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Peer-reviewed publication

Traditional and Rasch Psychometric Analyses of the Quality of Life in Adult Cancer Survivors (QLACS) Questionnaire in Shorter-Term Cancer Survivors 15 Months Post-Diagnosis

YHEC authors: Adam Smith
Publication date: October 2014
Journal: Journal of Psychomatic Research

Abstract

OBJECTIVE: The aim of this paper is to provide new insights into the psychometrics of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire, originally developed for longer-term survivors 5 + years post-diagnosis. Specifically, to examine the classic psychometric properties of QLACS in a sample of shorter-term survivors, and to undertake Rasch analysis to explore the extent to which the Generic and Cancer-Specific summary scales (and separately-analysed Benefits of cancer domain) are unidimensional, with linear measurement properties and no differential item functioning (DIF).

METHODS: Patients with potentially curable breast, colorectal or prostate cancer completed QLACS 15 months post-diagnosis (N = 407). Score distributions, floor and ceiling effects, internal reliability, and feasibility (completion time and missing data) were examined. Rasch analysis included examination of item fit, DIF and unidimensionality.

RESULTS: The QLACS domains and summary scales had very similar score distributions and classic psychometric properties (no ceiling effects, majority no floor effects, acceptable reliability) to those found in development work with longer-term survivors. Median completion time was 10 min and total missing data 2.3%. The Generic summary scale contained several misfitting items and exhibited multidimensionality. The Cancer-Specific summary scale and Benefits domain showed fit to the Rasch model and demonstrated unidimensionality and no DIF, with just one or no item modifications respectively.

CONCLUSION: QLACS demonstrates similarly good classic psychometric properties among shorter-term as among longer-term survivors, and has good feasibility. The Cancer-Specific summary scale and Benefits domain showed an impressive degree of fit to the Rasch model, although the validity of computing the Generic summary score was not supported.

Peer-reviewed publication

A Methodological Review of Recent Meta-Analyses Has Found Significant Heterogeneity in Age Between Randomized Groups

Publication date: September 2014
Journal: Journal of Clinical Epidemiology

Abstract

BACKGROUND: There is evidence to suggest that component randomized controlled trials (RCTs) within systematic reviews may be biased. It is important that these reviews are identified to prevent erroneous conclusions influencing health care policies and decisions.

PURPOSE: To assess the likelihood of bias in trials in 12 meta-analyses.

DESIGN: A review of 12 systematic reviews.

DATA SOURCES: Twelve recently published systematic reviews with 503 component randomized trials, published in the British Medical Journal, The Lancet, Journal of the American Medical Association, and The Annals of Internal Medicine before May 2012.

STUDY SELECTION AND DATA EXTRACTION: Systematic reviews were eligible for inclusion if they included only RCTs. We obtained the full text for the component RCTs of the 12 systematic reviews (in English only). We extracted summary data on age, number of participants in each treatment group, and the method of allocation concealment for each RCT.

DATA SYNTHESIS: Five of the 12 meta-analyses exhibited heterogeneity in age differences (I2 > 0.30), when there should have been none. In two meta-analyses, the age of the intervention group was significantly greater than that of the control group. Inadequate allocation concealment was a statistically significant predictor of heterogeneity in one trial as observed by a metaregression.

CONCLUSIONS: Most of the sample of recent meta-analyses showed that there were signs of imbalance and/or heterogeneity in ages between treatment groups, when there should have been none. Systematic reviewers might consider using the techniques described here to assess the validity of their findings.

Peer-reviewed publication

Applicability and Feasibility of Systematic Review for Performing Evidence-Based Risk Assessment in Food and Feed Safety

YHEC authors: Julie Glanville
Publication date: September 2014
Journal: Critical Reviews in Food Science and Nutrition

Abstract

Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare, and the environment. Systematic review and meta-analysis are established methods for answering questions in health care, and can be implemented to minimize biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritizing questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic review. Such questions can be structured by their "key elements" [e.g., for intervention questions, the population(s), intervention(s), comparator(s), and outcome(s)]. Prioritization of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual parameters in the risk model. This approach to planning and prioritizing systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment.

Peer-reviewed publication

The Association Between Proximity to Animal-Feeding Operations and Community Health: a Protocol for Updating a Systematic Review

YHEC authors: Julie Glanville, Hannah Wood
Publication date: September 2014
Journal: Systematic Reviews

Abstract

BACKGROUND: Livestock and poultry operations that feed large numbers of animals are common. Facility capacity varies, but it is not uncommon for facilities to house 1,000 swine with multiple barns at a single site, feedlots to house 50,000 cattle, and poultry houses to house 250,000 hens. There is primary research that suggests livestock facilities that confine animals indoors for feeding can represent a health hazard for surrounding communities. In this protocol, we describe a review about the association between proximity to animal-feeding operations (AFOs) and the health of individuals in nearby communities. A systematic review of the topic was published by some members of our group in 2010. The purpose of this review is to update that review.

METHODS/DESIGN
The populations of interest are people living in communities near livestock production facilities. Outcomes of interest are any health outcome measured in humans such as respiratory disease, gastrointestinal disease, and mental health. Measures of antibiotic resistance in people from the communities compared to measures of resistance found in animals and the environment on animal-feeding operations will also be summarized. The exposure of interest will be exposure to livestock production using a variety of metrics such as distance from facilities, endotoxin levels, and measures of odor. Electronic searches will be conducted using MEDLINE and MEDLINE In-Process (via OvidSP), CAB Abstracts (via Web of Knowledge), and Science Citation Index (via Web of Knowledge). No language or date restriction will be applied. We will access the risk of bias using a pilot version of a tool developed by the Methods Groups of the Cochrane Collaboration for non-randomized interventions. We propose to conduct a meta-analysis for each health metric (e.g., combining all respiratory disease outcomes, combining all gastrointestinal outcomes). A planned subgroup analysis will be based on the domains of the risk of bias.

DISCUSSION: This systematic review will provide synthesis of current evidence reporting the association between living near an animal-feeding operation and human health.

Report

Economic Analysis of Oral Health Improvement Programmes and Interventions

YHEC authors: Lindsay Claxton, Matthew Taylor, Michelle Jenks, Alexandra Filby
Publication date: August 2014

Abstract

No abstract available.

Peer-reviewed publication

Patient-Reported Outcomes, Measurement, Implementation and Interpretation

YHEC authors: Adam Smith
Publication date: August 2014
Journal: Quality of Life Research

Abstract

No abstract available

Peer-reviewed publication

Reporting Methodological Search Filter Performance Comparisons: A Literature Review

YHEC authors: Julie Glanville, Rachael McCool
Publication date: August 2014
Journal: Heath Information and Libraries Journal

Abstract

BACKGROUND: Methodological search filters are tools for retrieving database records reporting studies which use a specific research method. Choosing a filter is likely to be based on filter performance data. This review examines which measures are reported, and the way that filter performance is presented, in filter comparisons.

METHODS: Studies were identified from the current content and pending update (2010) of a filter website. Eligible studies compared two or more methodological search filters designed to identify randomised controlled trials, diagnostic test accuracy studies, systematic reviews or economic evaluations.

RESULTS: Eighteen studies met the inclusion criteria. The number of filters compared in a single study ranged from 2 to 38. The most commonly reported measures were sensitivity/recall and precision. All studies displayed results in tables and gave results as percentages or proportions. Two studies supplemented results tables with graphical displays of data: a bar graph of the proportion of retrieved and missed gold standard references per filter; a forest plot of the overall sensitivity and specificity of each filter.

CONCLUSIONS: Sensitivity/recall and precision are the most frequently reported performance measures. This review highlights the potential for presenting results in novel and innovative ways to aid filter selection.

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