related to drug exposure are NSAIDs, intra-articular corticosteroids, and narcotic use. Noted limitations included the limited ability to adjust for clinical severity and potential residual confounding factors. ConClusions: Gout disease was associated with a 31% increased risk of joint replacement in older adults. Further research is needed to confirm this potential associated risk.
Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved with the aim to provide some recommendations to carry out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2019. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines. We found major issues concerning: completely reproducible search procedures report, specification of the exact method to compute effect sizes, choice of weighting factors and estimators, lack of availability of the raw statistics used to compute the effect size and of interoperability of available data, and practically total absence of analysis script code sharing. Based on our findings, we conclude with recommendations intended to improve the transparency, openness and reproducibility-related reporting practices of meta-analyses in clinical psychology and related areas.
Objectives: Three projects have been implemented to gather the Real World Data (RWD) required to answer to National and Regional decision maker's need of estimating the impact of the introduction of PCSK9 inhibitors on the Italian National Healthcare Service at reimbursement time. MethOds: RWD on PCSK9 eligible patients were collected via thee projects: IFIGENIA (observational study in 10 Italian Local Health Units [LHUs]) on heterozygous familial hypercholesterolemia [HeFH]), CORE (database analysis on secondary prevention [SP] patients), HEALTH SEARCH (database analysis on patients at high and very high risk [HR/vHR] of cardiovascular events [CV]). RWD has been then discussed by a multidisciplinary panel and organized as evidences (RWE). Results: According to IFIGENIA interim results on 3 LHUs, 0,20% of the patients with a LDL-C determination were probable or definite HeFH . Of those, 49% were treated with statins while 16% were treated with statin plus ezetimibe. Approximately half (46%) of HeFH patients were not adherent to statin and nearly all patients(98%) had not reached their LDL-C target according to the Italian Guidelines (NOTA 13). CORE estimated that 40% of patients were not treated with statin and/or ezetimibe within the first year of follow up. One-third (37%) of these SP patients is aged above 80, 38% experienced a new CV hospitalization within 12 months from the first CV event. HEALTH SEARCH highlighted that 69% of HR and 84% of vHR treated patients were not able to reach their LDL-C target. One-half of not at target vHR patients had a LDL-C > 100 mg/dL. cOnclusiOns: RWD is key to decrease the uncertainties within the healthcare decisions. These projects have demonstrated that there is a specific unmet need to be covered by PCSK9 inhibitors. Epidemiological and C-LDL data were key to size the impact of their introduction within the Italian National Healthcare System.
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