Core outcome set in paediatric sepsis in low- and middle-income countries: a study protocol

IntroductionSepsis is the leading cause of death in children worldwide and has recently been declared a major global health issue. New interventions and a concerted effort to enhance our understanding of sepsis are required to address the huge burden of disease, especially in low- and middle-income countries (LMIC) where it is highest. An opportunity therefore exists to ensure that ongoing research in this area is relevant to all stakeholders and is of consistently high quality. One method to address these issues is through the development of a core outcome set (COS).Methods and analysisThis study protocol outlines the phases in the development of a core outcome set for paediatric sepsis in LMIC. The first step involves performing a systematic review of all outcomes reported in the research of paediatric sepsis in low middle-income countries. A three-stage international Delphi process will then invite a broad range of participants to score each generated outcome for inclusion into the COS. This will include an initial two-step online survey and finally, a face-to-face consensus meeting where each outcome will be reviewed, voted on and ratified for inclusion into the COS.Ethics and disseminationNo core outcome sets exist for clinical trials in paediatric sepsis. This COS will serve to not only highlight the heavy burden of paediatric sepsis in this setting and aid collaboration and participation between all stakeholders, but to promote ongoing essential high quality and relevant research into the topic. A COS in paediatric sepsis in LMIC will advocate for a common language and facilitate interpretation of findings from a variety of settings. A waiver for ethics approval has been granted by University of British Columbia Children’s and Women’s Research Ethics Board.

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Development of a core outcome set for multimorbidity trials in low- and middle-income countries (COSMOS): Study Protocol

10.1101/2021.03.23.21253685 ◽

2021 ◽

Author(s):

Jan R. Boehnke ◽

Rusham Zahra Rana ◽

Jamie J. Kirkham ◽

Louise Rose ◽

Gina Agarwal ◽

...

Keyword(s):

Core Outcome Set ◽

Core Outcome ◽

International Consensus ◽

Long Term Conditions ◽

Middle Income ◽

Middle Income Countries ◽

Effective Interventions ◽

Outcome Set ◽

Wide Range ◽

Low And Middle Income

Introduction 'Multimorbidity' describes the presence of two or more long-term conditions, which can include communicable and non-communicable diseases, and mental disorders. The rising global burden from multimorbidity is well-documented, but trial evidence for effective interventions in low- and middle-income countries (LMICs) is limited. Selection of appropriate outcomes is fundamental to trial design to ensure cross-study comparability, but there is currently no agreement on a core outcome set (COS) to include in trials investigating multimorbidity specifically in LMIC. Our aim is to develop international consensus on two COS for trials of interventions to prevent and treat multimorbidity in LMIC settings. Methods and Analysis Following methods recommended by the Core Outcome Measures in Effectiveness Trials (COMET initiative), the development of these two COS will occur in three stages: (1) generation of a long list of potential outcomes for inclusion; (2) two-round online Delphi surveys; and (3) consensus meetings. First, to generate an initial list of outcomes, we will conduct a systematic review of multimorbidity intervention and prevention trials and interviews with people living with multimorbidity and their caregivers in LMICs. Outcomes will be classified using an outcome taxonomy. Two-round Delphi surveys will be used to elicit importance scores for these outcomes from people living with multimorbidity, caregivers, healthcare professionals, policy makers, and researchers in LMICs. Finally, consensus meetings will be held to discuss the Delphi survey results and agree outcomes for inclusion in the two COS. Ethics and dissemination The study has been approved by the Research Governance Committee of the Department of Health Sciences, University of York, UK [HSRGC/2020/409/D:COSMOS]. Each participating country/research group will obtain local ethics board approval. Informed consent will be obtained from all participants. We will disseminate findings through peer-reviewed open access publications, and presentations at global conferences selected to reach a wide range of LMIC stakeholders.

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Participation and Achievement in the Summer Paralympic Games: The Influence of Income, Sex, and Assistive Technology

Sustainability ◽

10.3390/su132111758 ◽

2021 ◽

Vol 13 (21) ◽

pp. 11758

Author(s):

Giulia Oggero ◽

Louise Puli ◽

Emma Maria Smith ◽

Chapal Khasnabis

Keyword(s):

Assistive Technology ◽

Income Level ◽

High Income ◽

High Quality ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Significant Difference ◽

Paralympic Games ◽

Low And Middle Income

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and achievements in the Summer Paralympic Games by income level and sex, including in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses). A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income and population were collected from publicly available data available from the World Bank website. Participation in the Summer Paralympic Games differs significantly by income level (p = 0.000) with high- income countries sending, on average, more Paralympians than low- and middle-income countries. There is a significant difference between male and female participation (p = 0.00), with approximately 29% of all Paralympians being female. High-income countries demonstrate significantly higher achievement than low- and middle-income countries (p = 0.000), including in events requiring assistive products (p = 0.007). Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. More equitable participation and achievement in the Paralympics may be supported by addressing the barriers for females, for people from low- and low-middle income countries, and for those without access to high quality assistive products required.

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The development of a faecal incontinence core outcome set: an international Delphi study protocol

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03865-2 ◽

2021 ◽

Vol 36 (3) ◽

pp. 617-622

Author(s):

Sadé Assmann ◽

Daniel Keszthelyi ◽

Jos Kleijnen ◽

Merel Kimman ◽

Foteini Anastasiou ◽

...

Keyword(s):

Systematic Review ◽

Study Protocol ◽

Faecal Incontinence ◽

Delphi Study ◽

Evidence Synthesis ◽

Core Outcome Set ◽

Core Outcome ◽

Delphi Consensus ◽

Link Type ◽

Outcome Set

Abstract Purpose Faecal incontinence (FI) is estimated to affect around 7.7% of people. There is a lack of uniformity in outcome definitions, measurement and reporting in FI studies. Until now, there is no general consensus on which outcomes should be assessed and reported in FI research. This complicates comparison between studies and evidence synthesis, potentially leading to recommendations not evidence-based enough to guide physicians in selecting an FI therapy. A solution for this lack of uniformity in reporting of outcomes is the development of a Core Outcome Set (COS) for FI. This paper describes the protocol for the development of a European COS for FI. Methods Patient interviews and a systematic review of the literature will be performed to identify patient-, physician- and researcher-oriented outcomes. The outcomes will be categorised using the COMET taxonomy and put forward to a group of patients, physicians (i.e. colorectal surgeons, gastroenterologists and general practitioners) and researchers in a Delphi consensus exercise. This exercise will consist of up to three web-based rounds in which participants will prioritise and condense the list of outcomes, which is expected to result in consensus. A consensus meeting with participants from all stakeholder groups will take place to reach a final agreement on the COS. Discussion This study protocol describes the development of a European COS to improve reliability and consistency of outcome reporting in FI studies, thereby improving evidence synthesis and patient care. Trial registration This project has been registered in the COMET database on the 1st of April 2020, available at http://www.comet-initiative.org/Studies/Details/1554. The systematic review has been registered on the PROSPERO database on the 31st of August 2020, available at https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=202020&VersionID=1381336.

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Quality Measures to Deliver Safe, High-Quality Care on Hand Surgery Outreach Trips to Low and Middle-Income Countries

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.19.01506 ◽

2020 ◽

Vol 103 (8) ◽

pp. e32

Author(s):

Lauren M. Shapiro ◽

Keyword(s):

Quality Care ◽

Hand Surgery ◽

Quality Measures ◽

High Quality ◽

Middle Income ◽

High Quality Care ◽

Middle Income Countries ◽

Low And Middle Income

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Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

Global Journal of Health Science ◽

10.5539/gjhs.v8n11p278 ◽

2016 ◽

Vol 8 (11) ◽

pp. 278 ◽

Cited By ~ 2

Author(s):

Aprill Z. Dawson ◽

Rebekah J. Walker ◽

Jennifer A. Campbell ◽

Leonard E. Egede

Keyword(s):

Medical Training ◽

Skills Training ◽

High Income ◽

Training Methods ◽

Middle Income ◽

Training Outcomes ◽

Effective Strategies ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Low And Middle Income

INTRODUCTION: Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.METHODS: Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.RESULTS: Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.DISCUSSION: Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.

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Seroprevalence of SARS CoV-2 infection in Low and Middle-Income Countries and risk classification in the context of rolling out vaccine candidate across these countries : Protocol for a systematic review and meta-analysis

10.21203/rs.3.rs-578481/v1 ◽

2021 ◽

Author(s):

Martin Ackah ◽

Louise Ameyaw ◽

Kwadwo Owusu Akuffo ◽

Cynthia Osei Yeboah ◽

Nana Esi Wood ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Vaccine Candidate ◽

Meta Analysis ◽

Cochrane Library ◽

Research Database ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Low And Middle Income

Abstract Background Seroprevalence of SARS Cov-2 provides a good indication of the extent of exposure and spread in the population, as well as those likely to benefit from a vaccine candidate. To date, there is no published or ongoing systematic review on the seroprevalence of COVID-19 in Low- and Middle-Income Countries (LMICs). This systematic review and meta-analysis will estimate SARS Cov-2 seroprevalence and the risk factors for SARS Cov-2 infection in LMICs.Methods We will search PubMed, EMBASE, WHO COVID-19 Global research database, Google Scholar, the African Journals Online, LILAC, HINARI, medRxiv, bioRxiv and Cochrane Library for potentially useful studies on seroprevalence of COVID-19 in LMICs from December 2019 to December 2020 without language restriction. Two authors will independently screen all the articles, select studies based on pre-specified eligibility criteria and extract data using a pre-tested data extraction form. Any disagreements will be resolved through discussion between the authors. The pooled seroprevalence of SARS CoV-2 for people from LMICs will be calculated. Random effects model will be used in case of substantial heterogeneity in the included studies, otherwise fixed-effect model will be used. A planned subgroup, sensitivity and meta-regression analyses will be performed. For comparative studies, the analyses will be performed using Review Manager v 5.4; otherwise, STATA 16 will be used. All effect estimates will be presented with their confidence intervals.Discussion The study will explore and systematically review empirical evidence on SARS Cov-2 seroprevalence in LMICs, and to assess the risk factors for SARS Cov-2 infection in Low Middle Income Countries in the context of rolling out vaccines in these countries. Finally, explore risk classifications to help with the rolling out of vaccines in LMICs.Systematic review registration: The protocol for this review has been registered in PROSPERO (CRD422020221548).

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