Background The increasing use of preprints to disseminate evidence on the effect of interventions for the coronavirus disease 2019 (COVID-19) can lead to multiple evidence sources for a single study, which may differ in the reported evidence. We aim to describe the proportion of evidence on the effect of interventions for COVID-19 from preprints and journal articles and map changes in evidence between and within different sources reporting on the same study. Methods Meta-research study. We screened the Cochrane living systematic review and network meta-analysis (COVID-NMA) database to identify all preprints and journal articles on all studies assessing interventions for COVID-19 published up to 15 August 2020. We compared all evidence sources (i.e., preprint and associated journal article) and the first and latest versions of preprints for each study to identify changes in two evidence components: study results (e.g., numeric change in hazard ratio, odds ratio, event rate, or change in p value > or < 0.05 in any outcome) and abstract conclusions (classified as positive, negative or neutral regarding the intervention effect, and as reporting uncertainty in the findings or not). Changes in study results were further classified as important changes if they (1) represented a change in any effect estimate by ≥ 10% and/or (2) led to a change in the p value crossing the threshold of 0.05. Results We identified 556 studies. In total, 338 (61%) had been reported in a preprint: 66 (20%) of these had an associated journal article (median time to publication 76 days [interquartile range (IQR) 55–106]) and 91 (27%) had > 1 preprint version. A total of 139 studies (25% of the overall sample) were reported in multiple evidence sources or versions of the same source: for 63 (45%), there was a change in at least one evidence component between or within sources (42 [30%] had a change in study results, and in 29 [21%] the change was classified as important; 33 [24%] had a change in the abstract conclusion). For studies with both a preprint and an article, a median of 29% (IQR 14–50) of total citations were attributed to the preprint instead of the article. Conclusions Results on the effect of interventions for COVID-19 are often reported in multiple evidence sources or source versions for a single study. Evidence is not stable between and within evidence sources. Real-time linkage of all sources per study could help to keep systematic reviews up-to-date.
Preprints promote the open and fast communication of non-peer reviewed work. Once a preprint is published in a peer-reviewed venue, the preprint server updates its web page: a prominent hyperlink leading to the newly published work is added. Linking preprints to publications is of utmost importance as it provides readers with the latest version of a now certified work. Yet leading preprint servers fail to identify all existing preprint–publication links. This limitation calls for a more thorough approach to this critical information retrieval task: overlooking published evidence translates into partial and even inaccurate systematic reviews on health-related issues, for instance. We designed an algorithm leveraging the Crossref public and free source of bibliographic metadata to comb the literature for preprint–publication links. We tested it on a reference preprint set identified and curated for a living systematic review on interventions for preventing and treating COVID-19 performed by international collaboration: the COVID-NMA initiative (covid-nma.com). The reference set comprised 343 preprints, 121 of which appeared as a publication in a peer-reviewed journal. While the preprint servers identified 39.7% of the preprint–publication links, our linker identified 90.9% of the expected links with no clues taken from the preprint servers. The accuracy of the proposed linker is 91.5% on this reference set, with 90.9% sensitivity and 91.9% specificity. This is a 16.26% increase in accuracy compared to that of preprint servers. We release this software as supplementary material to foster its integration into preprint servers’ workflows and enhance a daily preprint–publication chase that is useful to all readers, including systematic reviewers. This preprint–publication linker currently provides day-to-day updates to the biomedical experts of the COVID-NMA initiative.
Background Researchers worldwide are actively engaging in research activities to search for preventive and therapeutic interventions against COVID-19. Our aim was to describe the planning of randomized controlled trials (RCTs) in terms of timing related to the course of the COVID-19 epidemic and research question evaluated. Method We performed a living mapping of RCTs registered in the WHO International Clinical Trials Registry Platform. We systematically search the platform every week for all RCTs evaluating preventive interventions and treatments for COVID-19 and created a publicly available interactive mapping tool at https://covid-nma.com to visualize all trials registered. Results By August 12, 2020, 1,568 trials for COVID-19 were registered worldwide. Overall, the median ([Q1-Q3]; range) delay between the first case recorded in each country and the first RCT registered was 47 days ([33-67]; 15-163). For the 9 countries with the highest number of trials registered, most trials were registered after the peak of the epidemic (from 100% trials in Italy to 38% in the United States). Most trials evaluated treatments (1,333 trials; 85%); only 223 (14%) evaluated preventive strategies and 12 post-acute period intervention. A total of 254 trials were planned to assess different regimens of hydroxychloroquine with an expected sample size of 110,883 patients. Conclusion This living mapping analysis showed that COVID-19 trials have relatively small sample size with certain redundancy in research questions. Most trials were registered when the first peak of the pandemic have passed.
BackgroundThe Migraine Disability Assessment (MIDAS) Questionnaire is a reliable and valid instrument for migraine-related disability. Such a tool is needed to quantify migraine-related disability in the Greek population.ObjectiveThis validation study aims to assess the test–retest reliability, internal consistency, item discriminant and convergent validity of the Greek translation of the MIDAS.MethodsAdults diagnosed with migraine completed the MIDAS Questionnaire on two occasions 3 weeks apart to assess reliability, and completed the RAND-36 to assess validity.ResultsParticipants (n = 152) had a median MIDAS score of 24 and mostly severe disability (58% were grade IV). The test–retest reliability analysis (N = 59) revealed excellent reliability for the total score. Internal consistency was α = 0.71 for initial and α = 0.82 for retest completion. For item discriminant validity, the correlations between each question and the total score were significant, with high correlations for questions 2–5 (range 0.67 ≤ r ≤ 0.79; p < 0.01). For convergent validity, there was significant negative correlation between the total score and all RAND-36 subscales except for ‘emotional wellbeing’. The negative correlation indicates that patients with a lower degree of disability according to their MIDAS score tended to have better wellbeing. Psychometric properties are comparable with those of other published validation studies of the MIDAS and the original. Findings on question 1 show that missing work/school days may be closely related with increased affect issues.ConclusionThe Greek version of the MIDAS Questionnaire has good reliability and validity. This study allowed for cross-cultural comparability of research findings.
IMPORTANCEThe COVID-19 pandemic led to the implementation of alternative care modalities (eg, teleconsultations and task shifting) that will continue to be implemented in parallel to traditional care after the pandemic. An ideal balance between alternative and traditional care modalities is unknown.OBJECTIVES To quantify the ideal postpandemic balance between alternative and traditional care modalities among patients with chronic illness and to qualify the circumstances in which patients consider it appropriate to replace traditional care with alternative care. DESIGN, SETTING, AND PARTICIPANTSThis survey study invited 5999 adults with chronic illness in ComPaRe, a French nationwide e-cohort of adults with chronic conditions who volunteer their time to participate in research projects, to participate in this study, which was performed from January 27 to February 23, 2021. MAIN OUTCOMES AND MEASURESParticipants rated the ideal proportion at which they would use 3 alternative care modalities instead of the traditional care equivalent on a 0% to 100% scale (with 0% indicating using alternative care modalities for none of one's future care and 100% indicating using alternative care modalities for all of one's future care) of their overall future care: (1) teleconsultations, (2) online symptom-checkers to react to new symptoms, and (3) remote monitoring to adapt treatment outside consultations. The median ideal proportion of alternative care use was calculated. Perceived appropriate circumstances in which each alternative modality could replace traditional care were collected with open-ended questions. Analyses were performed on a weighted data set representative of patients with chronic illness in France. RESULTS Of the 5999 invited individuals, 1529 (mean [SD] age, 50.3 [14.7] years; 1072 [70.1%]female) agreed to participate (participation rate, 25.5%). Participants would choose teleconsultations for 50.0% of their future consultations (IQR, 11.0%-52.0%), online symptomcheckers over contacting their physician for 22.0% of new symptoms (IQR, 2.0%-50.0%), and remote monitoring instead of consultations for 52.3% of their treatment adaptations (IQR, 25.4%-85.4%). Participants reported 67 circumstances for which replacing traditional with alternative care modalities was considered appropriate, including 31 care activities (eg, prescription renewal and addressing acute or minor complaints), 25 patient characteristics (eg, stable chronic condition and established patient-physician relationship), and 11 required characteristics of the alternative care modalities (eg, quality assurance). CONCLUSIONS AND RELEVANCEResults of this survey study suggest that after the pandemic, patients would choose alternative over traditional care for 22% to 52% of the time across different care needs. Participants proposed 67 criteria to guide clinicians in replacing traditional care with (continued) Key Points Question What is an ideal balance between alternative care modalities implemented during the COVID-19 pandemic and traditional care in...
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