Journal of clinical epidemiology
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Clinical Trial Observational Study
The adapted Zelen was a feasible design to trial exercise in myeloma survivors.
We used a method rarely seen in cancer behavioral trials to explore methods of overcoming difficulties often seen in randomized controlled trials. We report our experiences of the adapted Zelen design, so that other researchers can consider this approach for behavioral trials. ⋯ Future use of this design warrants careful consideration of the study resources and recruitment time frames required but holds potential value in reducing contamination, control group dissatisfaction, and resulting dropout. Adapted Zelen design reduces selection bias and therefore gives clinicians a better understanding of acceptability in clinical settings. Future studies should evaluate control group experiences of the design and formally record contamination throughout the study to confirm its acceptability.
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The objective of this study is to describe agreement between administrative and self-report data on the number and type of chronic conditions (CCs) and determine whether associations between CC count and health service use differ by data source. ⋯ Agreement on the number of CCs was low and resulted in different estimates on the association with health service use, illustrating the challenges in CC measurement and the ability to interpret the effects on outcomes.
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We assessed whether guidelines published by organizations based in the United States comply with published criteria for the use of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. ⋯ Approximately one in three US-based organizations developing evidence-based guidelines report the use of GRADE, but adherence to published criteria is inconsistent. As uptake of the GRADE approach increases in the United States, continued efforts to train guideline methodologists and panel members are important.
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The objective of the study was to compare multimorbidity prevalence using self-reported and administrative data and identify factors associated with agreement between data sources. ⋯ A better understanding is needed of what factors influence individuals' reporting of CCs and how they align with what is in administrative data as policy makers need a solid evidence base on which to make decisions for health planning. Our results suggest that data sources may need to be triangulated to provide accurate estimates of multimorbidity for health services planning and policy.