Frequency of applications of systematic reviews in evidence synthesis in management research : a scoping review of South African practices

Abstract: A wide range of frequently used methodological tools exist in other disciplines, yet are often not utilized in the management sciences. Tools such as systematic reviews are useful to objectively review, summarize, and appraise the results of published studies to guide practice or identify gaps in knowledge that require further research. The aim of this scoping review is to ascertain to what extent systematic reviews are utilized in South African management research. We employed a scoping review methodology and searched a number of prominent management databases. No limits on publication dates were set. Data was analyzed by means of charting. 9880 studies were identified during an initial search. From these 204 were assessed for eligibility, which 32 articles met. It was found that systematic reviews comprise 0.09% of South African managerial studies. An increase in the utilization was observed from 2014 onwards, yet systematic reviews are severely under-utilized in South African management research.. A roadmap identifying crucial steps in systematic reviews and best practices is provided

Training Cameroonian researchers on pragmatic knowledge translation trials: a workshop report

Limited health research capacity in one of the factors that prevents developing countries from attaining  optimal health outcomes and achieving the Millennium Development Goals. We report here, the details of a  workshop on pragmatic knowledge translation trials for Cameroonian researchers, the material covered and additional resources to support capacity development. At the end of this workshop, knowledge gains were noted and participants were able to initiate proposals for funding. These proposals were aimed at improving the clinical management of diabetes, hypertension and malaria.Key words: Pragmatic trials, knowledge translation, capacity building, Cameroon, worksho

Association between framing of the research question using the PICOT format and reporting quality of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Experts recommend formulating a structured research question to guide the research design. However, the basis for this recommendation has not been formally evaluated. The aim of this study was to examine if a structured research question using the PICOT (<b>P</b>opulation, <b>I</b>ntervention, <b>C</b>omparator, <b>O</b>utcome, <b>T</b>ime-frame) format is associated with a better reporting quality of randomized controlled trials (RCTs).</p> <p>Methods</p> <p>We evaluated 89 RCTs reports published in three endocrinology journals in 2005 and 2006, the quality of reporting of which was assessed in a previous study. We examined whether the reports stated each of the five elements of a structured research question: population, intervention, comparator, outcome and time-frame. A PICOT score was created with a possible score between 0 and 5. Outcomes were: 1) a 14-point overall reporting quality score (OQS) based on the Consolidated Standards for Reporting Trials; and 2) a 3-point key score (KS), based on allocation concealment, blinding and use of intention-to-treat analysis. We conducted multivariable regression analyses using generalized estimating equations to determine if a higher PICOT score or the use of a structured research question were independently associated with a better reporting quality. Journal of publication, funding source and sample size were identified as factors associated with OQS in our previous report on this dataset, and therefore included in the model.</p> <p>Results</p> <p>A higher PICOT score was independently associated with OQS (incidence rate ratio (IRR) = 1.021, 95% CI: 1.012 to 1.029) and KS (IRR = 1.142, 95% CI: 1.079 to 1.210). A structured research question was present in 33.7% of the reports and it was associated with a better OQS (IRR = 1.095, 95% CI 1.059-1.132) and KS (IRR = 1.530, 95% CI 1.311-1.786).</p> <p>Conclusions</p> <p>Better framing of the research question using the PICOT format is independently associated with better overall reporting quality - although the effect is small - and better reporting of key methodologies.</p

Considerations in using text messages to improve adherence to highly active antiretroviral therapy: a qualitative study among clients in Yaoundé, Cameroon

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Innovations in Research with Medically Fragile Populations: Using Bulletin Board Focus Groups

A new group of medically fragile young adults are graduating from pediatric palliative care programs with limited expectations to live beyond early adulthood, and no comparable adult services to support their complex needs. Accessing this population is difficult because of the complexity of their conditions, the extensive personal and equipment supports that limit feasibility for travel, and divergent communication abilities. Therefore, we undertook a descriptive case study using an asynchronous modification of an online focus group, a bulletin board focus group (BBFG). The greatest strengths of the BBFG are the appeal of this methodology for young adults and the multi day focus group becomes both a community and an intervention. An important limitation of this method was participant follow through on discussion threads. This BBFG provided rich and varied types of data, and very positive participant experiences

Workshop report: building biostatistics capacity in Sub-saharan Africa-taking action

To address the need for capacity development in biostatistics in the Sub-Saharan African region and to move recommendations from previous workshops into action, we brought together biostatisticians from the region to provide an opportunity to brainstorm biostatistics capacity development in Africa, how to enhance what is being done and establish collaborative links to work together. In order to move key recommendations forward working groups were established to focus on the structure and content of a MSc Biostatistics and on the development of a concept paper for an Africa Centre for Biostatistics Excellence.Pan African Medical Journal 2015; 2

Metastatic Renal Cell Cancer Treatments: An Indirect Comparison Meta-Analysis

Background: Treatment for metastatic renal cell cancer (mRCC) has advanced dramatically withunderstanding of the pathogenesis of the disease. New treatment options may provide improvedprogression-free survival (PFS). We aimed to determine the relative effectiveness of new therapiesin this field. Methods: We conducted comprehensive searches of 11 electronic databases from inception toApril 2008. We included randomized trials (RCTs) that evaluated bevacizumab, sorafenib, andsunitinib. Two reviewers independently extracted data, in duplicate. Our primary outcome wasinvestigator-assessed PFS. We performed random-effects meta-analysis with a mixed treatmentcomparison analysis. Results: We included 3 bevacizumab (2 of bevacizumab plus interferon-a [IFN-a]), 2 sorafenib, 1sunitinib, and 1 temsirolimus trials (total n = 3,957). All interventions offer advantages for PFS.Using indirect comparisons with interferon-α as the common comparator, we found that sunitinibwas superior to both sorafenib (HR 0.58, 95% CI, 0.38–0.86, P = &lt; 0.001) and bevacizumab + IFNa(HR 0.75, 95% CI, 0.60–0.93, P = 0.001). Sorafenib was not statistically different from bevacizumab+IFN-a in this same indirect comparison analysis (HR 0.77, 95% CI, 0.52–1.13, P = 0.23). Usingplacebo as the similar comparator, we were unable to display a significant difference betweensorafenib and bevacizumab alone (HR 0.81, 95% CI, 0.58–1.12, P = 0.23). Temsirolimus providedsignificant PFS in patients with poor prognosis (HR 0.69, 95% CI, 0.57–0.85). Conclusion: New interventions for mRCC offer a favourable PFS for mRCC compared tointerferon-α and placebo

Evaluating the test re-test reliability and inter-subject variability of health care provider manual fluid resuscitation performance

BACKGROUND: Health Care Providers (HCPs) report that manual techniques of intravascular fluid resuscitation are commonly used during pediatric shock management. The optimal pediatric fluid resuscitation technique is currently unknown. We sought to determine HCP test-retest reliability (repeatability) and inter-subject variability of fluid resuscitation performance outcomes to inform the design of future studies. METHODS: Fifteen consenting HCPs from McMaster Children’s Hospital, in Hamilton, Canada participated in this single-arm interventional trial. Participants were oriented to a non-clinical model representing a 15 kg toddler, which incorporated a 22-gauge IV catheter. Following a standardization procedure, participants administered 600 mL (40 mL/kg) of saline to the simulated child under emergency conditions using prefilled 60-mL syringes. Each participant completed 5 testing trials. All testing was video recorded, with fluid administration time outcome data (in seconds) extracted from trial videos by two blinded outcome assessors. Data describing catheter dislodgement events, volume of saline effectively delivered, and participant demographics were also collected. The primary outcome of fluid administration time test-retest reliability was analyzed by one-way analysis of variance (ANOVA) and intra-class correlation (ICC), with good reliability defined as ICC > 0.70. RESULTS: Differences in HCP fluid administration times are attributable to inter-subject variability rather than intra-subject variability based on one-way ANOVA analysis, F (14,60) = 43.125; p < 0.001. Test-retest reliability of subjects was excellent with ICC = 0.97 (95% CI: 0.95-0.99); p < 0.001. CONCLUSIONS: Findings demonstrate excellent test-retest reliability of HCP fluid resuscitation performance in a setting involving a non-clinical model. Investigators can justify a single evaluation of HCP performance in future studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1756-0500-7-724) contains supplementary material, which is available to authorized users

Patient data meta-analysis of Post-Authorization Safety Surveillance (PASS) studies of haemophilia A patients treated with rAHF-PFM.

SummaryA Post‐Authorization Safety Study (PASS) global program was designed to assess safety and effectiveness of rAHF‐PFM (ADVATE) use in haemophilia patients in routine clinical settings. The main aim of this project was to estimate the rate of inhibitors and other adverse events across ADVATE‐PASS studies by meta‐analysing individual patient data (IPD). Eligible Studies: PASS studies conducted in different countries, between 2003 and 2013, for which IPD were provided. Eligible patients: haemophilia A patients with baseline FVIII:C 150 EDs. Secondary outcomes: de novo inhibitors according to prior exposure and disease severity; other adverse events; annualized bleeding rate (ABR). Analysis: random‐effects logistic regression. Five of seven registered ADVATE‐PASS (Australia, Europe, Japan, Italy and USA) and 1188 patients were included (median follow‐up 384 days). Among severe PTPs with > 150 EDs, 1/669 developed de novo inhibitors (1.5 per 1000; 95% confidence interval [CI] 0.2, 10.6 per 1000). Among all patients included in the PASS studies, 21 developed any type of inhibitors (2.0%, 95% CI: 0.8%, 4.7%). Less than 1% of patients presented with other serious adverse events possibly related to ADVATE. The overall median ABR was 3.83 bleeds/year (first, third quartiles: 0.60, 12.90); 1.66 (0, 4.78) in the 557 patients continuously on prophylaxis ≥ twice/week. Meta‐analysing PASS data from different countries confirmed the overall favourable safety and effectiveness profile of ADVATE in routine clinical settings

An empirical comparison of time-to-event models to analyse a composite outcome in the presence of death as a competing risk

CITATION:Haushona N, Esterhuizen TM, Thabane L, Machekano R. An empirical comparison of time-to-event models to analyse a composite outcome in the presence of death as a competing risk. Contemp Clin Trials Commun. 2020;19:100639. Published 2020 Aug 14. doi:10.1016/j.conctc.2020.100639Introduction: Competing risks arise when subjects are exposed to multiple mutually exclusive failure events, and the occurrence of one failure hinders the occurrence of other failure events. In the presence of competing risks, it is important to use methods accounting for competing events because failure to account for these events might result in misleading inferences. Methods and Objective: Using data from a multisite retrospective observational longitudinal study done in Ethiopia, we performed sensitivity analyses using Fine-Gray model, Cause-specific Cox (Cox-CSH) model, Cause-specific Accelerated Failure Time (CS-AFT) model, accounting for death as a competing risk to deter- mine baseline covariates that are associated with a composite of unfavourable retention in care outcomes in people living with Human Immune Virus who were on both Isoniazid preventive therapy (IPT) and antiretrovi- ral therapy (ART). Non-cause specific (non-CSH) model that does not account for competing risk was also per- formed. The composite outcome comprises of loss to follow-up, stopped treatment and death. Age, World Health Organisation (WHO) stage, gender, and CD4 count were the considered baseline covariates. Results: We included 3578 patients in our analysis. WHO stage III-or-IV was significantly associated with the composite of unfavourable outcomes, Sub-hazard ratio (SHR) = 1.31, 95% confidence interval (CI):1.04–1.65 for the sub-distribution hazard model, hazard ratio [HR] = 1.31, 95% CI:1.05–1.65, for the Cox-CSH model, and HR = 0.81, 95% CI:0.69–0.96, for the CS-AFT model. Gender and WHO stage were found to be signifi- cantly associated with the composite of unfavourable outcomes, HR = 1.56, 95% CI:1.27–1.90, HR = 1.28, 95% CI: 1.06–1.55 for males and WHO stage III-or-IV, respectively for the non-CSH model. Conclusions: Results show that WHO stage III-or-IV is significantly associated with unfavourable outcomes. The results from competing risk models were consistent. However, results obtained from the non-CSH model were inconsistent with those obtained from competing risk analysis models