In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 33, Heft 8, S. 518-523
BACKGROUND: The producers of clinical practice guidelines (CPGs) may not disclose industry funding in their CPGs. We reviewed Canadian national CPGs to examine the existence and disclosure of industry-related organizational funding in the CPGs, financial conflicts of interest of committee members and organizational procedures for managing financial conflicts of interest. METHODS: For this descriptive study, we searched the asset map of the Strategy for Patient-Oriented Research Evidence Alliance and the CPG Infobase for CPGs published between Jan. 1, 2016, and Nov. 30, 2018. Eligible guidelines had to have a national focus and either a first-line drug recommendation or a screening recommendation leading to drug treatment. One investigator reviewed all CPG titles to exclude those that were clearly ineligible. Two reviewers independently reviewed all remaining guidelines and extracted data. We analyzed the data descriptively. RESULTS: We included 21 CPGs: 3 from government-sponsored organizations, 9 from disease or condition interest groups and 9 from medical professional societies. None of the 3 government-sponsored organizations reported industry funding, and none of their committee members disclosed financial conflicts of interest. Among the 18 disease or condition interest groups and medical professional societies, 14 (93%) of the 15 that disclosed funding sources on websites (3 did not disclose) reported organizational funding from industry, but none disclosed this information in the CPGs; 12 (86%) of the 14 with conflict-of-interest disclosure statements in the CPG (4 did not include disclosures) had at least 1 committee member with a financial conflict (mean proportion of committee members with a conflict 56%); and for all 8 CPGs with identifiable chairs or cochairs (chairs or cochairs not reported for 10) at least 1 of these people had a financial conflict of interest. None of the guidelines described a plan to manage organizational financial conflicts of interest. INTERPRETATION: Canadian CPGs are ...
Objectives: Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores >= 10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 >= 10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. Study Design and Setting: Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. Results: A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 >= 10 prevalence was 24.6% (95% confidence interval [CI]: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); and pooled difference was 11.9% (95% CI: 9.3%, 14.6%). The mean study-level PHQ-9 >= 10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 >= 14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8% for PHQ-9 >= 14 (95% prediction interval: -13.6%, 14.5%) and 5.6% for the PHQ-9 diagnostic algorithm (95% prediction interval: -16.4%, 15.0%). Conclusion: PHQ-9 >= 10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies. ; Canadian Institutes of Health Research (CIHR) KRS-134297 PCG155468 PJT-162206 Fonds de recherche du Quebec -Sante (FRQS) Postdoctoral Training Fellowships FRQS Research Institute of the McGill University Health Centre G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University Vanier Canada Graduate Scholarship Canadian Institutes of Health Research (CIHR) Cumming School of Medicine, University of Calgary Alberta Health Services through the Calgary Health Trust Hotchkiss Brain Institute Alberta Innovates Health Solutions Canada Research Chair in Neurological Health Services Research AIHS Population Health Investigator Award Department of Education (NIDRR) H133B080025 National Multiple Sclerosis Society MB 0008 Lundbeck International Tehran University of Medical Sciences M-288 Canadian Institutes of Health Research (CIHR) THC-135234 Crohn's and Colitis Canada Bingham Chair in Gastroenterology Waugh Family Chair in Multiple Sclerosis UK Department for International Development 201446 Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Washington H133N060033 Baylor College of Medicine H133N060003 University of Michigan System H133N060032 Grand Challenges Canada 0087-04 United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) R24MH071604 R34 MH072925 K02 MH65919 P30 DK50456 R24 MH56858 RO1-MH069666 R24 MH071604 MH014592-38 MH103210 United States Department of Health & Human Services Centers for Disease Control & Prevention - USA R49 CE002093 Spanish Ministry of Health's Health Research Fund (Fondo de Investigaciones Sanitarias) 97/1184 US National Center for Medical Rehabilitation Research RO1 HD39415 Federal Ministry of Education & Research (BMBF) 01GY1150 University of Technology Sydney Duke Global Health Institute 453-0751 Macao (SAR) Government, through the University of Macau RSKTO grants MYRG-2014-111 United States Agency for International Development (USAID) AID-DFD A-00-08-00308 UK National Institute for Health Research under its Programme Grants for Applied Research Programme RP-PG0606-1142 Consejo Nacional de Ciencia y Tecnologia (CONACyT) CB-2009133923-H National Health Research Institutes - Taiwan NHRI-EX97-9706PI Reitoria de Pesquisa da Universidade de Sao Paulo 09.1.01689.17.7 Banco Santander 10.1.01232.17.9 Pfizer medical faculty of the University of Heidelberg, Germany 121/2000 Research Manitoba Chair in Multiple Sclerosis Canadian Institutes of Health Research (CIHR) Niigata Seiryo University Productivity Grants (PQ-CNPq-2) 301321/2016-7 Ministry of Health, Italy United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI) U10CA21661 U10CA180868 U10CA180822 U10CA37422 Pennsylvania Department of Health United Kingdom National Health Service Lothian Neuro-Oncology Endowment Fund United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI) K07 CA 093512 Lance Armstrong Foundation United States Department of Health & Human Services United States Health Resources & Service Administration (HRSA) R40MC07840 United States Department of Health & Human Services National Institutes of Health (NIH) - USA T32 GM07356 United States Department of Health & Human Services Agency for Healthcare Research & Quality R36 HS018246 United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Center for Research Resources (NCRR) TL1 RR024135 medical faculty, University of Leipzig Hunter Medical Research Institute Netherlands Organization for Health Research and Development (ZonMw) Mental Health Program 100.003.005 100.002.021 Academic Medical Center/University of Amsterdam Fund for Innovation and Competitiveness of the Chilean Ministry of Economy, Development and Tourism, through the Millennium Scientific Initiative IS130005 Research Manitoba Chair
Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes summarize the data by reporting the sample median and one or both of (i) the minimum and maximum values and (ii) the first and third quartiles, but do not report the mean or standard deviation. To include these studies in meta-analysis, several methods have been developed to estimate the sample mean and standard deviation from the reported summary data. A major limitation of these widely used methods is that they assume that the outcome distribution is normal, which is unlikely to be tenable for studies reporting medians. We propose two novel approaches to estimate the sample mean and standard deviation when data are suspected to be non-normal. Our simulation results and empirical assessments show that the proposed methods often perform better than the existing methods when applied to non-normal data. ; anadian Institutes of Health Research (CIHR) KRS-134297 Fonds de recherche du Quebec -Sante (FRQS) Canadian Institutes of Health Research (CIHR) Canadian Institutes of Health Research (CIHR) FRQS Masters Training Awards Vanier Canada Graduate Scholarship FRQS Postdoctoral Training Fellowship Research Institute of the McGill University Health Centre G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University Cumming School of Medicine, University of Calgary Alberta Health Services through the Calgary Health Trust Hotchkiss Brain Institute Senior Health Scholar award from Alberta Innovates Health Solutions Health Research Council of New Zealand Lundbeck International Tehran University of Medical Sciences M-288 Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Washington H133N060033 Baylor College of Medicine H133N060003 University of Michigan System H133N060032 National Health and Medical Research Council of Australia 1002160 Safe Work Australia Australian Research Council FT130101444 European Foundation for Study of Diabetes Chinese Diabetes Society Lilly Foundation Asia Diabetes Foundation Liao Wun Yuk Diabetes Memorial Fund United States National Institute of Mental Health (NIMH) grant 5F30MH096664 United States Department of Health & Human Services National Institutes of Health (NIH) - USA United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Fogarty International Center (FIC) United States Department of Health & Human Services National Institutes of Health (NIH) - USA National Cancer Center United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI) NIH Office of Research for Women's Health through the Fogarty Global Health Fellows Program Consortium 1R25TW00934001 American Recovery and Reinvestment Act United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) R24MH071604 / R34 MH072925/ K02 MH65919 / P30 DK50456 / R24 MH56858 / RO1 MH073687 /RO1-MH069666 / R34MH084673 /R24 MH071604 United States Department of Health & Human Services Centers for Disease Control & Prevention - USA R49 CE002093 St Anne's Community Services, Leeds, UK US National Center for Medical Rehabilitation Research RO1 HD39415 Federal Ministry of Education & Research (BMBF) 01GY1150 United States Department of Health & Human Services National Institutes of Health (NIH) - USA T37 MD001449 / T32 GM07356 Ohio Board of Regents Research and Development Administration Office, University of Macau MYRG2015-00109-FSS Federal Ministry of Education & Research (BMBF) 01 GD 9802/4 ; 01 GD 0101 Federation of German Pension Insurance Institute Federal Ministry of Education & Research (BMBF) Perpetual Trustees Flora and Frank Leith Charitable Trust Jack Brockhoff Foundation Grosvenor Settlement Sunshine Foundation Danks Trust Canadian Institutes of Health Research (CIHR) FRN 83518 Scleroderma Society of Canada Scleroderma Society of Ontario Scleroderma Society of Saskatchewan Sclerodermie Quebec Cure Scleroderma Foundation Inova Diagnostics Inc Euroimmun FRQS Canadian Arthritis Network Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC FRQS Senior Investigator Award National Strategic Reference Framework European Union (EU) Greek Ministry of Education, Lifelong Learning and Religious Affairs (ARISTEIA-ABREVIATE) 1259 Ministry of Health, Labour and Welfare, Japan UK National Institute for Health Research under its Programme Grants for Applied Research Programme RP-PG-0606-1142 Canada Research Chair in Neurological Health Services Research AIHS Population Health Investigator Award National Health and Medical Research Council of Australia 1088313 Netherlands Organization for Health Research and Development 945-03-047 National Health Research Institutes - Taiwan NHRI-EX97-9706PI Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 49086 Reitoria de Pesquisa da Universidade de Sao Paulo 09.1.01689.17.7 Banco Santander 10.1.01232.17.9 Pfizer medical faculty of the University of Heidelberg, Germany 121/2000 Research University Grant Scheme from Universiti Putra Malaysia, Malaysia Postgraduate Research Student Support Accounts of the University of Auckland, New Zealand National Program for Centers of Excellence (PRONEX/FAPERGS/CNPq, Brazil) Pfizer US Pharmaceutical Inc. PQ-CNPq-2 301321/2016-7 Belgian Ministry of Public Health and Social Affairs Pfizer Ministry of Health, Italy UK National Health Service Lothian Neuro-Oncology Endowment Fund Universiti Sains Malaysia United States Department of Health & Human Services United States Health Resources & Service Administration (HRSA) R40MC07840 United States Department of Health & Human Services Agency for Healthcare Research & Quality R36 HS018246 United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Center for Research Resources (NCRR) TL1 RR024135 University of Melbourne Hunter Medical Research Institute Innovatiefonds Zorgverzekeraars Netherlands Organization for Health Research and Development (ZonMw) Mental Health Program 100.003.005 100.002.021 Academic Medical Center/University of Amsterdam Fund for Innovation and Competitiveness of the Chilean Ministry of Economy, Development and Tourism, through the Millennium Scientific Initiative IS130005 US Department of Veteran Affairs US Department of Veteran Affairs United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI) R01 HL079235 American Federation for Ageing Research Robert Wood Johnson Foundation (RWJF) Ischemia Research and Education Foundation