A simulation study of loss to follow up: The impact on time to event and prevention.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14097-e14097
Author(s):  
Donna Elise Levy ◽  
Bingyan Wu ◽  
Daniel Quinn ◽  
Sophie Jentzsch ◽  
Christine Lusk ◽  
...  
Keyword(s):  
Treatment Options ◽  
Patient Treatment ◽  
Future Research ◽  
Time To Event ◽  
Loss To Follow Up ◽  
Study Results ◽  
Patient Attrition ◽  
The Impact ◽  
Future Patient

e14097 Background: Patient attrition during study follow up is a concern in all clinical trials, although its impact on study results has rarely been assessed. In oncology, in particular, where studies are lengthier and may be extended into longitudinal studies, there is an increased likelihood of loss to follow up (LTFU) (Gill et al., 2018). This creates a heightened need to understand how it affects the trial’s validity. The loss of data from patients who have been LTFU can reduce a study’s precision and power. This imprecision not only impacts the results of the current study but can also affect future research as well as future patient treatment options. Studies have found that participant characteristics differ in individuals LTFU as compared to those who remain in follow up (Childs et al., 2011; Geng et al., 2008; Hochheimer et al., 2016). This further emphasizes how attrition can skew study results and their interpretation and supports the need to minimize patient attrition during follow up in order to reduce bias and generate robust study estimates. Methods: This study assessed the impact of LTFU rates on the study estimates through simulations using SAS software. While all endpoints can be affected by LTFU, this study assessed time-to-event endpoints. Exponential distribution was assumed with varying rates of LTFU. In addition, the work covered suggestions for reducing LTFU. Results: Even for low rates of LTFU, biases are introduced in time-to event endpoints. Conclusions: Researchers should make every effort to minimize the extent of LTFU in the design and of and conduct of their trials.

scholarly journals Advances of 2nd Life Applications for Lithium Ion Batteries from Electric Vehicles Based on Energy Demand

2021 ◽  
Vol 13 (10) ◽  
pp. 5726
Author(s):  
Aleksandra Wewer ◽  
Pinar Bilge ◽  
Franz Dietrich
Keyword(s):  
Life Cycle ◽  
Lithium Ion Batteries ◽  
Electric Vehicles ◽  
Energy Demand ◽  
Lithium Ion ◽  
Life Cycles ◽  
Future Research ◽  
Research Areas ◽  
Study Results ◽  
The Impact

Electromobility is a new approach to the reduction of CO2 emissions and the deceleration of global warming. Its environmental impacts are often compared to traditional mobility solutions based on gasoline or diesel engines. The comparison pertains mostly to the single life cycle of a battery. The impact of multiple life cycles remains an important, and yet unanswered, question. The aim of this paper is to demonstrate advances of 2nd life applications for lithium ion batteries from electric vehicles based on their energy demand. Therefore, it highlights the limitations of a conventional life cycle analysis (LCA) and presents a supplementary method of analysis by providing the design and results of a meta study on the environmental impact of lithium ion batteries. The study focuses on energy demand, and investigates its total impact for different cases considering 2nd life applications such as (C1) material recycling, (C2) repurposing and (C3) reuse. Required reprocessing methods such as remanufacturing of batteries lie at the basis of these 2nd life applications. Batteries are used in their 2nd lives for stationary energy storage (C2, repurpose) and electric vehicles (C3, reuse). The study results confirm that both of these 2nd life applications require less energy than the recycling of batteries at the end of their first life and the production of new batteries. The paper concludes by identifying future research areas in order to generate precise forecasts for 2nd life applications and their industrial dissemination.

Rural Barriers to Surgical Care for Children With Sleep-Disordered Breathing

2021 ◽  
pp. 019459982199338
Author(s):  
Flora Yan ◽  
Dylan A. Levy ◽  
Chun-Che Wen ◽  
Cathy L. Melvin ◽  
Marvella E. Ford ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Sleep Disordered Breathing ◽  
Healthy Children ◽  
Loss To Follow Up ◽  
Cox Regression Analysis ◽  
Obstructive Sleep ◽  
The Impact ◽  
Disordered Breathing

Objective To assess the impact of rural-urban residence on children with obstructive sleep-disordered breathing (SDB) who were candidates for tonsillectomy with or without adenoidectomy (TA). Study Design Retrospective cohort study. Setting Tertiary children’s hospital. Methods A cohort of otherwise healthy children aged 2 to 18 years with a diagnosis of obstructive SDB between April 2016 and December 2018 who were recommended TA were included. Rural-urban designation was defined by ZIP code approximation of rural-urban commuting area codes. The main outcome was association of rurality with time to TA and loss to follow-up using Cox and logistic regression analyses. Results In total, 213 patients were included (mean age 6 ± 2.9 years, 117 [55%] male, 69 [32%] rural dwelling). Rural-dwelling children were more often insured by Medicaid than private insurance ( P < .001) and had a median driving distance of 74.8 vs 16.8 miles ( P < .001) compared to urban-dwelling patients. The majority (94.9%) eventually underwent recommended TA once evaluated by an otolaryngologist. Multivariable logistic regression analysis did not reveal any significant predictors for loss to follow-up in receiving TA. Cox regression analysis that adjusted for age, sex, insurance, and race showed that rural-dwelling patients had a 30% reduction in receipt of TA over time as compared to urban-dwelling patients (hazard ratio, 0.7; 95% CI, 0.50-0.99). Conclusion Rural-dwelling patients experienced longer wait times and driving distance to TA. This study suggests that rurality should be considered a potential barrier to surgical intervention and highlights the need to further investigate geographic access as an important determinant of care in pediatric SDB.

Library Impact Research Report: Understanding and Communicating Research Impact: The Needs of STEM and Health Sciences Faculty and Postdoctoral Researchers

2021 ◽  
Author(s):  
Negeen Aghassibake ◽  
Lynly Beard ◽  
Jackie Belanger ◽  
Diana Louden ◽  
Robin Chin Roemer ◽  
...  
Keyword(s):  
Research Impact ◽  
Health Sciences ◽  
Future Research ◽  
Research Report ◽  
Library Impact ◽  
The University ◽  
Postdoctoral Researchers ◽  
Impact Framework ◽  
The Impact

As part of ARL’s Research Library Impact Framework initiative, the University of Washington (UW) Libraries explored UW faculty and postdoctoral researcher needs for understanding and communicating the impact of their work, with a focus on researchers in science, technology, engineering, and math (STEM) and health sciences fields. The project was designed to understand the challenges researchers face in this area, identify how participants in these fields define and measure impact, and explore their priorities for research-impact support. The project team conducted a survey and follow-up interviews to investigate these questions. This research report presents the project team’s methodology, findings, and recommendations for future research.

The Parent–Child Relationship and Sport Parents’ Experiences of Burnout and Engagement

2018 ◽  
Vol 12 (2) ◽  
pp. 218-233
Author(s):  
J.D. DeFreese ◽  
Travis E. Dorsch ◽  
Travis A. Flitton
Keyword(s):  
Youth Sport ◽  
Self Report ◽  
Future Research ◽  
Parent Child Relationship ◽  
Psychosocial Experiences ◽  
Child Relationship ◽  
Study Results ◽  
The Impact ◽  
Parents Experiences ◽  
Parent Child

Burnout and engagement are important psychological outcomes in sport with potential to impact athletes as well as sport parents. The present study examined associations among markers of the sport-based parent child-relationship (warmth and conflict) and parent burnout and engagement in organized youth sport. Youth sport parents (N = 214) aged 26–66 years (M = 43.2,SD = 6.2) completed valid and reliable self-report assessments of study variables. Study results showcased warmth, but not conflict, in the parent–child relationship as a significant negative contributor to global burnout and a significant positive contributor to global engagement in sport parents. Results offer preliminary insight into the impact of parent–child warmth in sport on parents’ experiences of burnout and engagement. Findings have implications for future research and practice designed to promote positive psychosocial experiences for sport families.

scholarly journals Impact of a child -friendly clinic on retention of HIV-infected children in care: an intervention study

1970 ◽  
Vol 44 (4) ◽  
pp. 175-179
Author(s):  
OR Ugwu
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Retention Rate ◽  
Retention In Care ◽  
Hiv Care ◽  
Satisfaction Survey ◽  
Loss To Follow Up ◽  
Child Friendly ◽  
Children In Care ◽  
The Impact

Background: Certain researchers have reported that a child-friendly clinic may improve patient/caregiver satisfaction at clinic attendance. This could serve as an innovation for reducing loss-to-follow up and increasing retention in care.Aim: To assess the impact of making the clinic more child-friendly on clinic experience, retention in care and loss-to-follow up of HIV -infected children.Method: The study was carried out in three phases. Phase one was a satisfaction survey to find out the patient/caregivers’ satisfaction of the clinic environment and services provided using a selfadministered questionnaire. Phase two was the creation of the childfriendly environment and phase three was a post-provision of child-friendly clinic satisfaction survey. The loss-to-follow up rate (failure to return to clinic ≥3months after the last scheduled clinic appointment in a child not known to be dead or transferred out of the facility) and retention rate (remaining alive and receiving highly active antiretroviral therapy) were also determined before and after setting up the childfriendly clinic.Results: There were 146 respondents before the study and 206 respondents after the intervention. The retention rate increased from 62.5% to 82% (p=0.02), while the loss-to-follow up rate dropped from 27.7% to 7.0% (p=0.00).Conclusion: Making the clinic area child-friendly can impact greatly on HIV care by improving patient satisfaction and retention of HIVinfected children in care and reducing loss-to-follow up.Key words: HIV, child-friendly environment, retention in care, loss to follow-up.

scholarly journals Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Regression Models ◽  
Community Dwelling ◽  
The Body ◽  
Study Results ◽  
The Impact ◽  
Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

scholarly journals The Evolution of Data Sharing Practices in the Psychological Literature

2021 ◽  
Author(s):  
Judith Neve ◽  
Guillaume A Rousselet
Keyword(s):  
Data Sharing ◽  
Linear Models ◽  
Generalized Additive Models ◽  
Additive Models ◽  
Future Research ◽  
Science Data ◽  
Editorial Policies ◽  
Psychological Science ◽  
The Impact

Sharing data has many benefits. However, data sharing rates remain low, for the most part well below 50%. A variety of interventions encouraging data sharing have been proposed. We focus here on editorial policies. Kidwell et al. (2016) assessed the impact of the introduction of badges in Psychological Science; Hardwicke et al. (2018) assessed the impact of Cognition’s mandatory data sharing policy. Both studies found policies to improve data sharing practices, but only assessed the impact of the policy for up to 25 months after its implementation. We examined the effect of these policies over a longer term by reusing their data and collecting a follow-up sample including articles published up until December 31st, 2019. We fit generalized additive models as these allow for a flexible assessment of the effect of time, in particular to identify non-linear changes in the trend. These models were compared to generalized linear models to examine whether the non-linearity is needed. Descriptive results and the outputs from generalized additive and linear models were coherent with previous findings: following the policies in Cognition and Psychological Science, data sharing statement rates increased immediately and continued to increase beyond the timeframes examined previously, until reaching close to 100%. In Clinical Psychological Science, data sharing statement rates started to increase only two years following the implementation of badges. Reusability rates jumped from close to 0% to around 50% but did not show changes within the pre-policy nor the post-policy timeframes. Journals that did not implement a policy showed no change in data sharing rates or reusability over time. There was variability across journals in the levels of increase, so we suggest future research should examine a larger number of policies to draw conclusions about their efficacy. We also encourage future research to investigate the barriers to data sharing specific to psychology subfields to identify the best interventions to tackle them.

scholarly journals Budgetary restrictions and ethical behaviours in a hospital context – evidence from general surgeons

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cristina Piedade Silva ◽  
Rita Martins de Sousa
Keyword(s):  
Medical Profession ◽  
Participant Observation ◽  
Methodological Approach ◽  
Treatment Options ◽  
Patient Treatment ◽  
Ethical Behaviour ◽  
Content Type ◽  
Ethical Implications ◽  
General Surgeons ◽  
The Impact

Purpose The purpose of this paper is to study how budgetary constraints can have ethical implications on patient treatment options. Design/methodology/approach By applying a qualitative methodological approach (interviews) and participant observation, this paper studies the behaviour of surgeons in scenarios of financial restriction. Findings The empirical findings show that despite the conflict between the economy and the leges artis, surgeons maintain the ethical and deontological principles of their profession with fair rules of orientation. Practical implications The importance of this study can be realised by its continuity. One of the authors is already implicated on a wider research to investigate the influence of the economic scarcity of resources on general surgeons’ ethical behaviours. Social implications This paper is a contribution to understanding the rules that restrain the activities of surgeons. Politicians sometimes do not have a full understanding of the pressures that the medical profession faces in their day-to-day activities. Currently, with the addition of problems relate to COVID-19, politicians and populations seem to better understand the importance of the Serviço Nacional de Saúde (SNS), This paper hopes that this understanding will be not only a conjectural moment. Originality/value In conjunction with the economic recession that began in the first decade of this century, health institutions have long faced budgetary constraints that condition their material and human resources and correspondingly shape the scope of health professional activities. Until now, it has not been studied the impact of economic crises on the ethical behaviour of Portuguese surgeons. Therefore, this research is a first step and a useful contribution to understanding the rules that can restrain (or not) the ethical conduct of these health professionals.

Improvement of Acupuncture Therapy on Relapse of P atients with G outy A rthritis: A Pairwise and Bayesian Network Meta analysis

2021 ◽  
Author(s):  
Zhihui Li ◽  
Min Chen ◽  
Chunzhi Tang
Keyword(s):  
Acupuncture Therapy ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Gouty Arthritis ◽  
Serum Urate ◽  
Cochrane Library ◽  
Future Research ◽  
Fire Needle ◽  
The Impact

Objective: The aim of this study is to investigate the impact of acupuncturetherapy on relapse of patients with gouty arthritis (GA). Methods: “gout ORgouty arthritis” AND “a cupuncture therapy OR acupuncture OR moxibustionOR electroacupuncture OR fire needle OR acupotomology OR blood lettingpuncture OR plum blossom needle” were used as search strategies forsearching related studies. Twenty two studies involving 2394 patient s wereenrolled in this research through the analysis of databases of CNKI, Wanfang,VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise metaanalysis and network meta analysis (NMA) indicated that patients withacupuncture therapy had a significantly lower relapse rate (RR) compared withthose without acupuncture therapy (OR = 0.21, 95% CI: 0.16 0.26, P <0.00001); the follow up time (TFU) and serum urate concentration (SUA)before treatment had no significant effect on the reductio n of RR caused byacupuncture therapy (P > 0.05); and patients treated with acupuncture plusWestern medicine (WM) had the lowest RR (surface under the cumulativeranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinesemedicine (TCM, SUC RA = 73.5%), acupuncture only (SUCRA = 72.8%),fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM(SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our findingmay facilitate the application of acupuncture therapy in patients with GA. Ourresearch also offered some information for the future research.

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