Background and Objectives: Filtering the deluge of new research to facilitate evidence synthesis has proven to be unmanageable using current paradigms of search and retrieval. Crowdsourcing, a way of harnessing the collective effort of a ''crowd'' of people, has the potential to support evidence synthesis by addressing this information overload created by the exponential growth in primary research outputs. Cochrane Crowd, Cochrane's citizen science platform, offers a range of tasks aimed at identifying studies related to health care. Accompanying each task are brief, interactive training modules, and agreement algorithms that help ensure accurate collective decisionmaking.The aims of the study were to evaluate the performance of Cochrane Crowd in terms of its accuracy, capacity, and autonomy and to examine contributor engagement across three tasks aimed at identifying randomized trials.Study Design and Setting: Crowd accuracy was evaluated by measuring the sensitivity and specificity of crowd screening decisions on a sample of titles and abstracts, compared with ''quasi gold-standard'' decisions about the same records using the conventional methods of dual screening. Crowd capacity, in the form of output volume, was evaluated by measuring the number of records processed by the crowd, compared with baseline. Crowd autonomy, the capability of the crowd to produce accurate collectively derived decisions without the need for expert resolution, was measured by the proportion of records that needed resolving by an expert.Results: The Cochrane Crowd community currently has 18,897 contributors from 163 countries. Collectively, the Crowd has processed 1,021,227 records, helping to identify 178,437 reports of randomized controlled trials (RCTs) for Cochrane's Central Register of Controlled Trials. The sensitivity for each task was 99.1% for the RCT identification task (RCT ID), 99.7% for the RCT identification task of trials
A pilot program was implemented to assess the feasibility of emergency department (ED) preexposure prophylaxis (PrEP) referral. Of 119 eligible patients approached and assessed, 39 (33%) expressed interest and were referred to peer navigators. Of these, 16 (41%) scheduled for appointments; four (10%) initiated PrEP, which demonstrated ED-based PrEP referral was feasible.
increased CT and/or NG risk (aHR=1.03, p<0.001), and men reporting having sex in exchange for money at screening were 2.35 times more likely to be infected (p=0.072). Number of sex partners, sexual positioning, condom use, lubricant use, and self-reported PrEP adherence were not associated with infection. Conclusion The incidence of urethral CT/NG infection was high in our cohort of MSM taking PrEP, despite risk reduction counselling and repeated testing and treatment, supporting need for ongoing etiologic testing and more effective risk reduction intervention. Additional analyses will examine risk compensation. Disclosure No significant relationships.
BackgroundOver the last 15 years the rapid development of an armoury of biological drugs has revolutionised the management of inflammatory arthritis and other rheumatological conditions1. In the past Rheumatology inpatient wards were largely occupied with patients with difficult rheumatoid arthritis and associated extra-articular disease, with little option bar synthetic DMARDS, corticosteroid, respite and physiotherapy.ObjectivesIn 1996 we audited inpatient services for the month of February within the Belfast Rheumatology Unit and a report was issued as a result of this to help plan service development. Twenty years later we repeated the audit.MethodsWe audited the inpatient admissions between 5th October 2015 and 5th November 2015. Data was collected contemporaneously by reviewing the medical notes whilst the patients remained on the ward and any omissions filled in retrospectively using our local database NIECR. Information collected included age, gender, method of admission, diagnosis on discharge, duration of admission, procedures carried out, allied health professionals inputting, radiology services required and onward referral as inpatient to other specialities. We compared this to the audit report from 1995.ResultsThe audit discovered that there was some similarities between the two eras including:1) Inpatients remain predominantly female – 77% in February 1996 compared with 88% in October 2015.2) Emergency admissions remain in the minority – 17% in February 1996 compared with 25% in October 2015.3) 59 patients were admitted to the ward in February 1996 compared with 44 in October 2015.4) The mean age of our inpatients was 56 years. The commonest age interval in 1996 in both males and females was 45–64.Conversely there are a few notable differences including;1) In 1996 there were 44 beds in the department compared with 16 beds currently.2) In 2015 21/44 patients were elective admissions to the ward for administration of Iloprost or Flolan. Other common reasons for admission included multiple joint injections (5/44) and flares of inflammatory arthritis (4/44). In 1996, 23/49 patients were admitted for the management of flares of inflammatory arthritis. This represents a 38% reduction in admissions for disease flares.3) Less patients required access to the multidisciplinary team (MDT). In 1996 85% of patients were reported to access inpatient physiotherapy, compared with 52% in 2015. 80% of patients in 1996 were said to access OT, but it was 18% in 2015.4) The mean length of stay in 1996 was 11.8 days, compared with 7.1 days in 2015.ConclusionsOur ward serves a comparable number of patients nowadays, as it did in 1996. However the inpatient population has certainly evolved. Better treatments for inflammatory arthritis have reduced the number of admissions to manage flares. Those patients that are admitted, stay for a shorter time and require less MDT input, perhaps due to less acquired disability.ReferencesKatherine S. Upchurch and Jonathan Kay. Evolution of treatment for rheumatoid arthritis Rheumatology 2...
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