scholarly journals Chronic acid-suppressant use and risk of Oesophageal cancer: protocol for a longitudinal study using a large population based cohort

2021 ◽  
Author(s):  
Julia Hippisley-Cox ◽  
Xue W Mei ◽  
Pui San Tan ◽  
Rebecca Fitzgerald ◽  
Carol Coupland ◽  
...  
Keyword(s):  
Cohort Study ◽  
Oesophageal Cancer ◽  
Public Involvement ◽  
Large Population ◽  
Acid Reflux ◽  
Patient And Public Involvement ◽  
Oesophageal Adenocarcinoma ◽  
Cancer Type ◽  
List Type ◽  
Academic Journal

AbstractIntroductionOesophageal cancer is the sixth most common cause for cancer related deaths with over 450,000 new cases and 400,000 resulting deaths per year globally. Most cases in the UK are adenocarcinoma with some of the poorest outcomes from this cancer type in Europe -- mainly due to late diagnosis. The main risk factor for oesophageal adenocarcinoma is chronic reflux disease and due to the high prevalence and non-specific nature of these symptoms most patients are often managed with acid-reflux medications (e.g. Proton Pump Inhibitors (PPIs)) without referral for endoscopy. For those patients that are referred the endoscopy is normal in over 70% of cases, and there is not enough capacity within the NHS for endoscopy especially considering colon cancer screening.The primary aim of this project is to improve early identification of individuals at risk of oesophageal cancer and reduce over-use of prescription antacids.Methods and analysisWe will conduct a longitudinal cohort study consisted of adults 40 years and over who are free of oesophageal cancer at study entry, using the QResearch database for data gathered between 2000 and 2020. The main exposure is the use of prescription antacids which includes PPI, H2RA, and other aluminium and magnesium containing antacids. The exposure will be categorised based on active ingredients, dose, and duration of use and will be modelled as a time-varying covariate.Ethics and disseminationEthical approval for this project was obtained from the QResearch Scientific Committee [Ref: OX39, project title “DELTA - integrated Diagnostic solution for Early detection of Oesophageal cAncer”]. This project has been supported by patient and public involvement panels. We intend to submit the findings for peer-reviewed publication in an academic journal and disseminate them to the public.Strength and limitations of this studyThis is an open cohort study comprising a nationally representative sample of English population.The cohort consists of GP clinic data linked to hospital records, the English national cancer registry and English national death registry.This study has access to detailed information on acid-suppressant prescriptions, allowing analysis with consideration of the specific compound, dose, and duration of exposure.This study is limited by high rates of missing data for cancer grade and stage, although completeness has improved in recent years, this will be accounted for using appropriate multiple imputation techniques.

scholarly journals Why Women Choose At-Home Abortion via Teleconsultation in France?: A Mixed-Method Study on Drivers of Telemedicine Abortion

2021 ◽  
Author(s):  
Hazal Atay ◽  
Helene Perivier ◽  
Kristina Gemzell-Danielson ◽  
Jean Guilleminot ◽  
Danielle Hassoun ◽  
...  
Keyword(s):  
Mixed Method ◽  
Public Involvement ◽  
Medical Abortion ◽  
Patient And Public Involvement ◽  
Mixed Method Study ◽  
List Type ◽  
Cross Sectional ◽  
Safe Abortion ◽  
Abortion Care ◽  
At Home

AbstractObjectivesIn face of the COVID-19 health emergency, France has allowed medical abortions to be performed by teleconsultation until 9 weeks of gestation. In an attempt to understand the demand and main drivers of telemedicine abortion, we analysed the requests that Women on Web (WoW), an online telemedicine abortion service operating worldwide, received from France throughout 2020.MethodsWe conducted a parallel convergent mixed-method study among 809 consultations received from France at WoW between 1 January and 31 December 2020. We performed a cross-sectional study of data obtained from the WoW consultation survey and a manifest content analysis of anonymised email correspondence of 140 women consulting with WoW helpdesk from France.ResultsWe found that women encounter macro-level, individual-level, and provider-level constraints while trying to access abortion in France. The preferences and needs over secrecy (46.2%), privacy (38.3%), and comfort (34.9%) are among the most frequent reasons for women from France to choose telemedicine abortion through WoW. The COVID-19 pandemic seems to be an important driver for resorting to telemedicine (30.6%). The lockdowns seem to have had an impact on the number of consultations received at WoW from France, increasing from 60 in March to 128 in April during the first lockdown and from 54 in October to 80 in November during the second lockdown.ConclusionsThe demand for at-home medical abortion via teleconsultation increased in France during the lockdowns. However, drivers of telemedicine abortion are multi-dimensional and go beyond the conditions unique to the pandemic. Given the various constraints women continue to encounter in accessing safe abortion, telemedicine can help meet women’s preferences and needs for secrecy, privacy and comfort, while facilitating improved access to and enabling more person-centred abortion care.Tweetable AbstractAt-home abortion via teleconsultation can help meet women’s needs and preferences for privacy, secrecy, and comfort, while facilitating improved access to abortion care in France.Key MessagesThe lockdowns seem to have had an impact on the number of consultations received at WoW from France, increasing from 60 in March to 128 in April during the first lockdown and from 54 in October to 80 in November during the second lockdown.While the COVID-19 pandemic was an important push factor for women to choose telemedicine, the drivers of telemedicine are multidimensional and go beyond conditions unique to the pandemic.Telemedicine can help meet women’s needs and preferences for privacy, secrecy, and comfort, while facilitating access to and enabling more person-centred abortion care in France.Funding InformationThis research was funded by a public grant overseen by the French National Research Agency (ANR) as part of the “Investissements d’Avenir” program LIEPP (ANR-11-LABX-0091, ANR-11-IDEX-0005-02) and the Université de Paris IdEx (ANR-18-IDEX-0001).Patient and public involvement statementThis public policy analysis does not involve patients or the public in the design, or conduct, or reporting, or dissemination plans of this work. However, the service that WoW provides is designed to address the priorities and experiences of people who access the service. Thus, the research questions were informed by the needs of people who rely on WoW to access abortion.Ethics approvalThe study was approved by the Regional Ethics Committee, Karolinska Institutet, Dnr 2009/2072-31/2 and Dnr 2020/05406.

scholarly journals Methods to Generate Innovative Research Ideas and Improve Patient and Public Involvement in Modern Epidemiological Research: a Review, a Patient Viewpoint and Guidelines for Implementation of a Digital Cohort Study (Preprint)

2020 ◽  
Author(s):  
Gloria A Aguayo ◽  
Catherine Goetzinger ◽  
Renza Scibilia ◽  
Aurélie Fischer ◽  
Till Seuring ◽  
...  
Keyword(s):  
Cohort Study ◽  
Public Involvement ◽  
Early Stage ◽  
Scale Up ◽  
Epidemiological Studies ◽  
Steering Committee ◽  
Patient And Public Involvement ◽  
Media Analysis ◽  
Epidemiological Research ◽  
Practical Recommendations

BACKGROUND Patient and public involvement in research (PPI) aims to increase the quality and relevance of research by incorporating the perspective from those ultimately affected by the research. Despite these potential benefits, PPI is rarely included in epidemiology protocols. OBJECTIVE to provide an overview of methods used for PPI and offer practical recommendations for the efficient implementation in epidemiological research. METHODS We conducted a review on PPI methods. We mirrored it with a patient advocate’s viewpoint about PPI. We then identified key steps to optimize PPI in epidemiological research based on our review and the viewpoint of the patient advocate taking into account the identification of barriers and facilitation of PPI. From these, we provided practical recommendations to launch a patient-centered cohort study. We used the implementation of a new digital cohort study as an exemplary use case. RESULTS We analyzed data from 98 studies, with 59% of studies performed in the United Kingdom. The most common methods were workshops (48.5%), meetings, events or conferences (35.1%), surveys (34.0%), focus groups (26.0%), interviews (23.7%), consensus techniques (8.2%), experience-based co-design (8.2%), James Lind Alliance (7.2%), and social media analysis (6.2%). The viewpoint of a patient showed a strong interest in participating in research. Research ideas (61.2%), co-design (42.9%), defining priorities (30.6%), participation in data analysis (26.5%) and being member of the steering committee (16.5%) were the most usual PPI modalities. We identified 8 general recommendations and 32 key PPI-related steps that can serve as guidelines to increase the relevance of epidemiological studies. CONCLUSIONS PPI is a project within a project that contributes to improving knowledge and increasing the relevance of research. PPI methods are mainly used for ideas generation. Based on our review and case study, we recommend to include PPI at an early stage and through all the research cycles and to combine methods for generation of new ideas. For e-cohorts, the use of digital tools are essential to scale up PPI. We encourage investigators to rely on our practical recommendations to extend PPI in future epidemiological studies.

scholarly journals ReIMAGINE: a prostate cancer research consortium with added value through its patient and public involvement and engagement

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
S. Green ◽  
S. Tuck ◽  
J. Long ◽  
T. Green ◽  
A. Green ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Stratification ◽  
Public Involvement ◽  
Specific Antigen ◽  
Patient And Public Involvement ◽  
Imaging Biomarkers ◽  
List Type ◽  
The Public ◽  
Research Engagement ◽  
The Impact

Abstract Background ReIMAGINE aims to improve the current prostate specific antigen (PSA)/biopsy risk stratification for prostate cancer (PCa) and develop a new image-based method (with biomarkers) for diagnosing high/low risk PCa in men. ReIMAGINE’s varied patient and public involvement (PPI) and engagement (PE) strategy maximises the impact of its scientific output by informing and shaping the different stages of research. Aims Through including the voice of patients and the public, the ReIMAGINE Consortium aims to translate these different perspectives into the design and implementation process. This will improve the overall quality of the research by: reflecting the needs and priorities of patients and the public, ensuring methods and procedures are feasible and appropriate ensuring information is relevant and accessible to those being recruited to the study identifying dissemination channels relevant to patients/the public and developing outputs that are accessible to a lay audience With support from our patient/user groups, the ReIMAGINE Consortium aims to improve our ability to derive prognostic information and allocate men to the most appropriate and effective therapies, using a novel image-based risk stratification with investigation of non-imaging biomarkers. Findings We have been working with patients and the public from initiation of the project to ensure that the research is relevant to men and their families. Our PPI Sub-Committee, led by a PCa patient, has been involved in our dissemination strategy, outreach activities, and study design recommendations. For example, the sub-committee have developed a variety of informative videos relevant and accessible to those being recruited, and organised multiple online research engagement events that are accessible to a lay audience. As quoted by one of the study participants, “the more we present the benefits and opportunities to patients and the public, the more research commitment we obtain, and the sooner critical clinical questions such as PCa diagnostics will be addressed”.

scholarly journals Patient and public involvement in oesophageal cancer survivorship research

2021 ◽  
pp. 1-7
Author(s):  
Anna Schandl ◽  
Kalle Mälberg ◽  
Lena Haglund ◽  
Lars Arnberg ◽  
Pernilla Lagergren
Keyword(s):  
Cancer Survivorship ◽  
Oesophageal Cancer ◽  
Public Involvement ◽  
Patient And Public Involvement

scholarly journals PP033 Patient And Public Involvement In Health Technology Assessment: The Brazilian Experience

2017 ◽  
Vol 33 (S1) ◽  
pp. 86-86
Author(s):  
Tacila Mega ◽  
Aline Silva ◽  
Clarice Petramale ◽  
Roberta Rabelo
Keyword(s):  
Health Technology Assessment ◽  
Social Participation ◽  
Technology Assessment ◽  
Clinical Guidelines ◽  
Educational Program ◽  
Public Involvement ◽  
Health Technology ◽  
Patient And Public Involvement ◽  
Mobile App ◽  
List Type

INTRODUCTION:The National Committee for Health Technology Incorporation (CONITEC) (1) was created in 2011, when the participation of civil society in the Health Technology Assessment (HTA) process was formalized in Brazil. According to legislation, patient and public involvement (PPI) in HTA occurs through: public consultations (PC); representation of SUS (Brazilian Public Health System) users in the plenary of CONITEC and by public hearings in relevant cases. Due the incipient culture of social participation in Brazil, strategies involving better communication, direct participation and popular education were developed to broaden and qualify this participation.METHODS:•Case study about PPI strategies developed in 5 years of CONITEC•Analysis of documents and official records from the Brazilian Ministry of Health.RESULTS:Since its creation, the innovations of CONITEC regarding PPI were: creation of specific PC form to reproduce or represent the perspectives of patients and caregivers; summarized versions of technical reports written in a simplified language to improve users involvement; surveys prior to elaborating clinical guidelines, a bi-weekly educational program transmitted by streaming, and the recent launch of an HTA Users Guide and a mobile app.After the implementation of these strategies (which started in 2014), there was an increase of annual contributions, from 2,584 in 2014 to 13,619 in 2015. Most participants were patients, family members or caregivers. Surveys concerning clinical guidelines received about 3,000 contributions. There were thirty-seven published society reports until December 2016. The publication of the HTA Users Guide and other related actions increased the number of accesses to the CONITEC website and its subsection for social participation. The educational program had more than 800 online accesses in five months.CONCLUSIONS:These actions allowed expanding and qualifying PPI beyond what is legally defined, and it is possible to predict an increasingly favorable scenario regarding the patient and public participation in HTA in Brazil.

scholarly journals P-OGC15 Impact of postoperative systemic treatment on survival for oesophageal adenocarcinoma after preoperative chemotherapy and oesophagectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Saqib Rahman ◽  
Betsan Thomas ◽  
Nick Maynard ◽  
Min Hae Park ◽  
Muhammed Wahedally ◽  
...  
Keyword(s):  
Preoperative Chemotherapy ◽  
Oesophageal Cancer ◽  
Surgical Complications ◽  
Large Population ◽  
National Level ◽  
Population Based ◽  
Postoperative Chemotherapy ◽  
Oesophageal Adenocarcinoma ◽  
Survival Times ◽  
Postoperative Therapy

Abstract Background Perioperative chemotherapy is widely used in the treatment of oesophageal cancer with substantial survival benefit over surgery alone. However, the postoperative part of these regimens is given in less than half of cases, reflecting uncertainty about its benefit. This study estimates the effect of postoperative chemotherapy after surgery for oesophageal cancer using a large population-based dataset and modern statistical methods. Methods Patients with oesophageal adenocarcinoma diagnosed between 2012 and 2018 and underwent preoperative chemotherapy followed by surgery, were identified from a national level audit in England and Wales (National Oesophagogastric Cancer Audit). Postoperative therapy was defined as the receipt of at least one cycle of systemic chemotherapy within 90 days of surgery. The comparative effectiveness of postoperative chemotherapy compared to observation was estimated using inverse propensity treatment weighting (IPTW). Results The study included 2,814 patients, in whom postoperative therapy was given to 1,054 (37.5%). Patients who received postoperative therapy were younger, with a lower ASA grade and were less likely to have surgical complications of any type, including anastomotic leak (all p < 0.001). Tumour characteristics were similar in both groups. Weighted median survival times for patients having no treatment or postoperative chemotherapy were 45.4 months and 57.5 months respectively. There was a life expectancy difference at five years of 2.9 months in favour of postoperative chemotherapy (95%CI 1.1–4.8 months, p < 0.001) with a Hazard Ratio of 0.80 (95%CI 0.70-0.91, p < 0.001). Conclusions Among patients with oesophageal adenocarcinoma treated with preoperative chemotherapy and surgery, improved overall survival was observed in those patients who received postoperative chemotherapy. Minimising surgical complications and improving patient fitness could increase the use of postoperative chemotherapy, leading to better outcomes for patients with oesophageal adenocarcinoma. 

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