Serial high-sensitivity cardiac troponin testing for the diagnosis of myocardial infarction: a scoping review.

Objectives: We aimed to assess the diversity and practices of existing studies on several assays and algorithms for serial measurements of high-sensitivity cardiac troponin (hs-cTn) for risk stratification and the diagnosis of myocardial infarction (MI) and 30-day outcomes in patients suspected of having non-ST-segment elevation MI (NSTEMI).

Methods: We searched multiple databases including MEDLINE, EMBASE, Science Citation Index, the Cochrane Database of Systematic Reviews and the CENTRAL databases for studies published between January 2006 and November 2021. Studies that assessed the diagnostic accuracy of serial hs-cTn testing in patients suspected of having NSTEMI in the emergency department (ED) were eligible.

Variation in Model-Based Economic Evaluations of Low-Dose Computed Tomography Screening for Lung Cancer: A Methodological Review.

Objectives: There is significant heterogeneity in the results of published model-based economic evaluations of low-dose computed tomography (LDCT) screening for lung cancer. We sought to understand and demonstrate how these models differ.

Methods: An expansion and update of a previous systematic review (N = 19).

Strategies to identify individuals with monogenic diabetes: results of an economic evaluation.

Objectives: To evaluate and compare the lifetime costs associated with strategies to identify individuals with monogenic diabetes and change their treatment to more appropriate therapy.

Design: A decision analytical model from the perspective of the National Health Service (NHS) in England and Wales was developed and analysed. The model was informed by the literature, routinely collected data and a clinical study conducted in parallel with the modelling.

Diagnostic accuracy of contemporary and high-sensitivity cardiac troponin assays used in serial testing, versus single-sample testing as a comparator, to triage patients suspected of acute non-ST-segment elevation myocardial infarction: a systematic review protocol.

Introduction: Although the new generation of cardiac troponin assays have revolutionised the diagnosis of myocardial infarction (MI), their application in triaging patients with suspected acute coronary syndrome requires further investigation. The objectives of the current systematic review are to evaluate the diagnostic accuracy of contemporary and high-sensitivity cardiac troponin assays used in serial testing, versus single-sample testing as a comparator, to identify patients with non-ST-segment-elevation MI in the emergency department.

Methods And Analysis: We will conduct systematic searches of MEDLINE, EMBASE, Science Citation Index, the Cochrane Database of Systematic Reviews and the CENTRAL database covering the period from 1 January 2006 to present, with no restrictions on language or publication status.

Immunosuppressive agents in adult kidney transplantation in the National Health Service: a model-based economic evaluation.

Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base.

Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime.

Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

Introduction: Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests.

Can clinical features be used to differentiate type 1 from type 2 diabetes? A systematic review of the literature.

Objective: Clinicians predominantly use clinical features to differentiate type 1 from type 2 diabetes yet there are no evidence-based clinical criteria to aid classification of patients. Misclassification of diabetes is widespread (7-15% of cases), resulting in patients receiving inappropriate treatment. We sought to identify which clinical criteria could be used to discriminate type 1 and type 2 diabetes.

Development of an economic evaluation of diagnostic strategies: the case of monogenic diabetes.

Objectives: To describe the development process for defining an appropriate model structure for the economic evaluation of test-treatment strategies for patients with monogenic diabetes (caused by mutations in the GCK, HNF1A or HNF4A genes).

Design: Experts were consulted to identify and define realistic test-treatment strategies and care pathways. A systematic assessment of published diabetes models was undertaken to inform the model structure.

Evolution of a cost-utility model of donepezil for Alzheimer's disease.

Objectives: The aim of this study was to describe the evolution of a cost-utility model used to inform the UK National Institute for Health and Clinical Excellence's (NICE) most recent decisions on the cost-utility of drug treatments for Alzheimer's disease (AD), and to explore the impact of structural assumptions on the cost-utility results.

Methods: Changes informed by noted limitations of the decision model used in NICE's previous decisions (in 2006) were made cumulatively to the original decision model for donepezil compared with best supportive care (for patients with mild to moderate AD). Deterministic and probabilistic analyses were undertaken for each cumulative change of the model.

Identifying clinical criteria to predict Type 1 diabetes, as defined by absolute insulin deficiency: a systematic review protocol.

Introduction: Management of a patient's diabetes is entirely dependent upon the type of diabetes they are deemed to have. Patients with Type 1 diabetes are insulin deficient so require multiple daily insulin injections, whereas patients with Type 2 diabetes still have some endogenous insulin production so insulin treatment is only required when diet and tablets do not establish good glycaemic control. Despite the importance of a correct diagnosis, classification of diabetes is based on aetiology and relies on clinical judgement.

Evaluating the impact and use of Transparent Reporting of Evaluations with Non-randomised Designs (TREND) reporting guidelines.

Introduction: Accurate and full reporting of evaluation of interventions in health research is needed for evidence synthesis and informed decision-making. Evidence suggests that biases and incomplete reporting affect the assessment of study validity and the ability to include this data in secondary research. The Transparent Reporting of Evaluations with Non-randomised Designs (TREND) reporting guideline was developed to improve the transparency and accuracy of the reporting of behavioural and public health evaluations with non-randomised designs.

The cost-effectiveness of mandatory 20 mph zones for the prevention of injuries.

Background: Traffic calming and speed limits are major public health strategies for further reducing road injuries, especially for vulnerable pedestrians such as children and the elderly. We conducted a cost-benefit analysis (CBA-favoured by transport economists) alongside a cost-utility analysis (CUA-favoured by health economists) of mandatory 20 mph zones, providing a unique opportunity to compare assumptions and results.

Methods: A CUA from the public sector perspective and a CBA from a broader societal perspective.

Interspecies extrapolation in environmental exposure standard setting: A Bayesian synthesis approach.

Currently the extrapolation of evidence from studies of non-human species to the setting of environmental exposure standards for humans includes the imposition of a variety of uncertainty factors reflecting unknown aspects of the procedure, including the relevance of evidence from one species to impacts in another. This paper develops and explores more flexible modelling of aspects of this extrapolation, using models proposed by DuMouchel [DuMouchel, W.H.

Assessment of regression-based methods to adjust for publication bias through a comprehensive simulation study.

Background: In meta-analysis, the presence of funnel plot asymmetry is attributed to publication or other small-study effects, which causes larger effects to be observed in the smaller studies. This issue potentially mean inappropriate conclusions are drawn from a meta-analysis. If meta-analysis is to be used to inform decision-making, a reliable way to adjust pooled estimates for potential funnel plot asymmetry is required.

Meta-analysis of repeated measures study designs.

Rationale, Aims And Objectives: Repeated measures studies are found in many areas of research, particularly in areas of healthcare. There is currently little information available to inform the method of meta-analysis of repeated measures studies so that the structural dependence of the data is appropriately accommodated and the findings are meaningful.

Method: Using a published meta-analysis on the impact of diet advice on weight reduction of obese or overweight individuals, we demonstrate possible approaches for repeated measures meta-analysis.

Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry.

Objectives: To present the contour-enhanced funnel plot as an aid to differentiating asymmetry due to publication bias from that due to other factors.

Study Design And Setting: An enhancement to the usual funnel plot is proposed that allows the statistical significance of study estimates to be considered. Contour lines indicating conventional milestones in levels of statistical significance (e.

Performance of the trim and fill method in the presence of publication bias and between-study heterogeneity.

The trim and fill method allows estimation of an adjusted meta-analysis estimate in the presence of publication bias. To date, the performance of the trim and fill method has had little assessment. In this paper, we provide a more comprehensive examination of different versions of the trim and fill method in a number of simulated meta-analysis scenarios, comparing results with those from usual unadjusted meta-analysis models and two simple alternatives, namely use of the estimate from: (i) the largest; or (ii) the most precise study in the meta-analysis.

A systematic review of systematic reviews and meta-analyses of animal experiments with guidelines for reporting.

To maximize the findings of animal experiments to inform likely health effects in humans, a thorough review and evaluation of the animal evidence is required. Systematic reviews and, where appropriate, meta-analyses have great potential in facilitating such an evaluation, making efficient use of the animal evidence while minimizing possible sources of bias. The extent to which systematic review and meta-analysis methods have been applied to evaluate animal experiments to inform human health is unknown.

Comparison of two methods to detect publication bias in meta-analysis.

Context: Egger's regression test is often used to help detect publication bias in meta-analyses. However, the performance of this test and the usual funnel plot have been challenged particularly when the summary estimate is the natural log of the odds ratio (lnOR).

Objective: To compare the performance of Egger's regression test with a regression test based on sample size (a modification of Macaskill's test) with lnOR as the summary estimate.