Browsing by Author "Tugwell, Peter"

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    Reporting of health equity considerations in cluster and individually randomized trials
    (BMC (part of Springer Nature), 2020-04-03) Petkovic, Jennifer; Jull, Janet; Yoganathan, Manosila; Dewidar, Omar; Baird, Sarah; Grimshaw, Jeremy M.; Johansson, Kjell A.; Kristjansson, Elizabeth; McGowan, Jessie; Moher, David; Petticrew, Mark; Robberstad, Bjarne; Shea, Beverley; Tugwell, Peter; Volmink, Jimmy; Wells, George A.; Whitehead, Margaret; Cuervo, Luis G.; White, Howard; Taljaard, Monica; Welch, Vivian
    Background: The randomized controlled trial (RCT) is considered the gold standard study design to inform decisions about the effectiveness of interventions. However, a common limitation is inadequate reporting of the applicability of the intervention and trial results for people who are “socially disadvantaged” and this can affect policy-makers’ decisions. We previously developed a framework for identifying health-equity-relevant trials, along with a reporting guideline for transparent reporting. In this study, we provide a descriptive assessment of healthequity considerations in 200 randomly sampled equity-relevant trials. Methods: We developed a search strategy to identify health-equity-relevant trials published between 2013 and 2015. We randomly sorted the 4316 records identified by the search and screened studies until 100 individually randomized (RCTs) and 100 cluster randomized controlled trials (CRTs) were identified. We developed and pilottested a data extraction form based on our initial work, to inform the development of our reporting guideline for equity-relevant randomized trials. Results: In total, 39 trials (20%) were conducted in a low- and middle-income country and 157 trials (79%) in a high-income country focused on socially disadvantaged populations (78% CRTs, 79% RCTs). Seventy-four trials (37%) reported a subgroup analysis across a population characteristic associated with disadvantage (25% CRT, 49% RCTs), with 19% of included studies reporting subgroup analyses across sex, 9% across race/ethnicity/culture, and 4% across socioeconomic status. No subgroup analyses were reported for place of residence, occupation, religion, education, or social capital. One hundred and forty-one trials (71%) discussed the applicability of their results to one or more socially disadvantaged populations (68% of CRT, 73% of RCT). Discussion: In this set of trials, selected for their relevance to health equity, data that were disaggregated for socially disadvantaged populations were rarely reported. We found that even when the data are available, opportunities to analyze health-equity considerations are frequently missed. The recently published equity extension of the Consolidated Reporting Standards for Randomized Trials (CONSORT-Equity) may help improve delineation of hypotheses related to socially disadvantaged populations, and transparency and completeness of reporting of health-equity considerations in RCTs. This study can serve as a baseline assessment of the reporting of equity considerations.
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    Reporting of methodological studies in health research : a protocol for the development of the Methodological Study reporting Checklist (MISTIC)
    (BMJ Publishing, 2020-12) Lawson, Daeria O.; Puljak, Livia; Pieper, Dawid; Schandelmaier, Stefan; Collins, Gary S.; Brignardello-Petersen, Romina; Moher, David; Tugwell, Peter; Welch, Vivian A.; Samaan, Zainab; Thombs, Brett D.; Nørskov, Anders K.; Jakobsen, Janus C.; Allison, David B.; Mayo-Wilson, Evan; Young, Taryn; Chan, An-Wen; Briel, Matthias; Guyatt, Gordon H.; Thabane, Lehana; Mbuagbaw, Lawrence
    Introduction: Methodological studies (ie, studies that evaluate the design, conduct, analysis or reporting of other studies in health research) address various facets of health research including, for instance, data collection techniques, differences in approaches to analyses, reporting quality, adherence to guidelines or publication bias. As a result, methodological studies can help to identify knowledge gaps in the methodology of health research and strategies for improvement in research practices. Differences in methodological study names and a lack of reporting guidance contribute to lack of comparability across studies and difficulties in identifying relevant previous methodological studies. This paper outlines the methods we will use to develop an evidence-based tool—the Methodological Study reporting Checklist—to harmonise naming conventions and improve the reporting of methodological studies. Methods and analysis: We will search for methodological studies in the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, MEDLINE, Web of Science, check reference lists and contact experts in the field. We will extract and summarise data on the study names, design and reporting features of the included methodological studies. Consensus on study terms and recommended reporting items will be achieved via video conference meetings with a panel of experts including researchers who have published methodological studies. Ethics and dissemination: The consensus study has been exempt from ethics review by the Hamilton Integrated Research Ethics Board. The results of the review and the reporting guideline will be disseminated in stakeholder meetings, conferences, peer-reviewed publications, in requests to journal editors (to endorse or make the guideline a requirement for authors), and on the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and reporting guideline websites. Registration: We have registered the development of the reporting guideline with the EQUATOR Network and publicly posted this project on the Open Science.