Journal of clinical epidemiology
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The American College of Chest Physicians Antithrombotic Guidelines ninth iteration placed restrictions on panelists with recommendations on which they disclosed a primary conflict of interest (COI). We aimed to describe panelists' financial and intellectual COI and evaluate to what extent, beyond assessing financial COI, assessing intellectual COI affected COI management. ⋯ COI had a relatively low prevalence and a skewed distribution, many panelists with none and some with many disclosures. A substantial number of disclosures should have resulted in restrictions based on intellectual COI in the absence of financial COI.
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Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. ⋯ The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
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Randomized Controlled Trial
The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains.
Proxy measures are an alternative source of data for care home residents who are unable to complete the health utility measure, but the agreement levels between residents and care home staff for the EQ-5D have not been investigated previously. The objective of the present study was to examine the inter-rater agreement levels for the reporting of EQ-5D by care home residents and staff, adjusting for the impact of clustering. ⋯ Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered.
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Review
Lack of blinding of outcome assessors in animal model experiments implies risk of observer bias.
To examine the impact of not blinding outcome assessors on estimates of intervention effects in animal experiments modeling human clinical conditions. ⋯ Lack of blinding of outcome assessors in animal model experiments with subjective outcomes implies a considerable risk of observer bias.
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Prognostication is difficult in a diverse patient population or when outcomes depend on multiple factors. This study derived and internally validated a model to predict risk of death from any cause within 1 year of admission to hospital. ⋯ Routinely collected administrative data can be used to accurately predict 1-year death risk in adults admitted to nonpsychiatric hospital services.