Treatment of Obsessive-Compulsive Disorder in Children and Youth: A Meta-Analysis.

Context: Treatments for obsessive-compulsive disorder (OCD) in children and adolescents.

Objective: Evaluate the comparative efficacy of behavioral and pharmacologic treatments.

Data Sources: Six databases and ClinicalTrials.

Brief Assessment Tools for Obsessive Compulsive Disorders in Children: A Systematic Review.

Context: Children and adolescents with suspected obsessive-compulsive disorder (OCD).

Objective: To estimate the comparative performance of brief diagnostic assessment tools.

Data Sources: PubMed, the Cochrane Register of Clinical Trials, the Cochrane Database of Systematic Reviews, Embase, CINAHL, PsycINFO, and ERIC, and for unpublished studies with reported results in ClinicalTrials.

The nhppp package for simulating non-homogeneous Poisson point processes in R.

We introduce the nhppp package for simulating events from one dimensional non-homogeneous Poisson point processes (NHPPPs) in R fast and with a small memory footprint. We developed it to facilitate the sampling of event times in discrete event and statistical simulations. The package's functions are based on three algorithms that provably sample from a target NHPPP: the time-transformation of a homogeneous Poisson process (of intensity one) via the inverse of the integrated intensity function; the generation of a Poisson number of order statistics from a fixed density function; and the thinning of a majorizing NHPPP via an acceptance-rejection scheme.

: a large language model that generates search queries for systematic reviews.

Objectives: Development of search queries for systematic reviews (SRs) is time-consuming. In this work, we capitalize on recent advances in large language models (LLMs) and a relatively large dataset of natural language descriptions of reviews and corresponding Boolean searches to generate Boolean search queries from SR titles and key questions.

Materials And Methods: We curated a training dataset of 10 346 SR search queries registered in PROSPERO.

A Descriptive Review and Meta-Regression Study of Demographic and Study Context Factors in US Clinical Trials of Cognitive Behavioral Interventions for Alcohol or Other Drug Use.

Cognitive-Behaviorally Based Interventions (CBIs) are evidence-based treatments for alcohol and other drug (AOD) use with potential variable effectiveness by population sub-groups. This study used evidence synthesis to examine treatment effect by demographic and study context factors in clinical trials of CBI for AOD. Studies were systematically identified, and their characteristics and outcome data were extracted and summarized.

Scientific Inference Does Not Rest on Statistical Testing.

The Strategic Timing of AntiRetroviral Treatment (START) trial found that in patients with HIV and CD4 cell counts above 500 cells/mm who had not previously received treatment, immediate initiation of antiretroviral therapy reduced the risk of serious adverse outcomes compared with delaying treatment initiation only when the CD4 cell count fell below 350 cells/mm. After the trial's completion, people with HIV not receiving therapy were offered the opportunity to start it without regard to their CD4 cell count. In this issue of the START group reports data from an additional 5 years of follow-up.

Long-term effects on clinical event, mental health, and related outcomes of CPAP for obstructive sleep apnea: a systematic review.

Study Objectives: We performed a systematic review of long-term health outcomes of continuous positive airway pressure (CPAP) use in adults with obstructive sleep apnea.

Methods: We updated prior systematic reviews with searches in multiple databases through January 3, 2023. We included randomized controlled trials (RCTs) and adjusted nonrandomized comparative studies that reported prespecified long-term (mostly > 1 year) health outcomes.

Efficacy and safety of ketamine-assisted electroconvulsive therapy in major depressive episode: a systematic review and network meta-analysis.

Objective: To meta-analyze clinical efficacy and safety of ketamine compared with other anesthetic agents in the course of electroconvulsive therapy (ECT) in major depressive episode (MDE).

Methods: PubMed/MEDLINE, Cochrane Library, Embase, GoogleScholar, and US and European trial registries were searched from inception through May 23, 2023, with no language limits. We included RCTs with (1) a diagnosis of MDE; (2) ECT intervention with ketamine and/or other anesthetic agents; and (3) measures included: depressive symptoms, cognitive performance, remission or response rates, and serious adverse events.

Approaches to developing de novo cancer population models to examine questions about cancer and race in bladder, gastric, and endometrial cancer and multiple myeloma: the Cancer Intervention and Surveillance Modeling Network incubator program.

Background: We are developing 10 de novo population-level mathematical models in 4 malignancies (multiple myeloma and bladder, gastric, and uterine cancers). Each of these sites has documented disparities in outcome that are believed to be downstream effects of systemic racism.

Methods: Ten models are being independently developed as part of the Cancer Intervention and Surveillance Modeling Network incubator program.

Evidence Synthesis for Complex Interventions Using Meta-Regression Models.

A goal of evidence synthesis for trials of complex interventions is to inform the design or implementation of novel versions of complex interventions by predicting expected outcomes with each intervention version. Conventional aggregate data meta-analyses of studies comparing complex interventions have limited ability to provide such information. We argue that evidence synthesis for trials of complex interventions should forgo aspirations of estimating causal effects and instead model the response surface of study results to 1) summarize the available evidence and 2) predict the average outcomes of future studies or in new settings.

Multi-state network meta-analysis of progression and survival data.

Multiple randomized controlled trials, each comparing a subset of competing interventions, can be synthesized by means of a network meta-analysis to estimate relative treatment effects between all interventions in the evidence base. Here we focus on estimating relative treatment effects for time-to-event outcomes. Cancer treatment effectiveness is frequently quantified by analyzing overall survival (OS) and progression-free survival (PFS).

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.

Background: There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision-makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations.

Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors.

Background: Disparities in the health and economic burden of gonorrhoea have not been systematically quantified. We estimated population-level health losses and costs associated with gonococcal infection and sequelae in the United States

Methods: We used probability-tree models to capture gonorrhoea sequelae and to estimate attributable disease burden in terms of the discounted lifetime costs and quality-adjusted life-years (QALYs) lost due to incident infections acquired during 2015 from the healthcare system perspective. Numbers of infections in 2015 were obtained from a published gonorrhoea transmission model.

Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials.

Background: The role of vitamin D in people who are at risk for type 2 diabetes remains unclear.

Purpose: To evaluate whether administration of vitamin D decreases risk for diabetes among people with prediabetes.

Data Sources: PubMed, Embase, and ClinicalTrials.

Assessing the Utility of Test-Based Prediction Models: Heart Failure as an Example.

Chirinos et al. demonstrated that endotrophin levels are strongly associated with all-cause mortality and a composite outcome in patients with heart failure with preserved ejection fraction (HFpEF). The authors established the association in a subset of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) and validated it in external data sets.

Comparison of Low-Value Care Among Commercial and Medicaid Enrollees.

Background: Low-value healthcare is costly and inefficient and may adversely affect patient outcomes. Despite increases in low-value service use, little is known about how the receipt of low-value care differs across payers.

Objective: To evaluate differences in the use of low-value care between patients with commercial versus Medicaid coverage.

In a pilot study, automated real-time systematic review updates were feasible, accurate, and work-saving.

Objectives: The aim of this study is to describe and pilot a novel method for continuously identifying newly published trials relevant to a systematic review, enabled by combining artificial intelligence (AI) with human expertise.

Study Design And Setting: We used RobotReviewer LIVE to keep a review of COVID-19 vaccination trials updated from February to August 2021. We compared the papers identified by the system with those found by the conventional manual process by the review team.

Intensive Care Based Interventions to Reduce Family Member Stress Disorders: A Systematic Review of the Literature.

Background: Increasing awareness of the emotional impact of an Intensive Care Unit (ICU) hospitalization on patients and their families has led to a rise in studies seeking to mitigate Post Intensive Care Syndrome (PICS) for both groups. In efforts to decrease symptoms of anxiety and depression, ICUs have implemented a variety of programs to reduce family distress.

Methods: We conducted a systematic review of experimental studies which aimed to reduce stress related disorders in family members after the experience of having a patient admitted to the ICU.

A novel tool that allows interactive screening of PubMed citations showed promise for the semi-automation of identification of Biomedical Literature.

Background And Objectives: Systematic reviews form the basis of evidence-based medicine, but are expensive and time-consuming to produce. To address this burden, we have developed a literature identification system (Pythia) that combines the query formulation and citation screening steps.

Methods: Pythia incorporates a set of natural-language questions with machine-learning algorithms to rank all PubMed citations based on relevance, returning the 100 top-ranked citations for human screening.

Assessments of the Value of New Interventions Should Include Health Equity Impact.

A formal evaluation of the health equity impact of a new intervention is hardly ever performed as part of a health technology assessment to understand its value. This should change, in our view. An evidence-based quantitative assessment of the health equity impact can help decision makers develop coverage policies, programme designs, and quality initiatives focused on optimizing both total health and health equity given the treatment options available.

Patient-centred outcomes of imaging tests: recommendations for patients, clinicians and researchers.

Background: Imaging tests are one of the most frequently used diagnostic modalities in healthcare, but the benefits of their direct impacts on clinical decision-making have been countered by concerns that they can be overused. Assessing the relative value of imaging tests has largely focused on measures of test accuracy, which overlooks more comprehensive benefits and risks of imaging tests, particularly their impact on patient-centred outcomes (PCOs). We present the findings of the Patient Reported Outcomes of Diagnostics (PROD) research study in response to a methodological gap in the area of diagnostic test comparative effectiveness research.