人进行检查:研究结果:研究结果数据将以表格形式进行描述性统计,并附有结果说明。研究结果将在学术期刊上发表。
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引用次数: 0
Examining Quality, Use and Impact of Psychotropic (Use) in older adults with intellectual disabilities (EQUIP): study protocol 研究智障老年人精神药物(使用)的质量、使用情况和影响(EQUIP):研究方案
Pub Date : 2023-11-21 DOI: 10.12688/hrbopenres.13645.2
Ashleigh Gorman, Marina Odalović, P. McCallion, Eilish M Burke, Malcolm MacLachlan, M. McCarron, M. Henman, Maeve Moran, J. O’Connell, Mike Walsh, Rohit Shankar, M. O'Dwyer
Widespread, and sometimes inappropriate use of psychotropics in adults with intellectual disability has been an international concern. These medicines have been used to treat mental health conditions, but also, controversially, some types of behaviours not necessarily associated with the diagnosis or in the absence of a relevant diagnosis. Results from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) study of older adults with intellectual disability in Ireland revealed that 60% were taking psychotropics in 2010. In the intervening decade changes in regulations, policy, and increased decongregation of people with intellectual disability have taken place likely influencing the use of psychotropics. The HSE National Clinical Programme for People with Disability (NCPDD) established in the 2020 has medicines optimisation as a key priority. Existing multi-wave data from the IDS-TILDA study and the HSE national prescribing database offers an opportunity to better understand psychotropic use and prescribing patterns. This is a novel collaboration on lived experience, research, practice and policy. The aim of this research is to examine the quality and trends of psychotropic use of older adults with intellectual disability over a ten-year period in Ireland to evaluate the effects of and to inform both practice and policy to optimise medicines use and health outcomes. Health and medication data from ten years (four waves) of the IDS-TILDA study and corresponding medicines data from the HSE-PCRS prescribing database are available. Descriptive and longitudinal analysis will examine association between long-term psychotropic use, changes in trends of use, and the impact of decongregation on medicines use. This research will inform the development of national guidance on medicines optimisation for older people with intellectual disability and has the potential to change prescribing practices and improve health and wellbeing for older people with intellectual disability.
精神药物在智障成人中的广泛使用,有时甚至是不当使用,一直是国际社会关注的问题。这些药物不仅被用于治疗精神疾病,而且还被用于治疗某些不一定与诊断相关或没有相关诊断的行为,这一点颇受争议。爱尔兰老龄化纵向研究(IDS-TILDA)智障补充研究对爱尔兰智障老年人的研究结果显示,2010 年有 60% 的智障老年人在服用精神药物。在这十年间,法规、政策发生了变化,智障人士的非集中化程度也有所提高,这些都可能对精神药物的使用产生影响。HSE 于 2020 年制定的 "国家残疾人临床计划"(NCPDD)将药物优化作为重点优先事项。来自 IDS-TILDA 研究和 HSE 国家处方数据库的现有多波数据为更好地了解精神药物的使用和处方模式提供了机会。这是一项关于生活经验、研究、实践和政策的新颖合作。这项研究的目的是对爱尔兰智障老年人在十年内使用精神药物的质量和趋势进行检查,以评估使用精神药物的影响,并为实践和政策提供信息,从而优化药物使用和健康结果。IDS-TILDA研究提供了十年(四波)的健康和用药数据,HSE-PCRS处方数据库提供了相应的用药数据。描述性分析和纵向分析将研究长期使用精神药物、使用趋势的变化之间的关联,以及解除隔离对药物使用的影响。这项研究将为制定国家智障老年人药物优化指南提供信息,并有可能改变处方做法,改善智障老年人的健康和福祉。
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引用次数: 0
Definitions of serious injury in long-term residential care: a systematic review protocol 长期寄宿护理中的严重伤害定义:系统性审查协议
Pub Date : 2023-11-20 DOI: 10.12688/hrbopenres.13705.1
David Morrissey, Elizabeth A. O'Donnell, L. Behan, Martin McMahon, L. Keyes
Background Evidence indicates that the reporting of serious injury in long-term residential care has increased substantially over the past decade. However, what constitutes a serious injury in residential care is poorly and inconsistently defined. This may result in incidences being unnecessarily reported as a serious injury. It is therefore, crucial to develop a consistent definition of serious injury to reduce reporting burden and to facilitate comparison between different residential care settings and across jurisdictions. This protocol describes the methods for a systematic review of existing definitions from the literature to inform the development of a consistent definition of serious injury in long-term residential care. Methods A wide range of published peer-reviewed and grey literature will be sought for this review, including guidance and policy documents. Searches will be conducted of databases including MEDLINE, CINAHL, SocINDEX, Academic Search Ultimate, and Westlaw International. Grey literature database searches will include Trip and Social Care Online. Country specific searches of government and health and social care websites will be conducted. Quality appraisal will be facilitated using the Quality Assessment for Diverse Studies (QuADS) tool and Tyndall’s checklist. The level of confidence in the findings will be assessed using the GRADE CERQual approach. A customised data extraction form will be used to extract data to reduce the risk of bias. Conceptual content analysis of data will facilitate identification of definitions of serious injury and their frequency within texts. Conclusion The findings will inform the development of a consistent definition of serious injury in long-term residential care that will reduce reporting burden, facilitate the accuracy of data collected and allow for comparison across jurisdictions. A more universal and consistent definition will enable regulators, policy makers, service providers and researchers to develop policy and practical interventions to prevent the occurrence of serious injury in long-term residential care.
背景 有证据表明,在过去十年中,关于长期寄宿护理中严重伤害的报告大幅增加。然而,对于什么是寄宿护理中的严重伤害却没有明确的定义,而且定义也不一致。这可能会导致不必要地将事故报告为严重伤害。因此,制定统一的严重伤害定义至关重要,这样可以减轻报告负担,并便于在不同的寄宿护理环境和不同的司法管辖区之间进行比较。本协议介绍了对文献中现有定义进行系统性回顾的方法,以便为制定长期寄宿护理中严重伤害的统一定义提供参考。方法 本综述将广泛收集已发表的同行评审文献和灰色文献,包括指导和政策文件。检索数据库包括 MEDLINE、CINAHL、SocINDEX、Academic Search Ultimate 和 Westlaw International。灰色文献数据库搜索将包括 Trip and Social Care Online。还将针对具体国家搜索政府、卫生和社会保健网站。将使用多元化研究质量评估(QuADS)工具和廷德尔核对表进行质量评估。研究结果的可信度将采用 GRADE CERQual 方法进行评估。将使用定制的数据提取表来提取数据,以降低偏倚风险。数据的概念内容分析将有助于确定严重伤害的定义及其在文本中的出现频率。结论 研究结果将为制定长期寄宿护理中严重伤害的统一定义提供信息,从而减轻报告负担,提高所收集数据的准确性,并可进行跨辖区比较。一个更加普遍和一致的定义将使监管者、政策制定者、服务提供者和研究人员能够制定政策和实际干预措施,以防止在长期寄宿护理中发生严重伤害。
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引用次数: 0
Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial. 一项试验(quality - swat)中定性方法学研究的方案开发:karma - deep -2试验。
Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13721.2
John McCaffrey, Andrew Hunter

Background: Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes.

Methods: A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10).

Ethics and dissemination: Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication.

Host trial registration: ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].

背景:尽管临床试验的设计和实施在方法学上有所改进,但有关精神卫生保健的试验仍然存在方法学上的局限性。在karma - deep -2宿主试验中,将进行一项定性研究(quality - swat),以探索和理解精神卫生保健随机试验中的两个方法学问题:(1)参与精神卫生随机试验的主要障碍和推动因素是什么;(2)随机试验如何成为常规精神卫生保健的一部分。这些问题将根据优先研究主题,从患者-参与者和临床医生/研究人员-参与者的角度进行检查。方法:采用描述性定性研究设计。数据将通过一对一的半结构化访谈收集,由微软团队进行。访谈数据将使用布劳恩和克拉克的主题分析方法进行分析。将对三个参与者组(N = 30)进行一对一访谈:1)主持试验的患者-参与者(N = 10);2)可能符合条件的宿主试验患者-拒绝纳入宿主试验的参与者(n = 10);3)与宿主试验相关的临床医生/研究人员参与者(n = 10)。伦理和传播:爱尔兰圣帕特里克精神卫生服务研究伦理委员会(参考:第09/20号议定书)批准了伦理批准。研究完成后,将编写一份报告并提交给卫生研究委员会(HRB)。研究结果将与主办试验团队和研究参与者共享,并提交发表。主试验注册:ClinicalTrials.gov (NCT04939649);草案(2019-003109-92)。官方标题:氯胺酮作为重度抑郁症的辅助治疗-一项随机对照试验:[KARMA-Dep(2)]。
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引用次数: 0
Using behavioural science to enhance use of core outcome sets in trials: protocol. 利用行为科学加强试验中核心结果集的使用:方案。
Pub Date : 2023-11-20 eCollection Date: 2022-01-01 DOI: 10.12688/hrbopenres.13510.2
Karen Matvienko-Sikar, Molly Byrne, Mike Clarke, Jamie Kirkham, Jan Kottner, Katie Mellor, Fiona Quirke, Ian J Saldanha, Valerie Smith, Elaine Toomey, Paula Williamson

Background: Core outcome sets (COS) represent agreed-upon sets of outcomes, which are the minimum that should be measured and reported in all trials in specific health areas. Use of COS can reduce outcome heterogeneity, selective outcome reporting, and research waste, and can facilitate evidence syntheses. Despite benefits of using COS, current use of COS in trials is low. COS use can be understood as a behaviour, in that it is something trialists do, or not do, adequately. The aim of this study is to identify strategies, informed by behaviour change theory, to increase COS use in trials.

Methods: The project will be conducted in two stages, informed by the behaviour change wheel (BCW). The BCW is a theoretically based framework that can be used to classify, identify, and develop behaviour change strategies. In Stage 1, barriers and enablers to COS use will be extracted from published studies that examined trialist's use of COS. Barriers and facilitators will be mapped to the components of COM-B model (capability, opportunity, and motivation), which forms part of the BCW framework. Stage 2 will build on Stage 1 findings to identify and select intervention functions and behaviour change techniques to enhance COS use in trials.

Discussion: The findings of this study will provide an understanding of the behavioural factors that influence COS use in trials and what strategies might be used to target these factors to increase COS use in trials.

背景:核心结局集(COS)是商定的结局集,是在特定卫生领域的所有试验中应测量和报告的最低限度。使用COS可减少结果异质性、选择性结果报告和研究浪费,并可促进证据合成。尽管使用COS有好处,但目前试验中COS的使用率很低。COS的使用可以被理解为一种行为,因为它是试验者做或不做的事情。本研究的目的是根据行为改变理论确定策略,以增加COS在试验中的使用。方法:该项目将分两个阶段进行,由行为改变轮(BCW)通知。BCW是一个基于理论的框架,可用于分类、识别和制定行为改变策略。在第一阶段,将从已发表的研究中提取COS使用的障碍和促进因素,这些研究检查了受试者使用COS的情况。障碍和促进因素将被映射到COM-B模型的组件(能力、机会和动机),它们构成了BCW框架的一部分。第二阶段将以第一阶段的发现为基础,确定和选择干预功能和行为改变技术,以加强COS在试验中的使用。讨论:本研究的结果将提供对影响试验中COS使用的行为因素的理解,以及可以使用哪些策略来针对这些因素来增加试验中COS的使用。
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引用次数: 0
Cohort profile: Improved Pregnancy Outcomes via Early Detection (IMPROvED), an International Multicentre Prospective Cohort 队列简介:通过早期检测改善妊娠结局(改善),一个国际多中心前瞻性队列
Pub Date : 2023-11-13 DOI: 10.12688/hrbopenres.13812.1
Gillian M. Maher, Louise C. Kenny, Kate Navaratnam, Zarko Alfirevic, Darina Sheehan, Philip N. Baker, Christian Gluud, Robin Tuytten, Marius Kublickas, Boel Niklasson, Johannes J. Duvekot, Caroline B. van den Berg, Pensee Wu, Karolina Kublickiene, Fergus P. McCarthy, Ali S. Khashan
Background Improved Pregnancy Outcomes via Early Detection (IMPROvED) is a multi-centre, European phase IIa clinical study. The primary aim of IMPROvED is to enable the assessment and refinement of innovative prototype preeclampsia risk assessment tests based on emerging biomarker technologies. Here we describe IMPROvED’s profile and invite researchers to collaborate. Methods A total of 4,038 low-risk nulliparous singleton pregnancies were recruited from maternity units in Ireland (N=1,501), United Kingdom (N=1,108), The Netherlands (N=810), and Sweden (N=619) between November 2013 to August 2017. Participants were interviewed by a research midwife at ~11 weeks (optional visit), ~15 weeks, ~20 weeks, ~34 weeks’ gestation (optional visit), and postpartum (within 72-hours following delivery). Findings to date Clinical data included information on maternal sociodemographic, medical history, and lifestyle factors collected at ~15 weeks’ gestation, and maternal measurements, collected at each study visit. Biobank samples included blood, urine, and hair collected at each study visit throughout pregnancy in all units plus umbilical cord/blood samples collected at birth in Ireland and Sweden. A total of 74.0% (N=2,922) had an uncomplicated pregnancy, 3.1% (N=122) developed preeclampsia, 3.6% (N=143) had a spontaneous preterm birth, and 10.5% (N=416) had a small for gestational age baby. We evaluated a panel of metabolite biomarkers and a panel of protein biomarkers at 15 weeks and 20 weeks’ gestation for preeclampsia risk assessment. Their translation into tests with clinical application, as conducted by commercial entities, was hampered by technical issues and changes in test requirements. Work on the panel of proteins was abandoned, while work on the use of metabolite biomarkers for preeclampsia risk assessment is ongoing. Future plans In accordance with the original goals of the IMPROvED study, the data and biobank are now available for international collaboration to conduct high quality research into the cause and prevention of adverse pregnancy outcomes.
背景:通过早期检测改善妊娠结局(Improved)是一项多中心、欧洲IIa期临床研究。改进的主要目的是使基于新兴生物标志物技术的创新原型子痫前期风险评估测试能够进行评估和改进。在这里,我们描述了改进的概况,并邀请研究人员进行合作。方法在2013年11月至2017年8月期间,从爱尔兰(N= 1501)、英国(N= 1108)、荷兰(N=810)和瑞典(N=619)的产科单位招募4038例低风险无产单胎妊娠。参与者在妊娠~11周(可选访问)、~15周、~20周、~34周(可选访问)和产后(分娩后72小时内)由一名研究助产士进行访谈。临床数据包括妊娠~15周时收集的产妇社会人口学、病史和生活方式因素信息,以及每次研究访问时收集的产妇测量数据。生物库样本包括在所有单位妊娠期间每次研究访问时收集的血液、尿液和头发,以及在爱尔兰和瑞典出生时收集的脐带/血液样本。74.0% (N= 2922)为无并发症妊娠,3.1% (N=122)为子痫前期,3.6% (N=143)为自发性早产,10.5% (N=416)为小于胎龄儿。我们在妊娠15周和20周时对一组代谢物生物标志物和一组蛋白质生物标志物进行了子痫前期风险评估。由于技术问题和测试要求的变化,商业实体将其转化为临床应用的测试受到阻碍。蛋白质小组的工作被放弃,而使用代谢物生物标志物进行子痫前期风险评估的工作仍在进行中。根据改进研究的最初目标,数据和生物库现在可用于国际合作,以对不良妊娠结局的原因和预防进行高质量的研究。
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引用次数: 0
Co-designing a recruitment strategy for lung cancer screening in high-risk individuals: protocol for a mixed-methods study 共同设计高风险人群肺癌筛查的招募策略:混合方法研究方案
Pub Date : 2023-11-13 DOI: 10.12688/hrbopenres.13793.1
Maeve Reilly, Ahmeda Ali, Prof Frank Doyle, Seamus Cotter, Laura Heavey, Prof Kate Brain, Prof Nicole Rankin, Grace Mccutchan, Prof Patrick Redmond
Background Lung cancer is a significant cause of cancer-related mortality globally, with early detection through screening critical to improving patient outcomes. However, recruiting high-risk individuals, particularly in deprived populations, for screening remains a considerable challenge. This study aims to co-design a targeted recruitment strategy for lung cancer screening, tailored to the specific needs and experiences of high-risk individuals, in collaboration with a Patient and Public Involvement (PPI) panel and expert stakeholders in Ireland. Methods We will employ a mixed-methods design guided by the Medical Research Council (MRC) framework for developing complex interventions. Our approach will integrate systematic review findings on screening participation interventions, evaluation of the recruitment strategy's feasibility in an Irish context, and the application of behavioural science frameworks. The target population includes individuals over 55 years, either current smokers or those who quit within the last year, who reside in highly deprived areas. Conclusion This co-designed recruitment strategy will combine evidence-based research, local context understanding, and stakeholder input to develop a solution that is both scientifically robust and tailored to the target population's needs. This patient-centred approach aims to increase the potential for successful implementation of lung cancer screening programs, thereby improving early detection and patient outcomes.
肺癌是全球癌症相关死亡的重要原因,通过筛查早期发现对改善患者预后至关重要。然而,招募高危人群,特别是在贫困人群中,进行筛查仍然是一个相当大的挑战。本研究旨在与爱尔兰的患者和公众参与(PPI)小组和专家利益相关者合作,共同设计针对高危人群的特定需求和经验量身定制的肺癌筛查目标招募策略。方法采用医学研究委员会(MRC)框架指导下的混合方法设计,制定复杂的干预措施。我们的方法将整合筛选参与干预措施的系统审查结果,在爱尔兰背景下评估招聘策略的可行性,以及行为科学框架的应用。目标人群包括居住在高度贫困地区的55岁以上的吸烟者或在去年戒烟的人。这一共同设计的招聘策略将结合循证研究、对当地情况的理解和利益相关者的意见,制定出既科学可靠又适合目标人群需求的解决方案。这种以患者为中心的方法旨在增加成功实施肺癌筛查计划的可能性,从而改善早期发现和患者预后。
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引用次数: 0
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HRB open research
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