Evidence based management of hypertension: Using cardiovascular risk profiles to individualise hypertensive treatment

This is the fourth in a series of five articles Individual risks must be assessed in order to for the best decision to be made as to which patients to treat and how. Assessment identifies important cardiovascular risk factors that may warrant treatment and helps to establish the absolute benefits that patients can expect from particular treatments. The benefits of treating hypertensive patients also vary, depending on each patient's competing risks of dying from other than cardiovascular causes. For example, patients with multiple serious conditions, such as end stage Alzheimer's disease, obstructive lung disease, frequent falls, gout, and urinary incontinence, have high competing risks that may minimise or negate the benefits of treating their hypertension. #### Summary points Several treatment options reduce risk of cardiovascular disease and improve outcomes in patients with hypertension Providers should consider the expected benefits and potential adverse effects of different treatment options and discuss them with patients The use of decision tools may help decision making about options for reducing cardiovascular risk Establishing treatment priorities for patients with multiple cardiovascular risk factors and multiple conditions is difficult. Factors such as those given in the box deserve consideration. Knowing and weighing up multiple risk factors, conditions, and treatments is difficult. Explaining them to patients is daunting and time consuming. Some patients prefer to be told what to do rather than to have to take in the diverse, complicated information necessary to make their

Mapping of reporting guidance for systematic reviews and meta-analyses generated a comprehensive item bank for future reporting guidelines

Objectives: The aim of the study was to generate a comprehensive bank of systematic review (SR) reporting items to inform an update of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2009 statement. Methods: We searched the Enhancing the QUAlity and Transparency Of health Research Network library in May 2019 to identify all reporting guidelines for SRs that were published after 2009, regardless of the scope of the guideline. We also conducted a selective review of four guidance manuals for SRs, three tools for assessing the risk of bias in SRs, six meta-research studies evaluating the reporting quality of SRs using a tailored checklist, and five reporting guidelines for other study designs. One author screened and selected sources for inclusion, extracted reporting guidance from sources, and mapped guidance against the PRISMA 2009 checklist items. Results: We included 60 sources providing guidance on reporting of SRs and meta-analyses. From these, we collated a list of 221 unique reporting items. Items were categorized into title (four items), abstract (10 items), introduction (12 items), methods (111 items), results (61 items), discussion (12 items), funding and conflicts of interest (four items), administrative information (three items), and data availability (four items). This exercise generated 175 reporting items that could be added to the guidance in the PRISMA 2009 statement. Conclusion: Generation of a comprehensive item bank through review and mapping of the literature facilitates identification of missing items and those needing modification, which may not otherwise be identified by the guideline development team or from other activities commonly used to develop reporting guidelines

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research

Mejorar la comunicación de estudios observacionales en epidemiología (STROBE): explicación y elaboración

Gran parte de la investigación biomédica es de tipo observacional. Los informes de los estudios observacionales a menudo poseen una calidad insuficiente, lo que dificulta la evaluación de sus fortalezas y debilidades para generalizar los resultados. Teniendo en cuenta la evidencia empírica y consideraciones teóricas, un grupo de expertos en metodología, investigadores y editores de revistas científicas, desarrollaron una lista de recomendaciones para aumentar la calidad de las publicaciones de los estudios observacionales: (STROBE). La Declaración STROBE consiste en una lista de verificación de 22 puntos que guardan relación con las diferentes secciones de un artículo: título, resumen, introducción, metodología, resultados y discusión. De ellos, 18 puntos son comunes a los tres diseños de estudio: cohorte, casos y controles, y transversales; los otros cuatro son específicos para cada una de estas tres modalidades. La Declaración STROBE proporciona a los autores información sobre cómo mejorar la calidad de los artículos sobre estudios observacionales y facilita a los revisores, editores de revistas y lectores su apreciación crítica y su interpretación. Este documento explicativo tiene el propósito de impulsar el uso, la comprensión y la difusión de la Declaración STROBE. Se presentan el significado y el análisis razonado para cada punto de la lista de verificación, proporcionando uno o varios ejemplos publicados en la literatura y, en lo posible, referencias de estudios empíricos relevantes y literatura metodológica. También se incluyen ejemplos de diagramas de flujo. La Declaración STROBE, el presente documento y la página Web asociada () son recursos útiles para mejorar la divulgación de la investigación observacional.Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site () should be helpful resources to improve reporting of observational research

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration.

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www. strobe-statement.org/) should be helpful resources to improve reporting of observational research. Present article is Russian-language translation of the original manuscript edited by Doctor of Medicine R.T. Saygitov.Present translation was first published in Digital Diagnostics. doi: 10.17816/DD70821. It is published with minor changes related to the literary editing of the translation itself

Повышение качества отчётов о наблюдательных исследованиях в эпидемиологии (STROBE): разъяснения и уточнения

Большинство медицинских исследований являются наблюдательными (observational). Сообщения о таких ис-следованиях часто невысокого качества, что затрудняет оценку сильных и слабых сторон работы, а также обоб-щаемости (generalizability) её результатов. Принимая во внимание эмпирические свидетельства и теоретические соображения, группа методологов, исследователей и научных редакторов разработала рекомендации «Повышение качества отчётов о наблюдательных исследованиях в эпидемиологии (STROBE): разъяснения и уточнения». Реко-мендации STROBE содержат 22 пункта, связанных с оформлением следующих разделов научных статей: название, аннотация, введение, методы, результаты и их обсуждение, при этом 18 пунктов являются общими для когортных исследований (cohort studies), исследований «случай–контроль» (case-control studies) и одномоментных исследова-ний (cross-sectional studies); 4 пункта специфичны для каждого из указанных дизайнов исследований (study designs). STROBE ― руководство для авторов, необходимое для повышения качества отчётов о наблюдательных исследова-ниях, облегчающее критическую оценку исследования и его интерпретацию рецензентами, редакторами журналов и читателями. Цель этой разъясняющей и уточняющей статьи ― способствовать более широкому применению, пониманию и распространению стандартов STROBE. В ней даётся разъяснение смысла и обоснование применения каждого пункта руководства (checklist). По каждому пункту приводятся один или несколько опубликованных при-меров правильного представления исследований и, при возможности, библиографические ссылки на подходящие эмпирические исследования и методологическую литературу. Представлены примеры потоковых диаграмм (flow diagrams) для описания последовательности исследования. Рекомендации STROBE, настоящая статья и соответ-ствующий веб-сайт (http://www.strobe-statement.org/) должны стать полезным источником для повышения качества отчётов о результатах наблюдательных исследований. This article is the reprint with Russian translation of the original that can be observed here: Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Med. 2007;4(10):e297. doi: 10.1371/journal.pmed.0040297

Reliability, validity and psychometric properties of the Greek translation of the zung depression rating scale

INTRODUCTION: The current study aimed to assess the reliability, validity and psychometric properties of the Greek translation of the Zung Depression Rating Scale (ZDRS). METHODS: The study sample included 40 depressed patients 29.65 ± 9.38 years old and 120 normal comparison subjects 27.23 ± 10.62 years old. In 20 of them (12 patients and 8 comparison subjects) the instrument was re-applied 1–2 days later. Translation and Back Translation was made. Clinical Diagnosis was reached by consensus of two examiners with the use of the SCAN v.2.0 and the IPDE. Statistical Analysis included ANOVA, the Pearson Product Moment Correlation Coefficient, Principal Components Analysis and Discriminant Function Analysis and the calculation of Cronbach's alpha (α) RESULTS: Both Sensitivity and specificity exceed 90.00 at 44/45, Chronbach's alpha for the total scale was equal to 0.09, suggesting that the scale covers a broad spectrum of symptoms. Factor analysis revealed five factors (anxiety-depression, thought content, gastrenterological symptoms, irritability and social-interpersonal functioning). The test-retest reliability was satisfactory (Pearson's R between 0.92). CONCLUSION: The ZDRS-Greek translation is both reliable and valid and is suitable for clinical and research use with satisfactory properties. Its properties are similar to those reported in the international literature, although the literature is limited. However one should always have in mind the limitations inherent in the use of self-report scales

PRISMA 2020 explanation and elaboration : updated guidance and exemplars for reporting systematic reviews

The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews

Reliability, Validity and Psychometric Properties of the Greek Translation of the Center for Epidemiological Studies-Depression (CES-D) Scale

INTRODUCTION: The aim of the current study was to assess the reliability, validity and psychometric properties of the Greek translation of the Center for Epidemiological Studies- Depression Scale (CES-D). METHODS: 40 depressed patients 29.65 ± 9.38 years old, and 120 normal controls 27.23 ± 10.62 years old entered the study. In 20 of them (12 patients and 8 controls) the instrument was re-applied 1-2 days later. Translation and Back Translation was made. Clinical Diagnosis was reached by consensus of two examiners with the use of the SCAN v.2.0 and the IPDE. Statistical Analysis included ANOVA, the Pearson Product Moment Correlation Coefficient, Principal Components Analysis and Discriminant Function Analysis and the calculation of Cronbach's alpha (α) RESULTS: Both Sensitivity and specificity exceed 90.00 at 23/24, Chronbach's alpha for the total scale was equal to 0.95. Factor analysis revealed three factors (positive affect, irritability and interpersonal relationships, depressed affect and somatic complains). The test-retest reliability was satisfactory (Pearson's R between 0.45 and 0.95 for individual items and 0.71 for total score). CONCLUSION: The Greek translation of the CES-D scale is both reliable and valid and is suitable for clinical and research use with satisfactory properties. Its properties are similar to those reported in the international literature. However one should always have in mind the limitations inherent in the use of self-report scales