Publications by authors named "Tomlinson G"
Objective: The study aims to assess the effect of intrauterine metformin exposure on offspring adiposity measures in childhood.
Design: Systematic review and meta-analysis.
Data Sources: Medline, Embase and Cochrane Central were searched from inception to 4 October 2024.
Objective: We sought to empirically evaluate whether the width of confidence interval (CI) of the relative risk (RR) and odds ratio (OR) can obviate the need for calculating the optimal information size (OIS) when making GRADE imprecision judgments.
Study Design And Setting: We analyzed a convenience sample of meta-analyses extracted from the Cochrane Database of Systematic Reviews. From each meta-analysis, we calculated OIS based on relative risk reductions (RRR) of 15%-50% and evaluated the ratio of upper to lower 95% CI boundaries of RR (RR CI ratio) and OR (OR CI ratio).
A Bayesian latent class approach to causal inference with longitudinal data.
Stat Methods Med Res
December 2024
Bayesian methods are becoming increasingly in demand in clinical and public health comparative effectiveness research. Limited literature has explored parametric Bayesian causal approaches to handle time-dependent treatment and time-dependent covariates. In this article, building on to the work on Bayesian g-computation, we propose a fully Bayesian causal approach, implemented using latent confounder classes which represent the patient's disease and health status.
View Article and Find Full Text PDFBackground: Metabolic dysfunction-associated steatohepatitis (MASH) has become the leading cause of chronic liver disease, but there has been no approved pharmacotherapy to date.
Methods: We used a network analysis approach to delineate protein-protein interactions that contribute to the transition from steatosis to MASH, in order to identify and target this transition as a potential pharmacotherapeutic strategy. Acyl-CoA thioesterase 1 (ACOT1) was identified as a critical node in the protein-protein interaction (PPI) network of the transition from steatosis to MASH in patient samples.
Objectives: Intubation is a common procedure in acute hypoxemic respiratory failure (AHRF), with minimal evidence to guide decision-making. We conducted a survey of when to intubate patients with AHRF to measure the influence of clinical variables on intubation decision-making and quantify variability.
Design: Factorial vignette-based survey asking "Would you recommend intubation?" Respondents selected an ordinal recommendation from a 5-point scale ranging from "Definite no" to "Definite yes" for up to ten randomly allocated vignettes.
Background: A Bayesian approach may be useful in the study of possible treatment-related rare serious adverse events, particularly when there are strongly held opinions in the absence of good quality previous data. We demonstrate the application of a Bayesian analysis by integrating expert opinions with population-based epidemiologic data to investigate the association between chiropractic care and acute lumbar disc herniation (LDH) with early surgery.
Methods: Experts' opinions were used to derive probability distributions of the incidence rate ratio (IRR) for acute LDH requiring early surgery associated with chiropractic care.
Importance: Pediatric patients with cancer experience severely bothersome symptoms during treatment. It was hypothesized that symptom screening and provision of symptom reports to the health care team would reduce symptom burden in pediatric patients with cancer.
Objective: To determine if daily symptom screening and provision of symptom reports to the health care team was associated with lower total symptom burden as measured by the Symptom Screening in Pediatrics Tool (SSPedi) compared to usual care among pediatric patients with cancer admitted to a hospital or seen in a clinic daily for at least 5 days.
Importance: Pediatric patients with cancer commonly experience severely bothersome symptoms. The effectiveness of routine symptom screening with symptom feedback and symptom management care pathways is unknown.
Objective: To determine whether thrice-weekly symptom screening with symptom feedback and management care pathways, compared with usual care, improves overall self-reported symptom scores measured by the Symptom Screening in Pediatrics Tool (SSPedi) in pediatric patients with cancer.
Wilms tumors are commonly associated with predisposition syndromes. Many of these syndromes are associated with specific phenotypic features and are discussed in the related article from the AACR Pediatric Cancer Working Group. Guidelines for surveillance in this population were published in 2017, but since then several studies have identified new genes with recurrent pathogenic variants associated with increased risk for Wilms tumor development.
View Article and Find Full Text PDFBackground: Lumbar disc herniation (LDH) with radiculopathy is associated with greater pain, disability, healthcare use, and costs compared with nonspecific low back pain. Reliable information about its incidence and risk factors were lacking.
Questions: (1) What is the incidence of lumbar disc herniation (LDH) with radiculopathy in adults? (2) What are the risk factors for LDH with radiculopathy in adults?
Methods: Systematic review.
Background: The relationship between social determinants of health (SDH) and disease outcomes in rheumatoid arthritis (RA) is not well documented.
Methods: Data were extracted from the Ontario Best Practices Research Initiative (OBRI) registry for patients between January 2008 and April 2022. Adjusted mixed models analysis was used to investigate the effect of baseline SDH on disease activity (Clinical Disease Activity Index (CDAI)) and functional disability (Health Assessment Questionnaire-Disability Index (HAQ-DI)) 12 months after enrollment.
SPiReL is a phase II clinical trial evaluating combination immunotherapy, pembrolizumab and cyclophosphamide, with maveropepimut-S, in survivin-expressing relapsed/refractory (R/R) Diffuse Large B Cell Lymphoma (DLBCL). We describe baseline tumor survivin expression and associations with clinico-pathological variables in 25 participants. The median number of survivin-expressing cells was 99%, and the intensity of survivin expression within tumors was heterogeneous by semi-quantitative immunohistochemistry assessment.
View Article and Find Full Text PDFArticle Synopsis
- - Wilms tumors are linked to various predisposition syndromes, many of which involve overgrowth and an increased risk for other cancers like hepatoblastoma.
- - In 2017, surveillance guidelines for patients at risk for Wilms tumors were established, and the AACR Pediatric Cancer Working Group recently updated these guidelines based on new research and risk data.
- - The update aims to inform healthcare professionals—including pediatric oncologists and geneticists—about revised diagnostic criteria and to standardize surveillance recommendations in North America and Australia for patients with relevant syndromes.
Purpose: To evaluate the relative diagnostic yield of clinical germline genomic tests in a diverse pediatric cancer population.
Patients And Methods: The KidsCanSeq study enrolled pediatric cancer patients across six sites in Texas. Germline analysis included both exome sequencing and a therapy-focused pediatric cancer gene panel.
Salting of roadways contaminates local waterways via snowmelt and precipitation runoff, eliciting various toxicological impacts on aquatic ecosystems. Recently, "eco-friendly" deicing alternatives have been introduced in hopes of mitigating environmental impacts of deicing agents, while maintaining human safety. These "eco-friendly" alternatives may pose their own set of environmental concerns that require further study.
View Article and Find Full Text PDFArticle Synopsis
- Neurofibromatosis type 1 (NF1) and Noonan syndrome, classified under RASopathies, disrupt the RAS-MAPK pathway and present diverse clinical features across multiple body systems.
- Children with RASopathies face a higher risk of developing both benign and malignant tumors compared to the general population, necessitating careful medical management.
- Recent clinical trials have shown that targeted therapies can benefit low-grade and benign tumors, emphasizing the need for collaborative care among pediatric oncologists, neurologists, and other healthcare professionals based on updated guidelines from the 2023 AACR Childhood Cancer Predisposition Workshop.
Article Synopsis
- Pediatric patients with gastrointestinal (GI) polyposis and cancer often have hereditary cancer risk syndromes that necessitate ongoing cancer screening.
- Recognizing at-risk individuals through family history and clinical features aids in effective cancer risk assessment and management from childhood onward.
- The 2024 updates to hereditary GI cancer screening guidelines emphasize collaboration between pediatric and adult gastroenterology to enhance management practices, focusing on conditions like familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome.
Background: Both obstructive and central sleep apnea (CSA) may contribute to nocturnal cardiac arrhythmias (NCAs). Data are scarce regarding the prevalence of clinically important nocturnal atrial and ventricular arrythmias in patients with heart failure with reduced ejection fraction (HFrEF) and OSA or CSA.
Research Question: In a cohort of patients with HFrEF, how does the prevalence of NCA compare among those with OSA, CSA, and those with no to mild sleep apnea? Is the severity of OSA or CSA associated with atrial and ventricular NCAs?
Study Design And Methods: This cross-sectional analysis is an ancillary study of the Effect of Adaptive Servo Ventilation on Survival and Hospital Admissions in Heart Failure (ADVENT-HF) trial.
Background: A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.
Objectives: To explore open-label tolerability and associations between trial outcomes and asymmetry data.
Methods: We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months.
Dexamethasone use during hematopoietic cell transplant (HCT) conditioning varies between pediatric centers. This study aimed to estimate the difference in 1-year treatment-related mortality (TRM) between patients who did or did not receive dexamethasone during HCT conditioning. Secondary objectives were to estimate the difference between dexamethasone-exposed and dexamethasone-unexposed groups in 1-year event-free survival (EFS), time to neutrophil engraftment, acute graft-versus-host disease (aGVHD), and invasive fungal disease (IFD) at day + 100.
View Article and Find Full Text PDFPurpose: African American/Black (AA/B) individuals are under-represented in genomic databases and thus less likely to receive definitive information from germline genetic testing (GGT) than non-Hispanic White (NHW) individuals. With nearly 500,000 AA/B and NHW individuals having undergone multigene panel testing (MGPT) for hereditary cancer risk at a single commercial laboratory, to our knowledge, we present the largest study to date investigating cancer GGT results in AA/B and NHW individuals.
Methods: MGPT results from a retrospective cohort of AA/B (n = 48,684) and NHW (n = 444,831) patients were evaluated.
Objective: To describe the associations between patient-to-nurse staffing ratios and rates of mortality, process of care events and vital sign documentation.
Design: Secondary analysis of data from the evaluating processes of care and outcomes of children in hospital (EPOCH) cluster-randomised trial.
Setting: 22 hospitals caring for children in Canada, Europe and New Zealand.
Purpose: Hypotension after induction of general anesthesia is common and is associated with significant adverse events. Identification of patients at high risk can inform the use of preoperative mitigation strategies. We conducted a systematic review and meta-analysis to assess the diagnostic accuracy of the inferior vena cava collapsibility index (IVC-CI) and maximal diameter (dIVC) in predicting postinduction hypotension and to identify their predictive performance across different threshold ranges.
View Article and Find Full Text PDFObjective: The Hearing Utility Measure (HUM) is a replacement hearing attribute for the Health Utilities Index, Mark 3 (HUI-3) designed to improve the responsiveness of utility estimates to changes in hearing-related quality of life. The final development step is to derive the instrument's utility scoring function.
Methods: Residents of Ontario, Canada, aged ≥18 years participated in standard gamble and visual analogue scale exercises.