Comparative effectiveness of alternative initial doses of opioid agonist treatment for individuals with opioid use disorder: a protocol for a retrospective population-based study using target trial emulation in British Columbia, Canada.

Introduction: Selecting an optimal initial dosage of opioid agonist treatment (OAT) balances effectiveness and safety, as initial doses that are too low may be insufficient, potentially prompting clients to seek unregulated drugs to alleviate withdrawal symptoms, which may increase the likelihood of treatment discontinuation. Conversely, initial doses that are too high carry a risk of overdose. As opioid tolerance levels have risen in the fentanyl era, linked population-level data capturing initial doses in the real world provide a valuable opportunity to refine existing guidance on optimal OAT dosing at treatment initiation.

Finding the right tool for the specific task: navigating RWE tools and checklists.

Real-world evidence (RWE) is increasingly used to support product approvals and label expansions, as well as clinical and payer decision-making. Various tools (e.g.

Comparative effectiveness of urine drug testing schedules alongside opioid agonist treatment: Emulation of a population-based target trial in British Columbia, Canada.

Background And Aim: Urine drug testing is often utilized alongside opioid agonist treatment to assess client progress by validating self-reported substance use, monitoring for diversion and supporting clinical decisions for take-home dosing. However, there is a paucity of evidence to support the practice of urine drug testing. We aimed to determine the association of alternative urine drug testing frequencies with opioid agonist treatment discontinuation, compared with no monitoring, among individuals receiving methadone or buprenorphine/naloxone treatment.

Sudden cardiac death in newly diagnosed non-ischaemic or ischaemic cardiomyopathy assessed with a wearable cardioverter-defibrillator: the German nationwide SCD-PROTECT study.

Background And Aims: Patients with newly diagnosed non-ischaemic cardiomyopathy (NICM) or myocardial infarction/coronary artery disease (MI/CAD) face an increased risk of sudden cardiac death (SCD) during the early phase of guideline-recommended medical therapy initiation and up-titration. Aim is to evaluate the risk in this population by assessing sudden cardiac arrest (SCA) due to ventricular tachycardia/ventricular fibrillation (VT/VF).

Methods: All patients in Germany who received a wearable cardioverter-defibrillator (WCD) between December 2021 and May 2023 were enrolled in the observational multicentre SCD-PROTECT study (NCT06883383).

Quality of diabetes mellitus healthcare and metabolic control during transition from paediatric to adult care: A systematic review and meta-analysis.

Aims: Emerging adults with chronic diseases like diabetes often experience a decline in health during the process of transition from paediatric to adult healthcare. This study assesses the impact of transition on healthcare quality of people with diabetes, focusing on glycated haemoglobin (HbA).

Methods: We conducted a systematic review and meta-analysis of the difference in HbA before and after transition following the PRISMA guidelines.

Life Expectancy Predicted by Decision-Analytic Models Evaluating Screening for Prostate, Lung, Breast, and Colorectal Cancer: A Systematic Review Focusing on Competing Mortality Risks.

BackgroundIt is still a matter of debate whether a reduction in cancer-specific mortality due to cancer screening fully translates into a reduction in all-cause mortality and thus into a gain in life expectancy. Nevertheless, decision-analytic models simulating the health consequences of screening compared with no screening predict substantial gains in life expectancy.PurposeThe aim of this review was to systematically assess methodological competing mortality risk features that affect the translation of cancer-specific mortality reductions into gains in life expectancy in decision-analytic screening models for prostate, lung, breast, and colorectal cancer.

Who Needs Real Data Anyway? Exploring the Use of Synthetic Data in Economic Evaluations of Health Interventions.

Objective: Data needed for economic evaluations in healthcare are often subject to privacy regulations and confidentiality, limiting accessibility. This poses challenges for conducting, reviewing and validating health economic evaluations. The use of 'synthetic data' may solve this problem.

MeDeMSA care study protocol: developing personalized best medical care with integrated mobile palliative and telemedicine support for individuals with multiple system atrophy.

Multiple system atrophy (MSA) represents a management challenge due to its variable clinical presentation, and lack of established multidisciplinary care protocols. In advanced stages, physical barriers often prevent access to specialized care, leaving patients and caregivers to face complications and fear alone. This 18-month, monocentric, open-label study evaluates the impact of a personalized, multidisciplinary treatment, integrating mobile palliative care, on the quality of life (QoL, measured by EQ-5D-5L indices) of MSA individuals compared to a matched historical European MSA cohort.

Cancer-Specificity of Sex Differences and Sex-Specific Impact of Sociodemographic Characteristics in Cancer Patients' Health-Related Quality of Life: A Cross-Sectional Study.

Background: Health-related quality of life (HRQoL) is a multi-dimensional concept commonly assessed in patient-centered research on the impact of cancer and its treatment. Apart from disease and treatment characteristics, HRQoL is also influenced by sociodemographic variables. However, detailed evaluations of the impact of sociodemographic variables on HRQoL are scarce.

Mammography screening and risk factor prevalence by sexual identity: A comparison of two national surveys.

Background: Emerging research suggests that lesbian, gay, bisexual, and queer (LGBQ) women face barriers to breast cancer screening. The authors sought to quantify sexual identity disparities in mammography screening, health care access, and lifestyle-related risk factors using two national surveys.

Methods: Data from the 2018, 2019, and 2021 National Health Interview Survey (NHIS) and the 2018, 2020, and 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed.

The Use of EQ-5D in the Middle East and North Africa Region: A Systematic Literature Review.

Introduction: The EQ-5D is the most commonly used preference-based measure of health-related quality of life. There is limited evidence about the use of the EQ-5D in the Middle East and North Africa (MENA) region. This study aimed to systematically identify, review, summarize, and synthesize the published literature on using the EQ-5D in this region.

Telemedicine for Ketogenic Dietary Treatment in Epilepsy and Inherited Metabolic Diseases: Survey of Health Care Professionals.

In refractory epilepsy and inherited metabolic disorders, Ketogenic Dietary Therapies (KDT) are established non-pharmacological treatments. Telemedicine might contribute to tackle various challenges related to KDT complexity and the respective target diseases. A questionnaire on the current use and future requirements was provided for health care professionals working in neuropediatrics, inherited metabolic diseases and nutrition within the region of German speaking countries.

Interrater reliability and practicability of the German version of the Ghent Global Incontinence-Associated Dermatitis Categorization Tool.

Incontinence-associated dermatitis (IAD) is a sequela of fecal and/or urinary incontinence with an estimated prevalence rate of 6% to 27%. To assess the severity of IAD the Ghent Global IAD Categorization Tool (GLOBIAD) was developed. A German translation of GLOBIAD (GLOBIAD-D) is available, but psychometric testing is pending.

Perioperative cisplatin-based chemotherapy for muscle-invasive bladder cancer: a decision analysis.

Purpose: While meta-analyses of randomised studies suggest that neoadjuvant (NAC) or adjuvant (ACT) cisplatin-based chemotherapy improve overall survival in patients with muscle-invasive bladder cancer (MIBC), there are no trials comparing NAC against ACT in terms of quality-adjusted life years (QALYs) and costs. We aimed to evaluate the long-term QALYs, costs, and cost-effectiveness of different strategies for treating patients with MIBC.

Methods: An individual-level state transition microsimulation model was developed for patients with urothelial non-metastatic MIBC eligible for surgery and NAC at diagnosis.

Treatment of an Opposing Metabolic Situation: GLUT1-Deficiency Syndrome and Type 1 Diabetes.

Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is a rare inborn disorder of metabolism leading to encephalopathy due to disturbed glucose transport via the blood-brain-barrier and consecutive energy deficit of the brain. Since ketone bodies can serve as an alternative fuel for the brain, ketogenic diet therapies (KDT) are the treatment of choice for these patients. KDT refers to all forms of nutrition that lead to the formation of ketone bodies.

Influence of prior knowledge and experience on willingness to pay for home hospice services: a contingent valuation study.

Home hospice services contribute to dying in dignity by addressing medical and social needs at the end of life. The respective monetary valuation in a sense of willingness to pay is not available yet. We aim to quantify the benefits of home hospice services to society using society's monetary valuation and examine the influence of prior knowledge and experience on willingness to pay for home hospice services.

Occupational Heat Stress Among Migrant and Ethnic Minority Outdoor Workers: A Scoping Review.

Purpose Of Review: Migrant and ethnic minority (MEM) outdoor workers might be at increased risk for heat-related illnesses (HRI), due to environmental exposures, heavy physical work, limited control over workplace conditions and language and cultural barriers. This review aims to synthesize the literature on health impacts of occupational heat exposure among MEM outdoor workers, including risk factors, heat-related perception and behaviour and healthcare utilization.

Recent Findings: Seventy-six publications were included.

Cervical cancer screening and risk factor prevalence by sexual identity: A comparison across three national surveys in the United States.

Objectives: Women identifying as lesbian, gay, bisexual, or queer (LGBQ) have lower cervical cancer screening use and differences in care access. Less known about how differences vary by data sources and within LGBQ subgroups. We evaluated LGBQ disparities in cervical cancer screening use and risk factors across three national surveys in the United States.

One in three adenomas could be missed by white-light colonoscopy - findings from a systematic review and meta-analysis.

Background: White light (conventional) colonoscopy (WLC) is widely used for colorectal cancer screening, diagnosis and surveillance but endoscopists may fail to detect adenomas. Our goal was to assess and synthesize overall and subgroup-specific adenoma miss rates (AMR) of WLC in daily practice.

Methods: We conducted a systematic review in MEDLINE, EMBASE, Cochrane Library, and grey literature on studies evaluating diagnostic WLC accuracy in tandem studies with novel-colonoscopic technologies (NCT) in subjects undergoing screening, diagnostic or surveillance colonoscopy.

Sex-Specific Fall Trajectories and Associated Self-Reported Risk Factors: A Prospective Analysis of the 3-Year 5-Country DO-HEALTH Trial.

Objective: Few studies have explored specific trajectories or patterns of falls over time in older adults, and the role of sex and self-reported risk factors for these trajectories were overlooked. This study aimed to identify sex-specific fall trajectories over 3 years and the self-reported risk factors associated with each trajectory in European older adults.

Design: Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial.

Efficacy of home-based and inpatient treatment for children and adolescents in psychiatric crisis: A systematic review protocol.

Purpose: Children and adolescents experiencing psychiatric crises often undergo inpatient treatment, which may limit family involvement, stigmatize young individuals, and impede the application of therapeutic outcomes in their daily lives. This situation can result in increased rates of rehospitalization, the development of chronic conditions, and prolonged hospital stays. Home-based treatment represents a potential alternative to traditional inpatient care.

Human Milk Feeding in Inherited Metabolic Disorders: A Systematic Review of Growth, Metabolic Control, and Neurodevelopment Outcomes.

Human milk (HM) is the optimal source of nutrition for infants. Yet the suitability of HM macronutrient composition, paired with the challenge of regulating HM intake, may deserve some consideration for infants with inherited metabolic disorders (IMDs) requiring restrictive and controlled dietary management. Except for classic galactosemia, HM feeding is expected to be feasible, allowing infants to maintain metabolic stability, while growing and developing optimally.

Directed Acyclic Graphs in Decision-Analytic Modeling: Bridging Causal Inference and Effective Model Design in Medical Decision Making.

Decision-analytic models (DAMs) are essentially informative yet complex tools for solving questions in medical decision making. When their complexity grows, the need for causal inference techniques becomes evident as causal relationships between variables become unclear. In this methodological commentary, we argue that graphical representations of assumptions on such relationships, directed acyclic graphs (DAGs), can enhance the transparency of decision models and aid in parameter selection and estimation through visually specifying backdoor paths (i.

Evaluations of digital public health interventions in the WHO Southeast Asia Region: a systematic literature review.

Introduction: Digital health technologies have been enhancing the capacity of healthcare providers and, thereby, the delivery of targeted health services. The Southeast Asia Region (SEAR) has invested in strengthening digital public health. Many digital health interventions have been implemented in public health settings but are rarely assessed using the holistic health technology assessment (HTA) approach.

Social, health and lifestyle-related determinants of older adults' preferences for place of death in South Tyrol, Italy - a cross-sectional survey study.

Background: As the global aging population expands, understanding older adults' preferences for place of death becomes pivotal in ensuring person-centered end-of-life care.

Objective: This study aimed to investigate the influence of sociodemographic, health, and lifestyle-related factors on end-of-life care preferences of older adults in South Tyrol, Italy.

Methods: Employing a cross-sectional design, a population-based survey was conducted with a stratified probabilistic sample of adults aged ≥ 75 years in South Tyrol (Autonomous Province of Bolzano/Bozen, Italy).