Use of advanced topic modeling to generate domains for a preference-based index in osteoarthritis.

Background: Health-related quality of life (HRQL) is an important endpoint when evaluating the effectiveness of interventions in people living with hip and knee osteoarthritis (OA). The aim of this study was to generate domains for a new OA-specific preference-based index of HRQL in people living with hip or knee OA.

Methods: The proposed HRQL index was based on a formative measurement model.

Longitudinal Quality of Life and Glycemic Outcomes of Total Pancreatectomy With Islet Autotransplantation in Children With Chronic Pancreatitis Followed in a Pediatric Multidisciplinary Pancreas Clinic.

Background: Total pancreatectomy with islet autotransplantation (TPIAT) is a potentially curative treatment for patients with chronic pancreatitis (CP) refractory to medical and endoscopic therapies. Patients often receive the initial follow-up medical care at the surgery-performing center, but then may follow up closer to where they live. We sought to describe the characteristics and outcomes of pediatric patients who underwent TPIAT at a national surgical referral center and were subsequently followed at our regional subspecialty center, the Children's Hospital Colorado.

Admission and discharge profiles of people with MS accessing in-patient rehabilitation in Canada.

Background: Rehabilitation is the mainstay of management for people with disabilities of neurological origin to maximize function and reduce disability. Access to in-patient rehabilitation is usually reserved for people after crises or those who are discharged from acute care such as in stroke or trauma. Access to people with Multiple Sclerosis (MS) differs across countries and unknown for Canada.

Synthesis of multi-band reflective polarizing metasurfaces using a generative adversarial network.

Electromagnetic linear-to-circular polarization converters with wide- and multi-band capabilities can simplify antenna systems where circular polarization is required. Multi-band solutions are attractive in satellite communication systems, which commonly have the additional requirement that the sense of polarization is reversed between adjacent bands. However, the design of these structures using conventional ad hoc methods relies heavily on empirical methods.

Examining Access to Primary Care for People With Opioid Use Disorder in Ontario, Canada: A Randomized Clinical Trial.

Importance: People with opioid use disorder are less likely than others to have a primary care physician.

Objective: To determine if family physicians are less likely to accept people with opioid use disorder as new patients than people with diabetes.

Design, Setting, And Participants: This randomized clinical trial used an audit design to survey new patient intake at randomly selected family physicians in Ontario, Canada.

Towards a Postgraduate Oncology Training Model for Family Medicine: Mixed Methods Evaluation of a Breast Oncology Rotation.

Background: Family physicians have low knowledge and preparedness to manage patients with cancer. A breast oncology clinical rotation was developed for family medicine residents to address this gap in medical education.

Objectives And Methods: A breast oncology rotation for family residents was evaluated using a pre-post knowledge questionnaire and semi-structured interviews comparing rotation (RRs) versus non-rotation (NRRs) residents.

Socioeconomic and immigration status and COVID-19 testing in Toronto, Ontario: retrospective cross-sectional study.

Background: Preliminary evidence suggests that individuals living in lower income neighbourhoods are at higher risk of COVID-19 infection. The relationship between sociodemographic characteristics and COVID-19 risk warrants further study.

Methods: We explored the association between COVID-19 test positivity and patients' socio-demographic variables, using neighborhood sociodemographic data collected retrospectively from two COVID-19 Assessment Centres in Toronto, ON.

Reducing research wastage by starting off on the right foot: optimally framing the research question.

Purpose: Strongly framed research questions are clear as to the population (P), the exposures or interventions (E/I), comparison groups (C), outcomes (O), time when relevant (T), and what the investigator wants to know. A solid framework sets up the measurement model, analysis, and anticipated results. The purpose of this study was to estimate the extent to which research questions in journals that focused on patient-reported outcome measures (PROM) and quality of life (QOL) are clear.

Clinician acceptability of self-collected human papillomavirus swabs as a primary cervical cancer screening method.

Objective: To determine knowledge and acceptability of and opinions about human papillomavirus (HPV) self-screening as an alternative to Papanicolaou testing among Canadian primary care providers (PCPs: family physicians and nurse practitioners) and obstetrician-gynecologists (OB-GYNs).

Design: Descriptive, cross-sectional, anonymous, online pilot survey.

Setting: Two academic teaching hospitals in downtown Toronto, Ont.

Are the Items of the Starkstein Apathy Scale Fit for the Purpose of Measuring Apathy Post-stroke?

Given the importance of apathy for stroke, we felt it was time to scrutinize the psychometric properties of the commonly used Starkstein Apathy Scale (SAS) for this purpose. The objectives were to: (i) estimate the extent to which the SAS items fit a hierarchical continuum of the Rasch Model; and (ii) estimate the strength of the relationships between the Rasch analyzed SAS and converging constructs related to stroke outcomes. Data was from a clinical trial of a community-based intervention targeting participation.

Association between new-onset anosmia and positive SARS-CoV-2 tests among people accessing outpatient testing in Toronto, Ontario: a retrospective cross-sectional study.

Background: Reports have suggested that anosmia is strongly associated with SARS-CoV-2 infection, but patients were often asked about this symptom after their diagnosis. This study assessed associations between prospectively reported anosmia and other symptoms related to SARS-CoV-2 infection, and SARS-CoV-2 positivity in community testing centres in Toronto, Ontario.

Methods: We conducted a retrospective cross-sectional study in which data were collected from 2 COVID-19 assessment centres affiliated with 2 hospitals in Toronto, Ontario, from Apr.

Clinical learnings from a virtual primary care program monitoring mild to moderate COVID-19 patients at home.

Background: Virtual consults have replaced in-person visits for many home-isolated patients with COVID-19 disease.

Objectives: To describe the natural history, clinical management and outcomes of community-dwelling patients with COVID-19, who received support from a family medicine-led, virtual CovidCare@Home program in Toronto, Ontario, Canada.

Methods: Observational, descriptive study conducted by retrospective chart review of 98 patients enrolled during the first 5 weeks of program implementation (8 April-11 May 2020); 73 patients with laboratory-confirmed COVID-19, with symptom onset ≤ 14 days before initial consult were included for analysis.

Properties of common anxiety scales among patients with bipolar disorder.

Objectives: Almost half of the patients with a bipolar disorder (BD) have anxiety disorder(s) (AD) during their lifetime, but feasible measures for all AD are few. Furthermore, cognitive impairments can compromise reliability of existing scales, since many are needed for full coverage. Thus, we investigated how reliably patients responded to anxiety scales and any symptom overlap to propose future improvements to anxiety assessments.

Functioning Profiles of Young People with MS in Inpatient Rehabilitation: Data from the National Rehabilitation Reporting System in Canada.

Background: Recent evidence has suggested an existence of a MS prodome, indicating that symptoms of neurodegeneration were present before the first clinical event. These early signs of MS are usually not recognized as a symptom of MS and some young adults with MS are very likely to have had these symptoms in their childhood or adolescence. It is thus of interest to examine the differences in disability profiles of young people with MS.

Clinical Decision Support Systems for Opioid Prescribing for Chronic Non-Cancer Pain in Primary Care: A Scoping Review.

Background And Objectives: Clinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions.

Methods: We searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019.

Adverse Events of Antibiotics Used to Treat Acute Otitis Media in Children: A Systematic Meta-Analysis.

Objective: To characterize the incidence of adverse events (AEs) associated with antibiotics used to treat acute otitis media in children.

Study Design: We searched MEDLINE for studies conducted between January 1, 1966, and August 25, 2018. Two authors independently assessed potential studies and extracted the data.

Breastfeeding During Family Medicine Residency.

Background And Objectives: Canadian residents' breastfeeding experiences have only been reported in studies that broadly explored pregnancy and parenthood. We sought to fully explore Canadian family medicine resident mothers' breastfeeding experiences, and identify strategies to support workplace breastfeeding for future trainees.

Methods: Using an online survey, University of Toronto family medicine residents who gave birth from 2010 through 2016 were queried about their exclusive and overall breastfeeding duration, barriers, and facilitators to workplace breastfeeding, and strategies to improve the breastfeeding experience for future resident mothers.

Outcomes During Early Implementation of Mifepristone-Buccal Misoprostol Abortions up to 63 Days of Gestation in a Canadian Clinical Setting.

Objective: In January 2017, mifepristone became available in Canada. The goal of this study was to determine the effectiveness and safety of mifepristone-misoprostol abortion during its early implementation in a Canadian setting.

Methods: This retrospective chart review included the first 477 patients who had a mifepristone-misoprostol abortion from March 13 to October 31, 2017, in an urban sexual health clinic.

Risk Factors for Delayed Antimicrobial Treatment in Febrile Children with Urinary Tract Infections.

Objectives: To identify factors associated with delayed antimicrobial treatment in febrile children with urinary tract infection (UTI).

Study Design: We reviewed data from 802 children with UTI enrolled in 2 previously conducted prospective studies (Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation) and extracted data on possible predictors of delayed treatment including age, sex, history of UTI, ethnicity, race, primary caregiver's education level, insurance, and income. We used univariate and multivariable analyses to investigate the relationship between these predictors and treatment delay.

Inadequate harms reporting in randomized control trials of antibiotics for pediatric acute otitis media: a systematic review.

Introduction: Reporting of harms in randomized control trials is often inconsistent and inadequate.

Objective: To assess the quality of harms reporting in randomized control trials evaluating the efficacy of antibiotics used to treat pediatric acute otitis media and to investigate whether connections to pharmaceutical companies or the publication of the CONSORT-Harms extension influenced the quality of harms reporting.

Study Design And Setting: We considered randomized control trials that evaluated the efficacy and safety of antibiotic treatment for uncomplicated acute otitis media in children aged 0-19.

Development and Validation of a Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children.

Importance: Accurately estimating the probability of urinary tract infection (UTI) in febrile preverbal children is necessary to appropriately target testing and treatment.

Objective: To develop and test a calculator (UTICalc) that can first estimate the probability of UTI based on clinical variables and then update that probability based on laboratory results.

Design, Setting, And Participants: Review of electronic medical records of febrile children aged 2 to 23 months who were brought to the emergency department of Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.