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Cardioversion in patients with newly diagnosed non-valvular atrial fibrillation: observational study using prospectively collected registry data BMJ (IF 39.89) Pub Date : 2021-10-27 Marita Knudsen Pope, Trygve S Hall, Valentina Schirripa, Petra Radic, Saverio Virdone, Karen S Pieper, Jean-Yves Le Heuzey, Petr Jansky, David A Fitzmaurice, Riccardo Cappato, Dan Atar, A John Camm, Ajay K Kakkar
Objective To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. Design Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF—GARFIELD-AF). Setting 1317 participating sites in 35 countries
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Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-10-21 S Iuliano, S Poon, J Robbins, M Bui, X Wang, L De Groot, M Van Loan, A Ghasem Zadeh, T Nguyen, E Seeman
Objective To assess the antifracture efficacy and safety of a nutritional intervention in institutionalised older adults replete in vitamin D but with mean intakes of 600 mg/day calcium and <1 g/kg body weight protein/day. Design Two year cluster randomised controlled trial. Setting 60 accredited residential aged care facilities in Australia housing predominantly ambulant residents. Participants 7195
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Risk of bias in studies on prediction models developed using supervised machine learning techniques: systematic review BMJ (IF 39.89) Pub Date : 2021-10-20 Constanza L Andaur Navarro, Johanna A A Damen, Toshihiko Takada, Steven W J Nijman, Paula Dhiman, Jie Ma, Gary S Collins, Ram Bajpai, Richard D Riley, Karel G M Moons, Lotty Hooft
Objective To assess the methodological quality of studies on prediction models developed using machine learning techniques across all medical specialties. Design Systematic review. Data sources PubMed from 1 January 2018 to 31 December 2019. Eligibility criteria Articles reporting on the development, with or without external validation, of a multivariable prediction model (diagnostic or prognostic)
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Acute urinary retention and risk of cancer: population based Danish cohort study BMJ (IF 39.89) Pub Date : 2021-10-19 Maria Bisgaard Bengtsen, Dóra Körmendiné Farkas, Michael Borre, Henrik Toft Sørensen, Mette Nørgaard
Objective To examine the risk of urogenital, colorectal, and neurological cancers after a first diagnosis of acute urinary retention. Design Nationwide population based cohort study. Setting All hospitals in Denmark. Participants 75 983 patients aged 50 years or older with a first hospital admission for acute urinary retention during 1995-2017. Main outcome measures Absolute risk of urogenital, colorectal
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Current evidence on dietary intakes of fatty acids and mortality BMJ (IF 39.89) Pub Date : 2021-10-14 Sina Naghshi, Omid Sadeghi
Findings from the associations between dietary intakes of different fatty acids and longevity are of particular interest to researchers, healthcare providers, and patients. Based on our meta-analysis of 41 articles from cohort studies, dietary intake of alpha linolenic acid (ALA) was associated with a reduced risk of mortality from all causes, cardiovascular disease, and coronary heart disease, and
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Conduct and reporting of formula milk trials: systematic review BMJ (IF 39.89) Pub Date : 2021-10-14 Bartosz Helfer, Jo Leonardi-Bee, Alexandra Mundell, Callum Parr, Despo Ierodiakonou, Vanessa Garcia-Larsen, Cynthia M Kroeger, Zhaoli Dai, Amy Man, Jessica Jobson, Fatemah Dewji, Michelle Kunc, Lisa Bero, Robert J Boyle
Objective To systematically review the conduct and reporting of formula trials. Design Systematic review. Data sources Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 January 2006 to 31 December 2020. Review methods Intervention trials comparing at least two formula products in children less than three years of age were included, but not trials of
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Dietary intake and biomarkers of alpha linolenic acid and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of cohort studies BMJ (IF 39.89) Pub Date : 2021-10-14 Sina Naghshi, Dagfinn Aune, Joseph Beyene, Sara Mobarak, Masoomeh Asadi, Omid Sadeghi
Objective To examine the associations between dietary intake and tissue biomarkers of alpha linolenic acid (ALA) and risk of mortality from all causes, cardiovascular disease (CVD), and cancer. Design Systematic review and meta-analysis of prospective cohort studies. Data sources PubMed, Scopus, ISI Web of Science, and Google Scholar to 30 April 2021. Study selection Prospective cohort studies that
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Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial BMJ (IF 39.89) Pub Date : 2021-10-14 Michelle Sholzberg, Grace H Tang, Hassan Rahhal, Musaad AlHamzah, Lisa Baumann Kreuziger, Fionnuala Ní Áinle, Faris Alomran, Khalid Alayed, Mohammed Alsheef, Fahad AlSumait, Carlos Eduardo Pompilio, Catherine Sperlich, Sabrena Tangri, Terence Tang, Peter Jaksa, Deepa Suryanarayan, Mozah Almarshoodi, Lana A Castellucci, Paula D James, David Lillicrap, Marc Carrier, Andrew Beckett, Christos Colovos,
Objective To evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with covid-19 admitted to hospital wards. Design Randomised controlled, adaptive, open label clinical trial. Setting 28 hospitals in Brazil, Canada, Ireland, Saudi Arabia, United Arab Emirates, and US. Participants 465 adults admitted to hospital wards with covid-19 and increased
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Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis BMJ (IF 39.89) Pub Date : 2021-10-12 Bruno R da Costa, Tiago V Pereira, Pakeezah Saadat, Martina Rudnicki, Samir M Iskander, Nicolas S Bodmer, Pavlos Bobos, Li Gao, Henry Dan Kiyomoto, Thais Montezuma, Matheus O Almeida, Pai-Shan Cheng, Cesar A Hincapié, Roman Hari, Alex J Sutton, Peter Tugwell, Gillian A Hawker, Peter Jüni
Objective To assess the effectiveness and safety of different preparations and doses of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and paracetamol for knee and hip osteoarthritis pain and physical function to enable effective and safe use of these drugs at their lowest possible dose. Design Systematic review and network meta-analysis of randomised trials. Data sources Cochrane Central
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Changes in exposure to ambient fine particulate matter after relocating and long term survival in Canada: quasi-experimental study BMJ (IF 39.89) Pub Date : 2021-10-08 Hong Chen, Jay S Kaufman, Toyib Olaniyan, Lauren Pinault, Michael Tjepkema, Li Chen, Aaron van Donkelaar, Randall V Martin, Perry Hystad, Chen Chen, Megan Kirby-McGregor, Li Bai, Richard T Burnett, Tarik Benmarhnia
Objective To investigate the association between changes in long term residential exposure to ambient fine particulate matter (PM2.5) and premature mortality in Canada. Design Population based quasi-experimental study. Setting Canada. Participants 663 100 respondents to the 1996, 2001, and 2006 Canadian censuses aged 25-89 years who had consistently lived in areas with either high or low PM2.5 levels
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Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis BMJ (IF 39.89) Pub Date : 2021-10-05 Zelalem F Negeri, Brooke Levis, Ying Sun, Chen He, Ankur Krishnan, Yin Wu, Parash Mani Bhandari, Dipika Neupane, Eliana Brehaut, Andrea Benedetti, Brett D Thombs
Objective To update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups. Design Systematic review and individual participant data meta-analysis. Data sources Medline, Medline In-Process
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Female authorship of covid-19 research in manuscripts submitted to 11 biomedical journals: cross sectional study BMJ (IF 39.89) Pub Date : 2021-10-06 Angèle Gayet-Ageron, Khaoula Ben Messaoud, Mark Richards, Sara Schroter
Objective To describe prominent authorship positions held by women and the overall percentage of women co-authoring manuscripts submitted during the covid-19 pandemic compared with the previous two years. Design Cross sectional study. Setting Nine specialist and two large general medical journals. Population Authors of research manuscripts submitted between 1 January 2018 and 31 May 2021. Main outcome
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Use of menopausal hormone therapy and risk of dementia: nested case-control studies using QResearch and CPRD databases BMJ (IF 39.89) Pub Date : 2021-09-30 Yana Vinogradova, Tom Dening, Julia Hippisley-Cox, Lauren Taylor, Michael Moore, Carol Coupland
Objective To assess the risks of developing dementia associated with different types and durations of menopausal hormone therapy. Design Two nested case-control studies. Setting UK general practices contributing to QResearch or the Clinical Practice Research Datalink (CPRD), using all links to hospital, mortality, and social deprivation data. Participants 118 501 women aged 55 and older with a primary
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Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-09-30 Michael H McGillion, Joel Parlow, Flavia K Borges, Maura Marcucci, Michael Jacka, Anthony Adili, Manoj M Lalu, Carley Ouellette, Marissa Bird, Sandra Ofori, Pavel S Roshanov, Ameen Patel, Homer Yang, Susan O’Leary, Vikas Tandon, Gavin M Hamilton, Marko Mrkobrada, David Conen, Valerie Harvey, Jennifer Lounsbury, Rajibul Mian, Shrikant I Bangdiwala, Ramiro Arellano, Ted Scott, Gordon H Guyatt, Peggy
Objective To determine if virtual care with remote automated monitoring (RAM) technology versus standard care increases days alive at home among adults discharged after non-elective surgery during the covid-19 pandemic. Design Multicentre randomised controlled trial. Setting 8 acute care hospitals in Canada. Participants 905 adults (≥40 years) who resided in areas with mobile phone coverage and were
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Early computed tomography coronary angiography in patients with suspected acute coronary syndrome: randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-09-29 Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O’Brien, Robert F Storey, Nick Curzen, Liza Keating, Attila Kardos, Dirk Felmeden, Robert J Lee, Praveen Thokala, Steff C Lewis, David E Newby
Objectives To establish if the use of early computed tomography (CT) coronary angiography improves one year clinical outcomes in patients presenting to the emergency department with acute chest pain and at intermediate risk of acute coronary syndrome and subsequent clinical events. Design Randomised controlled trial. Setting 37 hospitals in the UK. Participants Adults with suspected or a provisional
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Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study BMJ (IF 39.89) Pub Date : 2021-09-28 Roderick C Slieker, Amber A W A van der Heijden, Moneeza K Siddiqui, Marlous Langendoen-Gort, Giel Nijpels, Ron Herings, Talitha L Feenstra, Karel G M Moons, Samira Bell, Petra J Elders, Leen M ’t Hart, Joline W J Beulens
Objectives To identify and assess the quality and accuracy of prognostic models for nephropathy and to validate these models in external cohorts of people with type 2 diabetes. Design Systematic review and external validation. Data sources PubMed and Embase. Eligibility criteria Studies describing the development of a model to predict the risk of nephropathy, applicable to people with type 2 diabetes
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Antibody and cellular therapies for treatment of covid-19: a living systematic review and network meta-analysis BMJ (IF 39.89) Pub Date : 2021-09-23 Reed AC Siemieniuk, Jessica J Bartoszko, Juan Pablo Díaz Martinez, Elena Kum, Anila Qasim, Dena Zeraatkar, Ariel Izcovich, Sophia Mangala, Long Ge, Mi Ah Han, Thomas Agoritsas, Donald Arnold, Camila Ávila, Derek K Chu, Rachel Couban, Ellen Cusano, Andrea J Darzi, Tahira Devji, Farid Foroutan, Maryam Ghadimi, Assem Khamis, Francois Lamontagne, Mark Loeb, Anna Miroshnychenko, Sharhzad Motaghi, Srinivas
Objective To evaluate the efficacy and safety of antiviral antibody therapies and blood products for the treatment of novel coronavirus disease 2019 (covid-19). Design Living systematic review and network meta-analysis, with pairwise meta-analysis for outcomes with insufficient data. Data sources WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, and six Chinese
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Use of metformin to prolong gestation in preterm pre-eclampsia: randomised, double blind, placebo controlled trial BMJ (IF 39.89) Pub Date : 2021-09-23 Catherine A Cluver, Richard Hiscock, Eric H Decloedt, David R Hall, Sonja Schell, Ben W Mol, Fiona Brownfoot, Tu’uhevaha J Kaitu’u-Lino, Susan P Walker, Stephen Tong
Objective To evaluate whether extended release metformin could be used to prolong gestation in women being expectantly managed for preterm pre-eclampsia. Design Randomised, double blind, placebo controlled trial. Setting Referral hospital in Cape Town, South Africa. Participants 180 women with preterm pre-eclampsia between 26+0 to 31+6 weeks’ gestation undergoing expectant management: 90 were randomised
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Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial BMJ (IF 39.89) Pub Date : 2021-09-21 Loïc Lhopitallier, Andreas Kronenberg, Jean-Yves Meuwly, Isabella Locatelli, Yolanda Mueller, Nicolas Senn, Valérie D’Acremont, Noémie Boillat-Blanco
Objective To assess whether point-of care procalcitonin and lung ultrasonography can safely reduce unnecessary antibiotic treatment in patients with lower respiratory tract infections in primary care. Design Three group, pragmatic cluster randomised controlled trial from September 2018 to March 2020. Setting 60 Swiss general practices. Participants One general practitioner per practice was included
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Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-09-21 Tjarda M Boere, Laura W van Buul, Rogier M Hopstaken, Maurits W van Tulder, Jos W M R Twisk, Theo J M Verheij, Cees M P M Hertogh
Objective To evaluate whether C reactive protein point-of-care testing (CRP POCT) safely reduces antibiotic prescribing for lower respiratory tract infections in nursing home residents. Design Pragmatic, cluster randomised controlled trial. Setting The UPCARE study included 11 nursing home organisations in the Netherlands. Participants 84 physicians from 11 nursing home organisations included 241 participants
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Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination: national prospective cohort study BMJ (IF 39.89) Pub Date : 2021-09-17 Julia Hippisley-Cox, Carol AC Coupland, Nisha Mehta, Ruth H Keogh, Karla Diaz-Ordaz, Kamlesh Khunti, Ronan A Lyons, Frank Kee, Aziz Sheikh, Shamim Rahman, Jonathan Valabhji, Ewen M Harrison, Peter Sellen, Nazmus Haq, Malcolm G Semple, Peter W M Johnson, Andrew Hayward, Jonathan S Nguyen-Van-Tam
Objectives To derive and validate risk prediction algorithms to estimate the risk of covid-19 related mortality and hospital admission in UK adults after one or two doses of covid-19 vaccination. Design Prospective, population based cohort study using the QResearch database linked to data on covid-19 vaccination, SARS-CoV-2 results, hospital admissions, systemic anticancer treatment, radiotherapy,
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Evaluating agreement between bodies of evidence from randomised controlled trials and cohort studies in nutrition research: meta-epidemiological study BMJ (IF 39.89) Pub Date : 2021-09-15 Lukas Schwingshackl, Sara Balduzzi, Jessica Beyerbach, Nils Bröckelmann, Sarah S Werner, Jasmin Zähringer, Blin Nagavci, Joerg J Meerpohl
Objective To evaluate the agreement between diet-disease effect estimates of bodies of evidence from randomised controlled trials and those from cohort studies in nutrition research, and to investigate potential factors for disagreement. Design Meta-epidemiological study. Data sources Cochrane Database of Systematic Reviews, and Medline. Review methods Population, intervention or exposure, comparator
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Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials BMJ (IF 39.89) Pub Date : 2021-09-09 Li Wang, Patrick J Hong, Curtis May, Yasir Rehman, Yvgeniy Oparin, Chris J Hong, Brian Y Hong, Mahmood AminiLari, Lucas Gallo, Alka Kaushal, Samantha Craigie, Rachel J Couban, Elena Kum, Harsha Shanthanna, Ira Price, Suneel Upadhye, Mark A Ware, Fiona Campbell, Rachelle Buchbinder, Thomas Agoritsas, Jason W Busse
Objective To determine the benefits and harms of medical cannabis and cannabinoids for chronic pain. Design Systematic review and meta-analysis. Data sources MEDLINE, EMBASE, AMED, PsycInfo, CENTRAL, CINAHL, PubMed, Web of Science, Cannabis-Med, Epistemonikos, and trial registries up to January 2021. Study selection Randomised clinical trials of medical cannabis or cannabinoids versus any non-cannabis
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Regulatory and clinical consequences of negative confirmatory trials of accelerated approval cancer drugs: retrospective observational study BMJ (IF 39.89) Pub Date : 2021-09-09 Bishal Gyawali, Benjamin N Rome, Aaron S Kesselheim
Objectives To investigate the regulatory handling of cancer drugs that were granted accelerated approval by the US Food and Drug Administration (FDA) but failed to improve the primary endpoint in post-approval trials and to evaluate the extent to which negative post-approval trials changed the recommendations in treatment guidelines. Design Retrospective observational study. Setting FDA and National
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Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study BMJ (IF 39.89) Pub Date : 2021-09-09 Manuella Lech Cantuaria, Frans Boch Waldorff, Lene Wermuth, Ellen Raben Pedersen, Aslak Harbo Poulsen, Jesse Daniel Thacher, Ole Raaschou-Nielsen, Matthias Ketzel, Jibran Khan, Victor H Valencia, Jesper Hvass Schmidt, Mette Sørensen
Objective To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia. Design Nationwide prospective register based cohort study. Setting Denmark. Participants 1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017. Main outcome measures Incident cases of all cause dementia and dementia
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Use of antipsychotic drugs and cholinesterase inhibitors and risk of falls and fractures: self-controlled case series BMJ (IF 39.89) Pub Date : 2021-09-09 Grace Hsin-Min Wang, Kenneth K C Man, Wei-Hung Chang, Tzu-Chi Liao, Edward Chia-Cheng Lai
Objective To evaluate the association between the use of antipsychotic drugs and cholinesterase inhibitors and the risk of falls and fractures in elderly patients with major neurocognitive disorders. Design Self-controlled case series. Setting Taiwan’s National Health Insurance Database. Participants 15 278 adults, aged ≥65, with newly prescribed antipsychotic drugs and cholinesterase inhibitors, who
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Use of artificial intelligence for image analysis in breast cancer screening programmes: systematic review of test accuracy BMJ (IF 39.89) Pub Date : 2021-09-02 Karoline Freeman, Julia Geppert, Chris Stinton, Daniel Todkill, Samantha Johnson, Aileen Clarke, Sian Taylor-Phillips
Objective To examine the accuracy of artificial intelligence (AI) for the detection of breast cancer in mammography screening practice. Design Systematic review of test accuracy studies. Data sources Medline, Embase, Web of Science, and Cochrane Database of Systematic Reviews from 1 January 2010 to 17 May 2021. Eligibility criteria Studies reporting test accuracy of AI algorithms, alone or in combination
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Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study BMJ (IF 39.89) Pub Date : 2021-09-02 Lynda Fenton, Ciara Gribben, David Caldwell, Sam Colville, Jen Bishop, Martin Reid, Jane White, Marion Campbell, Sharon Hutchinson, Chris Robertson, Helen M Colhoun, Rachael Wood, Paul M McKeigue, David A McAllister
Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19
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Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis BMJ (IF 39.89) Pub Date : 2021-09-02 Maciej Strak, Gudrun Weinmayr, Sophia Rodopoulou, Jie Chen, Kees de Hoogh, Zorana J Andersen, Richard Atkinson, Mariska Bauwelinck, Terese Bekkevold, Tom Bellander, Marie-Christine Boutron-Ruault, Jørgen Brandt, Giulia Cesaroni, Hans Concin, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, Nicole A H Janssen, Karl-Heinz Jöckel, Jeanette T Jørgensen
Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. Design Pooled analysis of eight cohorts. Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries. Participants 325 367 adults from the
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Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study BMJ (IF 39.89) Pub Date : 2021-08-27 Julia Hippisley-Cox, Martina Patone, Xue W Mei, Defne Saatci, Sharon Dixon, Kamlesh Khunti, Francesco Zaccardi, Peter Watkinson, Manu Shankar-Hari, James Doidge, David A Harrison, Simon J Griffin, Aziz Sheikh, Carol A C Coupland
Objective To assess the association between covid-19 vaccines and risk of thrombocytopenia and thromboembolic events in England among adults. Design Self-controlled case series study using national data on covid-19 vaccination and hospital admissions. Setting Patient level data were obtained for approximately 30 million people vaccinated in England between 1 December 2020 and 24 April 2021. Electronic
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Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study BMJ (IF 39.89) Pub Date : 2021-08-20 Otavio T Ranzani, Matt D T Hitchings, Murilo Dorion, Tatiana Lang D’Agostini, Regiane Cardoso de Paula, Olivia Ferreira Pereira de Paula, Edlaine Faria de Moura Villela, Mario Sergio Scaramuzzini Torres, Silvano Barbosa de Oliveira, Wade Schulz, Maria Almiron, Rodrigo Said, Roberto Dias de Oliveira, Patricia Vieira da Silva, Wildo Navegantes de Araújo, Jean Carlo Gorinchteyn, Jason R Andrews, Derek
Objective To estimate the effectiveness of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech), against symptomatic covid-19 in the elderly population of São Paulo state, Brazil during widespread circulation of the gamma variant. Design Test negative case-control study. Setting Community testing for covid-19 in São Paulo state, Brazil. Participants 43 774 adults aged ≥70 years who were
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Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study BMJ (IF 39.89) Pub Date : 2021-08-20 Hannah Chung, Siyi He, Sharifa Nasreen, Maria E Sundaram, Sarah A Buchan, Sarah E Wilson, Branson Chen, Andrew Calzavara, Deshayne B Fell, Peter C Austin, Kumanan Wilson, Kevin L Schwartz, Kevin A Brown, Jonathan B Gubbay, Nicole E Basta, Salaheddin M Mahmud, Christiaan H Righolt, Lawrence W Svenson, Shannon E MacDonald, Naveed Z Janjua, Mina Tadrous, Jeffrey C Kwong
Objective To estimate the effectiveness of mRNA covid-19 vaccines against symptomatic infection and severe outcomes (hospital admission or death). Design Test negative design study. Setting Ontario, Canada between 14 December 2020 and 19 April 2021. Participants 324 033 community dwelling people aged ≥16 years who had symptoms of covid-19 and were tested for SARS-CoV-2. Interventions BNT162b2 (Pfizer-BioNTech)
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Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study BMJ (IF 39.89) Pub Date : 2021-08-18 Carmen Cabezas, Ermengol Coma, Nuria Mora-Fernandez, Xintong Li, Montse Martinez-Marcos, Francesc Fina, Mireia Fabregas, Eduardo Hermosilla, Angel Jover, Juan Carlos Contel, Yolanda Lejardi, Belen Enfedaque, Josep Maria Argimon, Manuel Medina-Peralta, Daniel Prieto-Alhambra
Objective To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. Design Prospective cohort study. Setting Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. Participants 28 456 nursing home residents
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Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies BMJ (IF 39.89) Pub Date : 2021-08-19 Mika Kivimäki, Keenan A Walker, Jaana Pentti, Solja T Nyberg, Nina Mars, Jussi Vahtera, Sakari B Suominen, Tea Lallukka, Ossi Rahkonen, Olli Pietiläinen, Aki Koskinen, Ari Väänänen, Jatinderpal K Kalsi, Marcel Goldberg, Marie Zins, Lars Alfredsson, Peter J M Westerholm, Anders Knutsson, Töres Theorell, Jenni Ervasti, Tuula Oksanen, Pyry N Sipilä, Adam G Tabak, Jane E Ferrie, Stephen A Williams, Gill
Objectives To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association. Design Multicohort study with three sets of analyses. Setting United Kingdom, Europe, and the United States. Participants Three associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population
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Association between characteristics of behavioural weight loss programmes and weight change after programme end: systematic review and meta-analysis BMJ (IF 39.89) Pub Date : 2021-08-17 Jamie Hartmann-Boyce, Annika Theodoulou, Jason L Oke, Ailsa R Butler, Peter Scarborough, Anastasios Bastounis, Anna Dunnigan, Rimu Byadya, F D Richard Hobbs, Falko F Sniehotta, Susan A Jebb, Paul Aveyard
Objective To determine if the characteristics of behavioural weight loss programmes influence the rate of change in weight after the end of the programme. Design Systematic review and meta-analysis. Data sources Trial registries, 11 electronic databases, and forward citation searching (from database inception; latest search December 2019). Randomised trials of behavioural weight loss programmes in
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Placental growth factor in assessment of women with suspected pre-eclampsia to reduce maternal morbidity: a stepped wedge cluster randomised control trial (PARROT Ireland) BMJ (IF 39.89) Pub Date : 2021-08-13 D Hayes-Ryan, A S Khashan, K Hemming, C Easter, D Devane, D J Murphy, A Hunter, A Cotter, F M McAuliffe, J J Morrison, F M Breathnach, E Dempsey, L C Kenny, K O’Donoghue
Objective To determine whether the addition of placental growth factor (PlGF) measurement to current clinical assessment of women with suspected pre-eclampsia before 37 weeks' gestation would reduce maternal morbidity without increasing neonatal morbidity. Design Stepped wedge cluster randomised control trial from 29 June 2017 to 26 April 2019. Setting National multisite trial in seven maternity hospitals
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Evaluation of an intervention targeted with predictive analytics to prevent readmissions in an integrated health system: observational study BMJ (IF 39.89) Pub Date : 2021-08-11 Ben J Marafino, Gabriel J Escobar, Michael T Baiocchi, Vincent X Liu, Colleen C Plimier, Alejandro Schuler
Objectives To determine the associations between a care coordination intervention (the Transitions Program) targeted to patients after hospital discharge and 30 day readmission and mortality in a large, integrated healthcare system. Design Observational study. Setting 21 hospitals operated by Kaiser Permanente Northern California. Participants 1 539 285 eligible index hospital admissions corresponding
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Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials BMJ (IF 39.89) Pub Date : 2021-08-05 Laura Chiavaroli, Danielle Lee, Amna Ahmed, Annette Cheung, Tauseef A Khan, Sonia Blanco, Mejia, Arash Mirrahimi, David J A Jenkins, Geoffrey Livesey, Thomas M S Wolever, Dario Rahelić, Hana Kahleová, Jordi Salas-Salvadó, Cyril W C Kendall, John L Sievenpiper
Objective To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, and the Cochrane Library searched up to 13 May 2021. Eligibility criteria for selecting studies Randomised controlled trials of three or more weeks investigating
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Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study BMJ (IF 39.89) Pub Date : 2021-08-05 Benjamin Landré, Aurore Fayosse, Céline Ben Hassen, Marcos D Machado-Fragua, Julien Dumurgier, Mika Kivimaki, Séverine Sabia, Archana Singh-Manoux
Objectives To examine multiple objective and self-reported measures of motor function for their associations with mortality. Design Prospective cohort study. Setting UK based Whitehall II cohort study, which recruited participants aged 35-55 years in 1985-88; motor function component was added at the 2007-09 wave. Participants 6194 participants with motor function measures in 2007-09 (mean age 65.6
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Diagnostic accuracy of rapid antigen tests in asymptomatic and presymptomatic close contacts of individuals with confirmed SARS-CoV-2 infection: cross sectional study BMJ (IF 39.89) Pub Date : 2021-07-27 Ewoud Schuit, Irene K Veldhuijzen, Roderick P Venekamp, Wouter van den Bijllaardt, Suzan D Pas, Esther B Lodder, Richard Molenkamp, Corine H GeurtsvanKessel, Jans Velzing, Robin C Huisman, Lieke Brouwer, Timo L Boelsums, Gregorius J Sips, Kimberly S M Benschop, Lotty Hooft, Janneke H H M van de Wijgert, Susan van den Hof, Karel G M Moons
Objective To assess the diagnostic test accuracy of two rapid antigen tests in asymptomatic and presymptomatic close contacts of people with SARS-CoV-2 infection on day 5 after exposure. Design Prospective cross sectional study. Setting Four public health service covid-19 test sites in the Netherlands. Participants 4274 consecutively included close contacts (identified through test-and-trace programme
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Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART) BMJ (IF 39.89) Pub Date : 2021-07-22 Roma Maguire, Lisa McCann, Grigorios Kotronoulas, Nora Kearney, Emma Ream, Jo Armes, Elisabeth Patiraki, Eileen Furlong, Patricia Fox, Alexander Gaiger, Paul McCrone, Geir Berg, Christine Miaskowkski, Antonella Cardone, Dawn Orr, Adrian Flowerday, Stylianos Katsaragakis, Andrew Darley, Simone Lubowitzki, Jenny Harris, Simon Skene, Morven Miller, Margaret Moore, Liane Lewis, Nicosha DeSouza, Peter T
Objective To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. Design Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. Setting Twelve cancer centres in Austria
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Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study BMJ (IF 39.89) Pub Date : 2021-07-15 Neeraj Narula, Emily C L Wong, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Fernando Lanas, Patricio Lopez-Jaramillo, Priyanka Rohatgi, P V M Lakshmi, Ravi Prasad Varma, Andres Orlandini, Alvaro Avezum, Andreas Wielgosz, Paul Poirier, Majid A Almadi, Yuksel Altuntas, Kien Keat Ng, Jephat Chifamba, Karen Yeates, Thandi Puoane, Rasha Khatib, Rita Yusuf, Kristina Bengtsson Boström, Katarzyna Zatonska
Objective To evaluate the relation between intake of ultra-processed food and risk of inflammatory bowel disease (IBD). Design Prospective cohort study. Setting 21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China). Participants 116 087 adults aged 35-70 years with at least one
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Risks of covid-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform BMJ (IF 39.89) Pub Date : 2021-07-15 Elizabeth J Williamson, Helen I McDonald, Krishnan Bhaskaran, Alex J Walker, Sebastian Bacon, Simon Davy, Anna Schultze, Laurie Tomlinson, Chris Bates, Mary Ramsay, Helen J Curtis, Harriet Forbes, Kevin Wing, Caroline Minassian, John Tazare, Caroline E Morton, Emily Nightingale, Amir Mehrkar, Dave Evans, Peter Inglesby, Brian MacKenna, Jonathan Cockburn, Christopher T Rentsch, Rohini Mathur, Angel
Objective To assess the association between learning disability and risk of hospital admission and death from covid-19 in England among adults and children. Design Population based cohort study on behalf of NHS England using the OpenSAFELY platform. Setting Patient level data were obtained for more than 17 million people registered with a general practice in England that uses TPP software. Electronic
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Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses BMJ (IF 39.89) Pub Date : 2021-07-15 Ting Cai, Lucy Abel, Oliver Langford, Genevieve Monaghan, Jeffrey K Aronson, Richard J Stevens, Sarah Lay-Flurrie, Constantinos Koshiaris, Richard J McManus, F D Richard Hobbs, James P Sheppard
Objective To assess the associations between statins and adverse events in primary prevention of cardiovascular disease and to examine how the associations vary by type and dosage of statins. Design Systematic review and meta-analysis. Data sources Studies were identified from previous systematic reviews and searched in Medline, Embase, and the Cochrane Central Register of Controlled Trials, up to
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Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-07-13 Manuel R Blum, Bastiaan T G M Sallevelt, Anne Spinewine, Denis O’Mahony, Elisavet Moutzouri, Martin Feller, Christine Baumgartner, Marie Roumet, Katharina Tabea Jungo, Nathalie Schwab, Lisa Bretagne, Shanthi Beglinger, Carole E Aubert, Ingeborg Wilting, Stefanie Thevelin, Kevin Murphy, Corlina J A Huibers, A Clara Drenth-van Maanen, Benoit Boland, Erin Crowley, Anne Eichenberger, Michiel Meulendijk
Objective To examine the effect of optimising drug treatment on drug related hospital admissions in older adults with multimorbidity and polypharmacy admitted to hospital. Design Cluster randomised controlled trial. Setting 110 clusters of inpatient wards within university based hospitals in four European countries (Switzerland, Netherlands, Belgium, and Republic of Ireland) defined by attending hospital
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Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence BMJ (IF 39.89) Pub Date : 2021-07-08 Ashley W Blom, Richard L Donovan, Andrew D Beswick, Michael R Whitehouse, Setor K Kunutsor
Objective To determine the clinical effectiveness of common elective orthopaedic procedures compared with no treatment, placebo, or non-operative care and assess the impact on clinical guidelines. Design Umbrella review of meta-analyses of randomised controlled trials or other study designs in the absence of meta-analyses of randomised controlled trials. Data sources Ten of the most common elective
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Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis BMJ (IF 39.89) Pub Date : 2021-07-08 Aidan G Cashin, Thiago Folly, Matthew K Bagg, Michael A Wewege, Matthew D Jones, Michael C Ferraro, Hayley B Leake, Rodrigo R N Rizzo, Siobhan M Schabrun, Sylvia M Gustin, Richard Day, Christopher M Williams, James H McAuley
Objective To investigate the efficacy, acceptability, and safety of muscle relaxants for low back pain. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, CINAHL, CENTRAL, ClinicalTrials.gov, clinicialtrialsregister.eu, and WHO ICTRP from inception to 23 February 2021. Eligibility criteria for study selection Randomised controlled trials of muscle
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Performance of the Innova SARS-CoV-2 antigen rapid lateral flow test in the Liverpool asymptomatic testing pilot: population based cohort study BMJ (IF 39.89) Pub Date : 2021-07-07 Marta García-Fiñana, David M Hughes, Christopher P Cheyne, Girvan Burnside, Mark Stockbridge, Tom A Fowler, Veronica L Fowler, Mark H Wilcox, Malcolm G Semple, Iain Buchan
Objective To assess the performance of the SARS-CoV-2 antigen rapid lateral flow test (LFT) versus polymerase chain reaction testing in the asymptomatic general population attending testing centres. Design Observational cohort study. Setting Community LFT pilot at covid-19 testing sites in Liverpool, UK. Participants 5869 asymptomatic adults (≥18 years) voluntarily attending one of 48 testing sites
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Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-07-06 Rebecca Kearney, Rebecca McKeown, Helen Parsons, Aminul Haque, Nick Parsons, Henry Nwankwo, James Mason, Martin Underwood, Anthony C Redmond, Jaclyn Brown, Siobhan Kefford, Matthew Costa
Objectives To assess function, quality of life, resource use, and complications in adults treated with plaster cast immobilisation versus a removable brace for ankle fracture. Design Multicentre randomised controlled trial. Setting 20 trauma units in the UK National Health Service. Participants 669 adults aged 18 years and older with an acute ankle fracture suitable for cast immobilisation: 334 were
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Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial BMJ (IF 39.89) Pub Date : 2021-07-01 Christopher E Ramsden, Daisy Zamora, Keturah R Faurot, Beth MacIntosh, Mark Horowitz, Gregory S Keyes, Zhi-Xin Yuan, Vanessa Miller, Chanee Lynch, Gilson Honvoh, Jinyoung Park, Russell Levy, Anthony F Domenichiello, Angela Johnston, Sharon Majchrzak-Hong, Joseph R Hibbeln, David A Barrow, James Loewke, John M Davis, Andrew Mannes, Olafur S Palsson, Chirayath M Suchindran, Susan A Gaylord, J Douglas
Objective To determine whether dietary interventions that increase n-3 fatty acids with and without reduction in n-6 linoleic acid can alter circulating lipid mediators implicated in headache pathogenesis, and decrease headache in adults with migraine. Design Three arm, parallel group, randomized, modified double blind, controlled trial. Setting Ambulatory, academic medical center in the United States
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Burden, treatment use, and outcome of secondary mitral regurgitation across the spectrum of heart failure: observational cohort study BMJ (IF 39.89) Pub Date : 2021-06-30 Philipp E Bartko, Gregor Heitzinger, Noemi Pavo, Maria Heitzinger, Georg Spinka, Suriya Prausmüller, Henrike Arfsten, Martin Andreas, Cornelia Gabler, Guido Strunk, Julia Mascherbauer, Christian Hengstenberg, Martin Hülsmann, Georg Goliasch
Objectives To define prevalence, long term outcome, and treatment standards of secondary mitral regurgitation (sMR) across the heart failure spectrum. Design Large scale cohort study. Setting Observational cohort study with data from the Viennese community healthcare provider network between 2010 and 2020, Austria. Participants 13 223 patients with sMR across all heart failure subtypes. Main outcome
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Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data BMJ (IF 39.89) Pub Date : 2021-06-24 Steven H Woolf, Ryan K Masters, Laudan Y Aron
Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations. Design Simulations of provisional mortality data. Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Population Data for the US
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Mobile health and privacy: cross sectional study BMJ (IF 39.89) Pub Date : 2021-06-17 Gioacchino Tangari, Muhammad Ikram, Kiran Ijaz, Mohamed Ali Kaafar, Shlomo Berkovsky
Objectives To investigate whether and what user data are collected by health related mobile applications (mHealth apps), to characterise the privacy conduct of all the available mHealth apps on Google Play, and to gauge the associated risks to privacy. Design Cross sectional study Setting Health related apps developed for the Android mobile platform, available in the Google Play store in Australia
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P2Y12 inhibitor monotherapy or dual antiplatelet therapy after coronary revascularisation: individual patient level meta-analysis of randomised controlled trials BMJ (IF 39.89) Pub Date : 2021-06-16 Marco Valgimigli, Felice Gragnano, Mattia Branca, Anna Franzone, Usman Baber, Yangsoo Jang, Takeshi Kimura, Joo-Yong Hahn, Qiang Zhao, Stephan Windecker, Charles M Gibson, Byeong-Keuk Kim, Hirotoshi Watanabe, Young Bin Song, Yunpeng Zhu, Pascal Vranckx, Shamir Mehta, Sung-Jin Hong, Kenji Ando, Hyeon-Cheol Gwon, Patrick W Serruys, George D Dangas, Eùgene P McFadden, Dominick J Angiolillo, Dik Heg, Peter
Objective To assess the risks and benefits of P2Y12 inhibitor monotherapy compared with dual antiplatelet therapy (DAPT) and whether these associations are modified by patients’ characteristics. Design Individual patient level meta-analysis of randomised controlled trials. Data sources Searches were conducted in Ovid Medline, Embase, and three websites ([www.tctmd.com][1], [www.escardio.org][2], [www
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Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis BMJ (IF 39.89) Pub Date : 2021-06-15 Tommy Nyberg, Katherine A Twohig, Ross J Harris, Shaun R Seaman, Joe Flannagan, Hester Allen, Andre Charlett, Daniela De Angelis, Gavin Dabrera, Anne M Presanis
Objective To evaluate the relation between diagnosis of covid-19 with SARS-CoV-2 variant B.1.1.7 (also known as variant of concern 202012/01) and the risk of hospital admission compared with diagnosis with wild-type SARS-CoV-2 variants. Design Retrospective cohort analysis. Setting Community based SARS-CoV-2 testing in England, individually linked with hospital admission data. Participants 839 278
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Characterising the background incidence rates of adverse events of special interest for covid-19 vaccines in eight countries: multinational network cohort study BMJ (IF 39.89) Pub Date : 2021-06-14 Xintong Li, Anna Ostropolets, Rupa Makadia, Azza Shoaibi, Gowtham Rao, Anthony G Sena, Eugenia Martinez-Hernandez, Antonella Delmestri, Katia Verhamme, Peter R Rijnbeek, Talita Duarte-Salles, Marc A Suchard, Patrick B Ryan, George Hripcsak, Daniel Prieto-Alhambra
Objective To quantify the background incidence rates of 15 prespecified adverse events of special interest (AESIs) associated with covid-19 vaccines. Design Multinational network cohort study. Setting Electronic health records and health claims data from eight countries: Australia, France, Germany, Japan, the Netherlands, Spain, the United Kingdom, and the United States, mapped to a common data model
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Postoperative low molecular weight heparin bridging treatment for patients at high risk of arterial thromboembolism (PERIOP2): double blind randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-06-09 Michael J Kovacs, Philip S Wells, David R Anderson, Alejandro Lazo-Langner, Clive Kearon, Shannon M Bates, Mark Blostein, Susan R Kahn, Sam Schulman, Elham Sabri, Susan Solymoss, Tim Ramsay, Erik Yeo, Marc A Rodger
Objective To determine the efficacy and safety of dalteparin postoperative bridging treatment versus placebo for patients with atrial fibrillation or mechanical heart valves when warfarin is temporarily interrupted for a planned procedure. Design Prospective, double blind, randomised controlled trial. Setting 10 thrombosis research sites in Canada and India between February 2007 and March 2016. Participants
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Effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery: multicentre, double blind, randomised controlled trial BMJ (IF 39.89) Pub Date : 2021-06-02 Karim Asehnoune, Charlene Le Moal, Gilles Lebuffe, Marguerite Le Penndu, Nolwen Chatel Josse, Matthieu Boisson, Thomas Lescot, Marion Faucher, Samir Jaber, Thomas Godet, Marc Leone, Cyrus Motamed, Jean Stephane David, Raphael Cinotti, Younes El Amine, Darius Liutkus, Matthias Garot, Antoine Marc, Anne Le Corre, Alexandre Thomasseau, Alexandra Jobert, Laurent Flet, Fanny Feuillet, Morgane Pere, Emmanuel
Objective To assess the effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery. Design Phase III, randomised, double blind, placebo controlled trial. Setting 34 centres in France, December 2017 to March 2019. Participants 1222 adults (>50 years) requiring major non-cardiac surgery with an expected duration of more than 90 minutes. The anticipated time frame
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Low and very low carbohydrate diets for diabetes remission BMJ (IF 39.89) Pub Date : 2021-05-24 Joshua Z Goldenberg, Bradley C Johnston
Dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse
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Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study BMJ (IF 39.89) Pub Date : 2021-05-25 Jacob Bodilsen, Peter Brønnum Nielsen, Mette Søgaard, Michael Dalager-Pedersen, Lasse Ole Zacho Speiser, Troels Yndigegn, Henrik Nielsen, Torben Bjerregaard Larsen, Flemming Skjøth
Objective To determine the incidence of hospital admissions and associated mortality rates for non-covid medical conditions during the covid-19 pandemic. Design Nationwide, population based cohort study. Setting Denmark from 13 March 2019 to 27 January 2021. Participants All Danish residents >1 year of age. Main outcomes measures Population based healthcare registries that encompass the entire Danish
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