scholarly journals Comparative effectiveness of the BNT162b2 vs ChAdOx1 vaccine against Covid-19

2021 ◽  
Author(s):  
Junqing Xie ◽  
shuo feng ◽  
Xintong Li ◽  
Ester Gea Mallorqui ◽  
Albert Prats-Uribe ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Direct Evidence ◽  
Hazard Ratio ◽  
Evidence Based ◽  
Probability Weighting ◽  
Uk Biobank ◽  
Cox Models ◽  
Inverse Probability ◽  
Related Hospitalisation ◽  
Vaccination Campaigns

Although pivotal trials with varying populations and study methods suggest higher efficacy for mRNA than adenoviral Covid-19 vaccines, no direct evidence is available. Here, we conducted a head-to-head comparison of BNT162b2 versus ChAdOx1 against Covid-19. We analysed 235,181 UK Biobank participants aged 50 years or older and vaccinated with one or two doses of BNT162b2 or ChAdOx1. People were followed from the vaccination date until 18/10/2021. Inverse probability weighting was used to minimise confounding and the Cox models to derive hazard ratio. We found that, compared with two doses of ChAdOx1, vaccination with BNT162b2 was associated with 30% lower risks of both SARS-CoV-2 infection and related hospitalisation during the period dominated by the delta variant. Also, this comparative effectiveness was consistent across several subgroups and persisted for at least six months, suggesting no differential waning between the two vaccines. Our findings can inform evidence-based Covid-19 vaccination campaigns and booster strategies.

Abstract 14658: Comparative Effectiveness of Torsemide versus Furosemide in Acute Heart Failure Patients: Insights from ASCEND-HF

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Robert J Mentz ◽  
Vic Hasselblad ◽  
Adam D DeVore ◽  
Paul W Armstrong ◽  
Justin A Ezekowitz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Comparative Effectiveness ◽  
Loop Diuretic ◽  
Probability Weighting ◽  
Lower Blood Pressure ◽  
Post Discharge ◽  
Inverse Probability ◽  
Lower Blood ◽  
The Relationship ◽  
Selection Of

Introduction: Furosemide is the most commonly used loop diuretic in heart failure (HF) patients despite potential pharmacologic and anti-fibrotic benefits with torsemide. Hypothesis: We hypothesized that the comparative benefits of post-discharge use of torsemide would be superior to furosemide in a large acute HF trial. Methods: We investigated HF patients in ASCEND-HF who were discharged on either torsemide or furosemide. Given regional variation in torsemide use, we restricted analyses to the 6 countries with at least 20 patients on one of the diuretics and patients on torsemide. Using inverse probability weighting (IPW) to account for selection of diuretic, we assessed the relationship between diuretic at discharge with 30-day mortality or HF hospitalization, and 30- and 180-day mortality. Results: Of 7,141 patients in the trial, 3,282 patients were included in this analysis, of which, 88% (n=2,893) received furosemide and 12% (n=389) received torsemide. Torsemide-treated patients had lower blood pressure, and higher creatinine and BUN at baseline compared with furosemide-treated patients. On adjusted analysis, torsemide use was associated with a trend toward lower 30-day mortality or HF hospitalization (OR 0.62, 95% CI: 0.37-1.04; P=0.067). Torsemide was associated with similar 30-day mortality (OR 0.77, 95% CI: 0.28-2.09; P=0.60), and significantly reduced 180-day mortality (HR 0.56, 95% CI: 0.36-0.87; P=0.038) compared with furosemide (Figure). Conclusion: In this acute HF trial, a minority of patients received torsemide and commonly had indicators of higher risk. After risk-adjustment, torsemide was associated with lower risk of 180-day mortality. These data should be considered as hypothesis-generating and prospective, randomized comparative effectiveness trials are needed to investigate the optimal diuretic choice between torsemide vs. furosemide.

Implementation Strategies

2017 ◽  
Author(s):  
JoAnn E. Kirchner ◽  
Thomas J. Waltz ◽  
Byron J. Powell ◽  
Jeffrey L. Smith ◽  
Enola K. Proctor
Keyword(s):  
Implementation Science ◽  
Comparative Effectiveness ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Efficient Manner

As the field of implementation science moves beyond studying barriers to and facilitators of implementation to the comparative effectiveness of different strategies, it is essential that we create a common taxonomy to define the strategies that we study. Similarly, we must clearly document the implementation strategies that are applied, the factors that influence their selection, and any adaptation of the strategy during the course of implementation and sustainment of the innovation being implemented. By incorporating this type of rigor into our work we will be able to not only advance the science of implementation but also our ability to place evidence-based innovations into the hands of practitioners in a timely and efficient manner.

scholarly journals Impact of Adopting Improved Seeds on Access to Broader Food Groups Among Small-Scale Sorghum Producers in Tanzania

SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402097999
Author(s):  
Aloyce R. Kaliba ◽  
Anne G. Gongwe ◽  
Kizito Mazvimavi ◽  
Ashagre Yigletu
Keyword(s):  
Food Security ◽  
Dietary Diversity ◽  
Sampling Technique ◽  
Inverse Probability Weighting ◽  
Reproductive Age ◽  
Small Scale ◽  
Probability Weighting ◽  
Food Groups ◽  
Inverse Probability ◽  
Double Robust

In this study, we use double-robust estimators (i.e., inverse probability weighting and inverse probability weighting with regression adjustment) to quantify the effect of adopting climate-adaptive improved sorghum varieties on household and women dietary diversity scores in Tanzania. The two indicators, respectively, measure access to broader food groups and micronutrient and macronutrient availability among children and women of reproductive age. The selection of sample households was through a multistage sampling technique, and the population was all households in the sorghum-producing regions of Central, Northern, and Northwestern Tanzania. Before data collection, enumerators took part in a 1-week training workshop and later collected data from 822 respondents using a structured questionnaire. The main results from the study show that the adoption of improved sorghum seeds has a positive effect on both household and women dietary diversity scores. Access to quality food groups improves nutritional status, food security adequacy, and general welfare of small-scale farmers in developing countries. Agricultural projects that enhance access to improved seeds are, therefore, likely to generate a positive and sustainable effect on food security and poverty alleviation in sorghum-producing regions of Tanzania.

scholarly journals Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000809 ◽  
Author(s):  
Kim Lauper ◽  
Denis Mongin ◽  
Florenzo Iannone ◽  
Eirik Klami Kristianslund ◽  
Tore K Kvien ◽  
...  
Keyword(s):  
Disease Activity ◽  
Comparative Effectiveness ◽  
Treatment Initiation ◽  
Activity Index ◽  
Disease Activity Index ◽  
Real Word ◽  
Cox Models ◽  
Low Disease Activity ◽  
Kaplan Meier ◽  
European Collaboration

ObjectiveTo compare the real-word effectiveness of subcutaneous tocilizumab (TCZ-SC) and intravenous tocilizumab (TCZ-IV) in rheumatoid arthritis (RA).MethodsPatients with RA with TCZ from eight European registries were included. Drug retention was compared using unadjusted Kaplan-Meier and Cox models adjusted for baseline patient, disease and treatment characteristics, using a strata term for year of treatment initiation and country of registry. The proportions of patients achieving Clinical Disease Activity Index (CDAI) remission and low disease activity (LDA) at 1 year were compared using samples matched on the same covariates and corrected for attrition using LUNDEX.Results3448 patients were retrieved, 2414 with TCZ-IV and 1034 with TCZ-SC. Crude median retention was 3.52 years (95% CI 3.22 to 3.85) for TCZ-IV and 2.12 years for TCZ-SC (95% CI 1.88 to 2.38). In a country-stratified and year of treatment initiation–stratified, covariate-adjusted analysis, hazards of discontinuation were similar between TCZ-SC and TCZ-IV treated patients (HR 0.93, 95% CI 0.80 to 1.09). The average adjusted CDAI change at 1 year was similar in both groups (−6.08). After matching, with 560 patients in each group, CDAI remission corrected for attrition at 1 year was also similar between TCZ-SC and TCZ-IV (10.4% in TCZ-IV vs 12.8% in TCZ-SC (difference: 2.4%, bootstrap 95% CI −2.1% to 7.6%)), but CDAI LDA was lower in TCZ-IV patients: 41.0% in TCZ-IV versus 49.1% in TCZ-SC (difference: 8.0 %; bootstrap 95% CI 2.4% to 12.4%).ConclusionWith similar retention and effectiveness, TCZ-SC is an adequate alternative to TCZ-IV for RA. When possible, considering the costs of the TCZ-IV route, TCZ-SC should be the preferred mode of administration.

scholarly journals Contextualizing selection bias in Mendelian randomization: how bad is it likely to be?

2018 ◽  
Vol 48 (3) ◽  
pp. 691-701 ◽  
Author(s):  
Apostolos Gkatzionis ◽  
Stephen Burgess
Keyword(s):  
Risk Factor ◽  
Selection Bias ◽  
Simulation Study ◽  
Cardiovascular Mortality ◽  
Mendelian Randomization ◽  
Inverse Probability Weighting ◽  
Probability Weighting ◽  
Inverse Probability ◽  
Type 1 Error

Abstract Background Selection bias affects Mendelian randomization investigations when selection into the study sample depends on a collider between the genetic variant and confounders of the risk factor–outcome association. However, the relative importance of selection bias for Mendelian randomization compared with other potential biases is unclear. Methods We performed an extensive simulation study to assess the impact of selection bias on a typical Mendelian randomization investigation. We considered inverse probability weighting as a potential method for reducing selection bias. Finally, we investigated whether selection bias may explain a recently reported finding that lipoprotein(a) is not a causal risk factor for cardiovascular mortality in individuals with previous coronary heart disease. Results Selection bias had a severe impact on bias and Type 1 error rates in our simulation study, but only when selection effects were large. For moderate effects of the risk factor on selection, bias was generally small and Type 1 error rate inflation was not considerable. Inverse probability weighting ameliorated bias when the selection model was correctly specified, but increased bias when selection bias was moderate and the model was misspecified. In the example of lipoprotein(a), strong genetic associations and strong confounder effects on selection mean the reported null effect on cardiovascular mortality could plausibly be explained by selection bias. Conclusions Selection bias can adversely affect Mendelian randomization investigations, but its impact is likely to be less than other biases. Selection bias is substantial when the effects of the risk factor and confounders on selection are particularly large.

scholarly journals Comparative Effectiveness Research: Using Systematic Reviews and Meta-Analyses to Synthesize Empirical Evidence

2011 ◽  
Vol 25 (3) ◽  
pp. 191-209 ◽  
Author(s):  
Maria C. Katapodi ◽  
Laurel L. Northouse
Keyword(s):  
Systematic Reviews ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Meta Analysis ◽  
Research Question ◽  
Alternative Methods ◽  
Evidence Based ◽  
Effectiveness Research ◽  
Meta Analyses ◽  
Research Studies

The increased demand for evidence-based health care practices calls for comparative effectiveness research (CER), namely the generation and synthesis of research evidence to compare the benefits and harms of alternative methods of care. A significant contribution of CER is the systematic identification and synthesis of available research studies on a specific topic. The purpose of this article is to provide an overview of methodological issues pertaining to systematic reviews and meta-analyses to be used by investigators with the purpose of conducting CER. A systematic review or meta-analysis is guided by a research protocol, which includes (a) the research question, (b) inclusion and exclusion criteria with respect to the target population and studies, © guidelines for obtaining relevant studies, (d) methods for data extraction and coding, (e) methods for data synthesis, and (f ) guidelines for reporting results and assessing for bias. This article presents an algorithm for generating evidence-based knowledge by systematically identifying, retrieving, and synthesizing large bodies of research studies. Recommendations for evaluating the strength of evidence, interpreting findings, and discussing clinical applicability are offered.

Sign in / Sign up

Export Citation Format

Share Document