Qualitative studies are needed to better understand the attitude of health professionals when prescribing PPIs.

The use of predictive models is becoming widespread. However, these models should be developed appropriately (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies [CHARMS] and Prediction model Risk Of Bias ASsessment Tool [PROBAST] statements). Concerning mortality/recurrence in oropharyngeal cancer, we are not aware of any systematic reviews of the predictive models. We carried out a systematic review of the MEDLINE/EMBASE databases of those predictive models. In these models, we analyzed the 11 domains of the CHARMS statement and the risk of bias and applicability, using the PROBAST tool. Six papers were finally included in the systematic review and all of them presented high risk of bias and several limitations in the statistical analysis. The applicability was satisfactory in five out of six studies. None of the models could be considered ready for use in clinical practice.

Introduction Predictive models must meet clinical/methodological standards to be used in clinical practice. However, no critique of those models relating to mortality/recurrence in tongue cancer has been done bearing in mind the accepted standards. Methods We conducted a systematic review evaluating the methodology and clinical applicability of predictive models for mortality/recurrence in tongue cancer published in MEDLINE and Scopus. For each model, we analysed (domains of CHARMS, Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) the following: source of data, participants, outcome to be predicted, candidate predictors, sample size, missing data, model development, model performance, model evaluation, results and interpretation and discussion. Results We found two papers that included eight prediction models, neither of which adhered to the CHARMS recommendations. Conclusion Given the quality of tongue cancer models, new studies following current consensus are needed to develop predictive tools applicable in clinical practice.

Background Clustering of cardiovascular risk factors (CVRFs) is extraordinarily common and is associated with an increased risk of cardiovascular disease (CVD). However, the particular impact of the sum of CVRFs on cardiovascular morbidity and mortality has not been sufficiently explored in Europe. Objective The aim of this study was to analyze the differences in survival-free probability of CVD in relation to the number of CVRFs in a Spanish population. Methods A prospective cohort study was conducted from 1992 to 2016 in a Spanish population that included 1144 subjects with no history of CVD (mean age, 46.7 years) drawn from the general population. We calculated the number of CVRFs for each subject (male sex, smoking, diabetes, hypertension, dyslipidemia, obesity, and left ventricular hypertrophy). Cardiovascular morbidity and mortality records were collected, and survival analysis was applied (competing risk models). Results There were 196 cardiovascular events (17.1%). The differences in total survival-free probability of cardiovascular morbidity and mortality of the different values of the sum of CVRFs were significant, increasing the risk of CVD (hazard ratio, 1.30; 95% confidence interval, 1.13–1.50) per each additional risk factor. Conclusion Differences in survival-free probability of CVD in relation to the number of CVRFs present were statistically significant. Further studies are needed to corroborate our results.

Background: A reliability generalization study of a questionnaire is necessary to provide higher-level evidence for its reliability. This has not been performed for the Victorian Institute of Sport Assessment–Achilles tendinopathy (VISA-A) questionnaire. The VISA-A has been a commonly used questionnaire to evaluate the symptoms of Achilles tendon disorders and their impact on physical activity, one of the most common disorders among athletes and sports persons (9%-40%). Furthermore, this questionnaire has been translated to several languages and due to its simplicity is one of the most widely used questionnaires for patients with this type of disorder. Therefore, we performed a reliability generalization study of the VISA-A using MEDLINE (through PubMed) and Scopus as data sources. Methods: We selected studies that analyzed the reliability of the VISA-A by evaluating Cronbach’s alpha, the intraclass correlation coefficient (ICC), and the Spearman correlation coefficients to compare VISA-A with similar scales. The data were analyzed using fixed- and random-effects models. We assessed sensitivity through the leave-one-out method. Quality analysis was performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results: Of a total of 263 studies (eliminating duplicates), 7 fulfilled inclusion criteria. The mean reliability was (1) Cronbach’s alpha, 0.75 (95% CI, 0.70-0.79); (2) ICC, 0.91 (95% CI, 0.82-0.96); (3) correlation coefficient with the Curwin and Stanish grading system, –0.82 (95% CI, −0.93 to −0.56); and (4) correlation coefficient with the Percy and Conochie classification, 0.91 (95% CI, 0.87-0.93). We were unable to perform the funnel plot analysis and estimate meta-regression models. The Spearman correlation coefficients for both comparative scales showed influential studies (sensitivity analysis). Conclusion: Internal consistency and reproducibility were found to be good, but the parallel-forms reliability could not be supported. Therefore, more scientific evidence is needed to generalize the reliability of the VISA-A. Level of Evidence: Level I, meta-analysis of literature.