Target trial framework for determining the effect of changes in training load on injury risk using observational data: a methodological commentary.

In recent years, a large focus has been placed on managing training load for injury prevention. To minimise injuries, training recommendations should be based on research that examines causal relationships between load and injury risk. While observational studies can be used to estimate causal effects, conventional methods to study the relationship between load and injury are prone to bias.

Principles of musculoskeletal sport injuries for epidemiologists: a review.

Background: Musculoskeletal injuries are a common occurrence in sport. The goal of sport injury epidemiology is to study these injuries at a population level to inform their prevention and treatment.

Main Body: This review provides an overview of musculoskeletal sport injuries and the musculoskeletal system from a biological and epidemiologic perspective, including injury mechanism, categorizations and types of sport injuries, healing, and subsequent injuries.

Effect modification of cancer on the association between dysphagia and mortality in early idiopathic inflammatory myopathies.

Objective: The interplay between dysphagia, cancer, and mortality in idiopathic inflammatory myopathies (IIM) has not been carefully studied. The aim of this study was to investigate possible effect modification of cancer on the association between dysphagia and mortality in early IIM.

Methods: A multi-center cohort of 230 adult IIM patients with dysphagia assessment within 6 months of disease onset was assembled.

Implementing Multiple Imputation for Missing Data in Longitudinal Studies When Models are Not Feasible: An Example Using the Random Hot Deck Approach.

Purpose: Researchers often use model-based multiple imputation to handle missing at random data to minimize bias. However, constraints within the data may sometimes result in implausible values, making model-based imputation infeasible. In these contexts, we illustrate how random hot deck imputation can allow for plausible multiple imputation in longitudinal studies.

Investigating the Effect of Return-to-Play Timing After Injury on Performance: Does the Analysis Answer the Research Objective?

Return-to-play decision making should be based on all the advantages and disadvantages of return to play for athletes, not just the risk of injury. For competitive athletes, this includes the effect of early versus delayed return to sport on performance. In this paper, we address the questions "How can I estimate the effect of injury on the individual's performance at return to play?" and "What is the effect of delaying return to sport on the individual's performance?".

Observed Injury Rates Did Not Follow Theoretically Predicted Injury Risk Patterns in Professional Human Circus Artists.

Objective: Identifying which types of athletes have increased injury risk (ie, predictive risk factors) should help develop cost-effective selective injury prevention strategies. Our objective was to compare a theoretical injury risk classification system developed by coaches and rehabilitation therapists, with observed injury rates in human circus acts across dimensions of physical stressors, acrobatic complexity, qualifications, and residual risks.

Design: Descriptive epidemiological study.

Causal effects, workload and injury risk: The importance of specifying the research question.

Objectives: To illustrate why the research question determines whether and how sport medicine investigators should adjust for workload when interested in interventions or causal risk factors for injury.

Design: Theoretical conceptualization.

Methods: We use current concepts of causal inference to demonstrate the advantages and disadvantages of adjusting for workload through different analytic approaches when evaluating causal effects on injury risk.

Patient-specific finite element analysis of heart failure and the impact of surgical intervention in pulmonary hypertension secondary to mitral valve disease.

Pulmonary hypertension (PH), a chronic and complex medical condition affecting 1% of the global population, requires clinical evaluation of right ventricular maladaptation patterns under various conditions. A particular challenge for clinicians is a proper quantitative assessment of the right ventricle (RV) owing to its intimate coupling to the left ventricle (LV). We, thus, proposed a patient-specific computational approach to simulate PH caused by left heart disease and its main adverse functional and structural effects on the whole heart.

Balancing Inferential Integrity and Disclosure Risk via Model Targeted Masking and Multiple Imputation.

There is a growing expectation that data collected by government-funded studies should be openly available to ensure research reproducibility, and so is the concern on data-privacy. A strategy to protect individuals' identity is to release multiply imputed (MI) synthetic datasets with masked sensitivity values (Rubin, 1993). However, information loss or incorrectly specified imputation models can weaken or invalidate the inferences obtained from the MI-datasets.

Association between gastroprotective agents and risk of incident interstitial lung disease in systemic sclerosis.

Objectives: Although interstitial lung disease (ILD) occurs in over half of systemic sclerosis (SSc) patients and represents a leading cause of mortality, there are currently no preventative strategies. We evaluated if gastroprotective agents were associated with a lower incident risk of SSc-ILD.

Methods: An SSc cohort without clinically apparent ILD at baseline was constructed from the Canadian Scleroderma Research Group registry.

The semiparametric accelerated trend-renewal process for recurrent event data.

Recurrent event data arise in many biomedical longitudinal studies when health-related events can occur repeatedly for each subject during the follow-up time. In this article, we examine the gap times between recurrent events. We propose a new semiparametric accelerated gap time model based on the trend-renewal process which contains trend and renewal components that allow for the intensity function to vary between successive events.

The Influence of Time of Season on Injury Rates and the Epidemiology of Canadian Football Injuries.

Objective: To describe injury rates and injury patterns in the Canadian Football League (CFL) according to time during the season, player position, injury type, and injury location.

Design: Prospective, cohort study.

Setting And Participants: Eight seasons from CFL injury surveillance database.

Association between immunosuppressive therapy and course of mild interstitial lung disease in systemic sclerosis.

Objective: Interstitial lung disease (ILD) is a leading cause of mortality in SSc. Little is known about the benefits of immunosuppressive drugs in mild ILD. Our aim was to determine whether use of CYC or MMF was associated with an improved ILD course in patients with normal or mildly impaired lung function.

Challenges in interpreting results from 'multiple regression' when there is interaction between covariates.

Properly interpreting research results is the foundation of evidence-based medicine. Most observational studies use multiple regression and report adjusted effects. In randomised trials, adjusted effects are often provided when there are chance baseline imbalances.

A randomized controlled trial assessing the efficacy of a self-administered psycho-educational intervention for patients with cancer.

Objective: Bibliotherapy refers to psychological self-help interventions that utilize treatment books to improve psychological well-being. Research supports bibliotherapy as an efficacious intervention for a variety of mental health problems. Yet, few studies have investigated bibliotherapy in psychosocial oncology.

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used.

Synthesizing Risk from Summary Evidence Across Multiple Risk Factors.

Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided.

Estimating Causal Effects of Treatment in a Randomized Trial When Some Participants Only Partially Adhere.

The intention-to-treat analysis evaluates the causal effect of treatment assignment in a randomized controlled trial; however, participants do not always adhere to assigned treatment and the intention-to-treat effect may differ from the effect of treatment receipt. Although more recent adherence-based methods assess a well-defined causal effect of receiving treatment, adherence is assumed to be dichotomized as all or none. This approach can lack precision in the real world because adherence is a complex and heterogeneous phenomenon.

Reconciling disparate data to determine the right answer: A grounded theory of meta analysts' reasoning in meta-analysis.

While the systematic review process is intended to maximize objectivity and limit researchers' biases, examples remain of discordant recommendations from meta-analyses. Current guidelines to explore discrepancies assume the variation is produced by methodological differences and thus focus only on the study process. Because heterogeneity of interpretation also occurs when experts examine the same data, our purpose was to examine if there are reasoning differences, ie, in how information is processed and valued.

Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool.

In studies of diagnostic test accuracy, authors sometimes report results only for a range of cutoff points around data-driven "optimal" cutoffs. We assessed selective cutoff reporting in studies of the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) depression screening tool. We compared conventional meta-analysis of published results only with individual-patient-data meta-analysis of results derived from all cutoff points, using data from 13 of 16 studies published during 2004-2009 that were included in a published conventional meta-analysis.