scholarly journals Optimising recruitment to the HAND-1 RCT feasibility study: integration of the QuinteT Recruitment Intervention (QRI)

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Samantha Husbands ◽  
Daisy Elliott ◽  
Tim R. C. Davis ◽  
Jane M. Blazeby ◽  
Eleanor F. Harrison ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Good Practice ◽  
Feasibility Studies ◽  
Fine Tuning ◽  
Screening Methods ◽  
Main Stage ◽  
Main Trial ◽  
Recruitment Challenges ◽  
Set Up ◽  
And Training

Abstract Background Recruitment to randomised controlled trials (RCTs) can be challenging, with most trials not reaching recruitment targets. Randomised feasibility studies can be set up prior to a main trial to identify and overcome recruitment obstacles. This paper reports on an intervention—the QuinteT Recruitment Intervention (QRI)—to optimise recruitment within a randomised feasibility study of surgical treatments for patients with Dupuytren’s contracture (the HAND-1 study). Methods The QRI was introduced in 2-phases: phase 1 sought to understand the recruitment challenges by interviewing trial staff, scrutinising screening logs and analysing audio-recorded patient consultations; in phase 2 a tailored plan of action consisting of recruiter feedback and training was delivered to address the identified challenges. Results Two key recruitment obstacles emerged: (1) issues with the recruitment pathway, in particular methods to identify potentially eligible patients and (2) equipoise of recruiters and patients. These were addressed by liaising with centres to share good practice and refine their pathway and by providing bespoke feedback and training on consent discussions to individual recruiters and centres whilst recruitment was ongoing. The HAND-1 study subsequently achieved its recruitment target. Conclusions Transferable lessons learnt from the QRI in the feasibility study will be implemented in the definitive RCT, enabling a “head start” in the tackling of wider issues around screening methods and consent discussions in the set up/early recruitment study phases, with ongoing QRI addressing specific issues with new centres and recruiters. Findings from this study are likely to be relevant to other surgical and similar trials that are anticipated to encounter issues around patient and recruiter equipoise of treatments and variation in recruitment pathways across centres. The study also highlights the value of feasibility studies in fine-tuning design and conduct issues for definitive RCTs. Embedding a QRI in an RCT, at feasibility or main stage, offers an opportunity for a detailed and nuanced understanding of key recruitment challenges and the chance to address them in “real-time” as recruitment proceeds.

scholarly journals Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eva Seckler ◽  
Verena Regauer ◽  
Melanie Krüger ◽  
Anna Gabriel ◽  
Joachim Hermsdörfer ◽  
...  
Keyword(s):  
Primary Care ◽  
Data Collection ◽  
Older People ◽  
Process Evaluation ◽  
Feasibility Study ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Care Pathway ◽  
Main Trial ◽  
Telephone Helpline

Abstract Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).

scholarly journals Fine-Tuning and Training of DenseNet for Histopathology Image Representation Using TCGA Diagnostic Slides

2021 ◽  
pp. 102032
Author(s):  
Abtin Riasatian ◽  
Morteza Babaie ◽  
Danial Maleki ◽  
Shivam Kalra ◽  
Mojtaba Valipour ◽  
...  
Keyword(s):  
Image Representation ◽  
Fine Tuning ◽  
And Training

scholarly journals Maudsley International: improving mental health and well-being around the world

2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Care ◽  
Well Being ◽  
Building Capacity ◽  
The Past ◽  
Health And Social Care ◽  
The World ◽  
Set Up ◽  
Health And Well Being ◽  
And Training

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.

“Bridging the Gap”: School Nurse Experiences Providing Care for Transgender and Gender Diverse Students and Their Parents/Guardians

2021 ◽  
pp. 105984052110254
Author(s):  
Tammy Neiman ◽  
Laurie Sieve ◽  
Louise Stenberg ◽  
Nicole Molesky ◽  
G. Nic Rider
Keyword(s):  
School Nurses ◽  
Parental Acceptance ◽  
Institutional Barriers ◽  
Gender Diverse ◽  
Semistructured Interviews ◽  
Gender Affirmation ◽  
And Gender ◽  
Set Up ◽  
Interpersonal Collaboration ◽  
And Training

School systems are often not set up to support transgender and gender diverse (TGD) students, which results in unsafe and unsupportive environments and other institutional barriers to helping TGD students thrive. An important factor to students' feeling safe and supported in schools may be their relationship with school nurses. The purpose of this study was to describe school nurses' experiences working with TGD students and their parents/guardians, their role in working with this community, and the challenges nurses face when trying to serve TGD students. Semistructured interviews were conducted with 23 school nurses across a Midwestern state. Thematic analysis was used to identify themes: gender-affirming education and interpersonal collaboration, bridging the gap between TGD youth and parents/guardians, gender-affirming care and confidentiality, and navigating parental acceptance and gender-affirmation. School nurses expressed a strong desire to support TGD students but lack the structure and training within schools.

Continuity of care for drug users in prison and beyond: A qualitative insight

2021 ◽  
pp. 002087282110489
Author(s):  
Heino Stöver ◽  
Daniela Jamin ◽  
Marie Jauffret-Roustide ◽  
Laurent Michel ◽  
Vânia Mendes ◽  
...  
Keyword(s):  
Social Work ◽  
Qualitative Study ◽  
Social Workers ◽  
Continuity Of Care ◽  
Drug Users ◽  
Good Practice ◽  
The People ◽  
Set Up ◽  
Opioid Users

Social work in prisons is linked to specific tasks regarding the care for the people who are incarcerated. A multi-country qualitative study was set up to explore drug users’ and professionals’ perceptions of continuity of care in prison and beyond. It has been pointed out that continuity of care is associated with different barriers, especially regarding social work. Nevertheless, good practice examples do exist and could be implemented by social workers. Social workers and opioid users face challenges in the context of imprisonment, so different measures need to be implemented to support opioid users and for social workers to support them.

scholarly journals Recognizing human activities from smartphone sensors using hierarchical continuous hidden Markov models

2017 ◽  
Vol 13 (1) ◽  
pp. 155014771668368 ◽  
Author(s):  
Charissa Ann Ronao ◽  
Sung-Bae Cho
Keyword(s):  
Hierarchical Structure ◽  
Markov Models ◽  
Hidden Markov ◽  
Classification Performance ◽  
Fine Tuning ◽  
Sensor Data ◽  
Model Framework ◽  
The Hierarchical Structure ◽  
Smartphone Sensors ◽  
And Training

Human activity recognition has been gaining more and more attention from researchers in recent years, particularly with the use of widespread and commercially available devices such as smartphones. However, most of the existing works focus on discriminative classifiers while neglecting the inherent time-series and continuous characteristics of sensor data. To address this, we propose a two-stage continuous hidden Markov model framework, which also takes advantage of the innate hierarchical structure of basic activities. This kind of system architecture not only enables the use of different feature subsets on different subclasses, which effectively reduces feature computation overhead, but also allows for varying number of states and iterations. Experiments show that the hierarchical structure dramatically increases classification performance. We analyze the behavior of the accelerometer and gyroscope signals for each activity through graphs, and with added fine tuning of states and training iterations, the proposed method is able to achieve an overall accuracy of up to 93.18%, which is the best performance among the state-of-the-art classifiers for the problem at hand.

Ready for take‐off: realising the potential of the education and training consortia

1998 ◽  
Vol 24 (5) ◽  
pp. 188-191 ◽  
Author(s):  
John Edmonstone
Keyword(s):  
Resource Allocation ◽  
Good Practice ◽  
Workforce Planning ◽  
Education And Training ◽  
Planning System ◽  
Top Down ◽  
Allocation System ◽  
Developing System ◽  
Resource Allocation System ◽  
And Training

Education consortia are now over 18 months old and can be seen as a “hybrid” between a top‐down resource allocation system and a bottom‐up workforce planning system. The strengths and weaknesses of the developing system are identified, as is emerging good practice in consortia operations. A model for consortia working which emphasises strategic working is proposed.

scholarly journals Role of feasibility and pilot studies in randomised controlled trials: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022233 ◽  
Author(s):  
Amanda Jane Blatch-Jones ◽  
Wei Pek ◽  
Emma Kirkpatrick ◽  
Martin Ashton-Key
Keyword(s):  
Feasibility Study ◽  
Randomised Controlled Trials ◽  
Feasibility Studies ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2 ◽  
Randomised Controlled ◽  
Pilot Feasibility Study ◽  
Group 1

ObjectivesTo assess the value of pilot and feasibility studies to randomised controlled trials (RCTs) funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. To explore the methodological components of pilot/feasibility studies and how they inform full RCTs.Study designCross-sectional study.SettingBoth groups included NIHR HTA programme funded studies in the period 1 January 2010–31 December 2014 (decision date). Group 1: stand-alone pilot/feasibility studies published in the HTA Journal or accepted for publication. Group 2: all funded RCT applications funded by the HTA programme, including reference to an internal and/or external pilot/feasibility study. The methodological components were assessed using an adapted framework from a previous study.Main outcome measuresThe proportion of stand-alone pilot and feasibility studies which recommended proceeding to full trial and what study elements were assessed. The proportion of ‘HTA funded’ trials which used internal and external pilot and feasibility studies to inform the design of the trial.ResultsGroup 1 identified 15 stand-alone pilot/feasibility studies. Study elements most commonly assessed weretesting recruitment(100% in both groups),feasibility(83%, 100%) andsuggestions for further study/investigation(83%, 100%). Group 2 identified 161 ‘HTA funded’ applications: 59 cited an external pilot/feasibility study wheretesting recruitment(50%, 73%) andfeasibility(42%, 73%) were the most commonly reported study elements: 92 reported an internal pilot/feasibility study wheretesting recruitment(93%, 100%) andfeasibility(44%, 92%) were the most common study elements reported.Conclusions‘HTA funded’ research which includes pilot and feasibility studies assesses a variety of study elements. Pilot and feasibility studies serve an important role when determining the most appropriate trial design. However, how they are reported and in what context requires caution when interpreting the findings and delivering a definitive trial.

scholarly journals Enhanced Language Model with Hybrid Knowledge Graph for Mathematical Topic Prediction

2021 ◽  
Author(s):  
Minghui Wu ◽  
Canghong Jin ◽  
Wenkang Hu ◽  
Yabo Chen
Keyword(s):  
Language Model ◽  
Real Data ◽  
Mathematical Concept ◽  
Fine Tuning ◽  
Knowledge Graph ◽  
Mathematics Knowledge ◽  
Hybrid Knowledge ◽  
Model Set ◽  
Set Up ◽  
Mathematical Topic

Understanding mathematical topics is important for both educators and students to capture latent concepts of questions, evaluate study performance, and recommend content in online learning systems. Compared to traditional text classification, mathematical topic classification has several main challenges: (1) the length of mathematical questions is relatively short; (2) there are various representations of the same mathematical concept(i.e., calculations and application); (3) the content of question is complex including algebra, geometry, and calculus. In order to overcome these problems, we propose a framework that combines content tokens and mathematical knowledge concepts in whole procedures. We embed entities from mathematics knowledge graphs, integrate entities into tokens in a masked language model, set up semantic similarity-based tasks for next-sentence prediction, and fuse knowledge vectors and token vectors during the fine-tuning procedure. We also build a Chinese mathematical topic prediction dataset consisting of more than 70,000 mathematical questions with topics. Our experiments using real data demonstrate that our knowledge graph-based mathematical topic prediction model outperforms other state-of-the-art methods.

scholarly journals Generating Property-Matched Decoy Molecules Using Deep Learning

2020 ◽  
Author(s):  
Fergus Imrie ◽  
Anthony R. Bradley ◽  
Charlotte M. Deane
Keyword(s):  
Deep Learning ◽  
Virtual Screening ◽  
Method Development ◽  
Screening Method ◽  
Screening Methods ◽  
Additional Risk ◽  
Link Type ◽  
Screening Performance ◽  
And Training ◽  
Virtual Screening Performance

An essential step in the development of virtual screening methods is the use of established sets of actives and decoys for benchmarking and training. However, the decoy molecules in commonly used sets are biased meaning that methods often exploit these biases to separate actives and decoys, rather than learning how to perform molecular recognition. This fundamental issue prevents generalisation and hinders virtual screening method development. We have developed a deep learning method (DeepCoy) that generates decoys to a user’s preferred specification in order to remove such biases or construct sets with a defined bias. We validated DeepCoy using two established benchmarks, DUD-E and DEKOIS 2.0. For all DUD-E targets and 80 of the 81 DEKOIS 2.0 targets, our generated decoy molecules more closely matched the active molecules’ physicochemical properties while introducing no discernible additional risk of false negatives. The DeepCoy decoys improved the Deviation from Optimal Embedding (DOE) score by an average of 81% and 66%, respectively, decreasing from 0.163 to 0.032 for DUD-E and from 0.109 to 0.038 for DEKOIS 2.0. Further, the generated decoys are harder to distinguish than the original decoy molecules via docking with Autodock Vina, with virtual screening performance falling from an AUC ROC of 0.71 to 0.63. The code is available at https://github.com/oxpig/DeepCoy. Generated molecules can be downloaded from http://opig.stats.ox.ac.uk/resources.

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