This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013–2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines repository, GRADEpro Database, MAGICapp, NICE and WHO websites. Two reviewers will independently screen full texts of the documents identified. The following information will be extracted: methods used for identifying different stakeholders and incorporating their perspectives; methods for identification and prioritization of non-health outcomes; methods for determining thresholds for decision-making; methods for incorporating and grading evidence from non-randomized studies; methods for addressing concerns with conditional recommendations in public health; methods for reaching consensus; additional methodological concerns; and any modifications made to GRADE. A combination of directed content analysis and descriptive statistics will be used for data analysis, and the findings presented narratively in a tabular and graphical form. In this protocol, we present the pilot results from 13 identified eligible guidelines issued between January and August 2021. We will publish the full review results when they become available.
AimTo facilitate the development of a COVID-19 predictive model in Croatia by analyzing three different methodological approaches.Method We used the historical data to explore the fit of the extended SEIRD compartmental model, the Heidler function, an exponential approximation in analyzing electromagnetic phenomena related to lightning strikes, and the Holt-Winters smoothing (HWS) for short-term epidemic predictions. We also compared various methods for the estimation of R0. ResultsThe R0 estimates for Croatia varied from 2.09 (95% CI 1.77-2.40) obtained by using an empirical post-hoc method to 2.28 (95% CI 2.27-2.28) when we assumed an exponential outbreak at the very beginning of the COVID-19 epidemic in Croatia. Although the SEIRD model provided a good fit for the early epidemic stages, it was outperformed by the Heidler function fit. HWS achieved accurate short-term predictions and depended the least on model entry parameters. Neither model performed well across the entire observed period, which was characterized by multiple wave-form events, influenced by the re-opening for the tourist season during the summer, mandatory masks use in closed spaces, and numerous measures introduced in retail stores and public places. However, an extension of the Heidler function achieved the best overall fit.Conclusions Predicting future epidemic events remains difficult because modeling relies on the accuracy of the information on population structure and micro-environmental exposures, constant changes of the input parameters, varying societal adherence to anti-epidemic measures, and changes in the biological interactions of the virus and hosts.
Aims To investigate the association between socioeconomic status and psychological distress measured by the General health questionnaire (GHQ-30) with all-cause mortality, cardiovascular mortality and cancer mortality on the Croatian island of Vis. Methods This population-based cohort consisted of 1,025 subjects (426 men and 599 women), who were followed up for 18 years or a total of 5.8 million days. The causes of death were extracted from the Croatian National Institute of Public Health database. We calculated the adjusted hazard ratios, with subjective material status, years of schooling and a composite household material status used as estimates of socioeconomic status. Results There were 279 cases of death (27.2%). Socioeconomic status and psychological distress did not predict either the specific or the all-cause mortality risk. In addition, the interaction between socioeconomic variables and psychological distress also did not yield a significant hazard ratio in all three instances (all-cause, cardiovascular or tumour mortality). Conclusions These results confirm previous reports of the high level of social equality in the population of the island of Vis. Small and isolated communities may experience a lesser extent of social inequalities in health.
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