Public Health Commons^™

Predicting Important Patient-Reported Outcomes For Glaucoma Management: Cross-Sectional Study, Lavanya Uruthiramoorthy

Electronic Thesis and Dissertation Repository

The initiative to understand patient-reported outcomes (PROs) has increased to improve glaucoma management. We sought to identify important predictors of four PROs: social support and community integration, presence of depressive symptoms, vision-related quality of life (VRQoL) and preference-based Health-Related quality of life (HRQoL). A cross-sectional study was conducted among patients in London, Ontario (n=250). Regression models, and classification and regression trees were built. Leave-one-out cross-validation assessed the models’ predictive performance. Mobility aid use, best corrected visual acuity (BCVA), income and living arrangements were predictors identified for VRQoL, and social support and community integration. Mobility aid use was also predictive of …

Cognition And Motor Function: A Novel Outcome Measure For Studies On Pre-Dementia Syndromes, Jacqueline K. Kueper

Electronic Thesis and Dissertation Repository

Advances in dementia research have shifted attention towards earlier stages in the natural history, such as Mild Cognitive Impairment. The current gold standard outcome measure, the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, is not optimally responsive to changes in pre-dementia populations. Modifications to scoring methodology and content have improved the measurement performance of the ADAS-Cog. However, no published modifications have addressed a second key shift in the field towards understanding motor function as an important component of dementia and pre-dementia syndromes. This thesis used a Pooled Index approach to combine an ADAS-Cog-Proxy measure with assessments of gait velocity and dual-task cost. …

Reducing Distortion – Identifying Areas To Improve The Quality Of Randomized Clinical Trials Published In Anesthesiology Journals, Jeffrey T.Y. Chow

Electronic Thesis and Dissertation Repository

Randomized clinical trials (RCTs) provide important evidence to inform clinical decision making; if these trials are of low quality, the resulting clinical decision will likely also be of low quality. The main purpose of this thesis was to conduct a series of methodological surveys that would identify potential areas of improvement in the quality of reporting for RCTs published in anesthesiology journals. Trial registration adequacy, adherence to CONSORT for Abstracts guidelines, and sample size calculation quality were all assessed, with a final chapter exploring the effect of industry funding on these methodological quality measures. While the results suggest improvement over …

Evidence Reversal: An Exploratory Analysis Of Randomized Controlled Trials From The New England Journal Of Medicine, Riaz G. Qureshi

Electronic Thesis and Dissertation Repository

BACKGROUND: Evidence Reversal (ER) is the phenomenon whereby new and stronger evidence contradicts previously established evidence.

OBJECTIVES: To quantify evidence reversals and to determine characteristics associated with reversibility.

METHODS: Original articles from the New England Journal of Medicine (2000 to 2016) were screened for three inclusion criteria: tested a clinical practice; Randomized Controlled Trial design; and tested an established clinical practice. The proportion of RCTs that represented ER was determined. Association of trial characteristics with reversal was explored using logistic regression in order to inform a potential framework of reversibility.

RESULTS: In total, 611 RCTs met the inclusion criteria, of …