The impact of COVID‐19 has underlined the need for reliable information to guide clinical practice and policy. This urgency has to be balanced against disruption to journal handling capacity and the ...continued need to ensure scientific rigour. We examined the reporting quality of highly disseminated COVID‐19 research papers using a bibliometric analysis examining reporting quality and risk of bias (RoB) amongst 250 top scoring Altmetric Attention Score (AAS) COVID‐19 research papers between January and April 2020. Method‐specific RoB tools were used to assess quality. After exclusions, 84 studies from 44 journals were included. Forty‐three (51%) were case series/studies, and only one was an randomized controlled trial. Most authors were from institutions based in China (n = 44, 52%). The median AAS and impact factor was 2015 (interquartile range IQR 1,105–4,051.5) and 12.8 (IQR 5–44.2) respectively. Nine studies (11%) utilized a formal reporting framework, 62 (74%) included a funding statement, and 41 (49%) were at high RoB. This review of the most widely disseminated COVID‐19 studies highlights a preponderance of low‐quality case series with few research papers adhering to good standards of reporting. It emphasizes the need for cautious interpretation of research and the increasingly vital responsibility that journals have in ensuring high‐quality publications.
Aims
There is increasing interest in using stratification in type 2 diabetes to target resources, individualise care and improve outcomes. We aim to systematically review and collate literature that ...has utilised population stratification methods in the study of adults with type 2 diabetes; and to describe and compare stratification methodologies, population characteristics, variables used to stratify and outcome variables.
Methods
The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched from inception to July 2020. Studies included adults with type 2 diabetes using population stratification methods. The review protocol was registered on PROSPERO (ID: CRD42020206604) and conducted in line with PRISMA guidance. Extracted data included study aims; study setting (primary or secondary care); population characteristics; stratification variables and outcomes; and methodological approach to stratification.
Results
Across 348 included studies, there were a total of 10,776,009 participants with a mean age of 61.0 years (SD 5.94). 6.7% of studies used data‐driven methods and the rest employed expert‐driven approaches using pre‐defined stratification criteria. The commonest variable used to stratify populations was HbA1c (n = 57, 16.4%); few studies stratified using clinically important non‐traditional variables such as health behaviours and beliefs.
Conclusions
Most studies performing population stratification in type 2 diabetes used expert‐driven approaches with the aim of predicting outcomes in glycaemic control, mortality and cardiovascular complications. We identified relatively few studies using data‐driven approaches, which offer opportunities generate hypotheses beyond current expert knowledge. We describe important research gaps including stratification with regard to disease remission.
There is some evidence that Altmetric scores correlate with citations in medical research, but this is not consistent across different specialties. No previous studies have examined the association ...between Altmetric score and citations amongst primary care research journals. The aim of this study was therefore to describe this association. We identified the ten most frequently cited articles published in the top 15 highest impact factor primary care research journals. Article and journal metrics were extracted and summarized using descriptive statistics. We used Spearman's correlation coefficient (rs) and log–log linear regression modelling to examine the relationship between citations and Altmetric score. 150 articles were included with a median of 36.5 (IQR 20–59; range 5–811) citations. We found a positive association between citations and Altmetric score (rs = 0.519; p < 0.001). A unit increase in log Altmetric score was associated with increased log citations 0.175 (95% CI 0.091–0.259, p < 0.001) in an adjusted linear regression model. The regression findings indicate that increasing Altmetric score by 10% was associated with a 1.68% increase in citation rate. This has implications for how authors, academic institutions and primary care research journals approach dissemination of articles.
ObjectiveTo describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation ...length and organisational-level economic, and health outcomes.Design and outcome measuresThis is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.
In the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A
(HbA
) levels. We aim to determine the acceptability of self-collected posted capillary ...blood samples, and if they produce accurate and reliable HbA
results.
We include adult studies comparing capillary blood to venous blood for measuring HbA
. We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed.
Our search retrieved 3747 records. Following de-duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA
were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range -0.4 to 1.4 mmol/mol vs. capDBS MD range -4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self-collection kits, 83%-96% of participants reported satisfaction, 87%-99% found it easy and 69%-94% reported they would use it again.
Microtubes/capillary tubes look promising as a method of self-collecting and posting capillary blood samples for the measurement of HbA
based on the accuracy and reliability findings presented. DBS samples demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.
AbstractPurposeTo examine the association between primary care practitioner (physician and nurse) empathy and incidence of cardiovascular disease (CVD) events and all-cause mortality among patients ...with type 2 diabetes.MethodsThis was a population-based prospective cohort study of 49 general practices in East Anglia (United Kingdom). The study population included 867 individuals with screen-detected type 2 diabetes who were followed up for an average of 10 years until December 31, 2014 in the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen Detected Diabetes in Primary Care (ADDITION)-Cambridge trial. Twelve months after diagnosis, patients assessed practitioner empathy and their experiences of diabetes care during the preceding year using the consultation and relational empathy (CARE) measure questionnaire. CARE scores were grouped into tertiles. The main outcome measures were first recorded CVD event (a composite of myocardial infarction, revascularization, nontraumatic amputation, stroke, and fatal CVD event) and all-cause mortality, obtained from electronic searches of the general practitioner record, national registries, and hospital records. Hazard ratios (HRs) were estimated using Cox models adjusted for relevant confounders. The ADDITION-Cambridge trial is registered as ISRCTN86769081.ResultsOf the 628 participants with a completed CARE score, 120 (19%) experienced a CVD event, and 132 (21%) died during follow up. In the multivariable model, compared with the lowest tertile, higher empathy scores were associated with a lower risk of CVD events (although this did not achieve statistical significance) and a lower risk of all-cause mortality (HRs for the middle and highest tertiles, respectively: 0.49; 95% CI, 0.27–0.88, P = .01 and 0.60; 95% CI, 0.35–1.04, P = .05). ConclusionsPositive patient experiences of practitioner empathy in the year after diagnosis of type 2 diabetes may be associated with beneficial long-term clinical outcomes. Further work is needed to understand which aspects of patient perceptions of empathy might influence health outcomes and how to incorporate this understanding into the education and training of practitioners.
Aim
To quantify the association between type 2 diabetes remission and 5‐year incidence of cardiovascular disease outcomes, overall and in pre‐defined subgroups.
Methods
Retrospective cohort analysis ...of 60,287 adults with type 2 diabetes from the Care and Health Information Analytics (CHIA) database. Multivariable Cox models were used to assess the association between remission within the first two years of follow‐up and incidence of cardiovascular disease (CVD) outcomes including events, microvascular and macrovascular complications at 7‐year follow‐up. Effect modification by age, sex, diabetes duration, pre‐existing CVD, baseline body mass index (BMI) and HbA1c level was assessed.
Results
7489 (12.4%) people achieved remission during the first two years of follow‐up. Overall, remission was associated with lower risk of CVD outcomes. Remission was associated with lower risk of microvascular complications for younger compared with older age groups (eg aHR: 0.59 (0.41–0.84) and aHR: 0.78 (0.67–0.92) for those aged <45 years and 75–84 years, respectively). Amongst those achieving remission, those with no or 1–2 comorbidities had lower risk of microvascular complications (aHR: 0.65 (0.56–0.75)) compared to those with more than three comorbidities (aHR: 0.83 (0.69–0.99), respectively). There were no significant interactions in the remaining subgroups or for models assessing CVD events or macrovascular complications.
Conclusions
Achieving remission of type 2 diabetes is associated with a lower risk of microvascular complications, particularly for younger groups and those with fewer comorbidities. Targeted interventions that focus on promoting remission in these groups may reduce the impact of microvascular complications and associated health costs.
Remission of type 2 diabetes has been shown to be achievable through lifestyle changes alone. The extent to which remission is associated with reduced cardiovascular disease (CVD) outcomes in key subgroups of people with type 2 diabetes has not previously been assessed. We found that achieving remission of type 2 diabetes was associated with a lower risk of microvascular complications, particularly for younger groups and those with no or few comorbidities. Targeted interventions that focus on promoting remission in these groups may reduce the impact of microvascular complications and associated health costs.
PDF
