Project description:The application of serum creatinine and cystatin C in patients with CKD has been limited to using estimated glomerular filtration rate (eGFR). Criteria for choosing the best GFR estimating equation are 1) accuracy in estimating measured GFR, 2) optimal discrimination of clinical outcomes, and 3) association with CKD risk factors and outcomes similar to that of measured GFR. Notably, these criteria are often not in agreement; and while the last criterion is the most important, it has been widely overlooked. The primary problem with eGFR is that the non-GFR determinants of serum creatinine and cystatin C, as well as their surrogates (age, sex, and race), associate with CKD risk factors and outcomes. This leads to a distorted understanding of CKD, though eGFR based on serum creatinine appears to be less biased than eGFR based on cystatin C. Because of this problem, the use of eGFR should be limited to settings where knowing actual GFR is relevant and eGFR is more informative about GFR than serum creatinine or cystatin C alone. Such settings include staging CKD severity by GFR and dosing medications cleared by glomerular filtration. Alternatively, the diagnosis of CKD, the longitudinal progression of CKD, and prognostic models for CKD are settings where serum creatinine and cystatin C can be better applied and interpreted without eGFR.
Project description:BackgroundFactors associated with the survival of truth of clinical conclusions in the medical literature are unknown. We hypothesized that publications with a first author having a higher Hirsch' index value (h-I), which quantifies and predicts an individual's scientific research output, should have a longer half-life.Methods and results474 original articles concerning cirrhosis or hepatitis published from 1945 to 1999 were selected. The survivals of the main conclusions were updated in 2009. The truth survival was assessed by time-dependent methods (Kaplan Meier method and Cox). A conclusion was considered to be true, obsolete or false when three or more observers out of the six stated it to be so. 284 out of 474 conclusions (60%) were still considered true, 90 (19%) were considered obsolete and 100 (21%) false. The median of the h-I was=24 (range 1-85). Authors with true conclusions had significantly higher h-I (median=28) than those with obsolete (h-I=19; P=0.002) or false conclusions (h-I=19; P=0.01). The factors associated (P<0.0001) with h-I were: scientific life (h-I=33 for>30 years vs. 16 for<30 years), -methodological quality score (h-I=36 for high vs. 20 for low scores), and -positive predictive value combining power, ratio of true to not-true relationships and bias (h-I=33 for high vs. 20 for low values). In multivariate analysis, the risk ratio of h-I was 1.003 (95%CI, 0.994-1.011), and was not significant (P=0.56). In a subgroup restricted to 111 articles with a negative conclusion, we observed a significant independent prognostic value of h-I (risk ratio=1.033; 95%CI, 1.008-1.059; P=0.009). Using an extrapolation of h-I at the time of article publication there was a significant and independent prognostic value of baseline h-I (risk ratio=0.027; P=0.0001).ConclusionsThe present study failed to clearly demonstrate that the h-index of authors was a prognostic factor for truth survival. However the h-index was associated with true conclusions, methodological quality of trials and positive predictive values.
Project description:Online studies enable researchers to recruit large, diverse samples, but the nature of these studies provides an opportunity for applicants to misrepresent themselves to increase the likelihood of meeting eligibility criteria for a trial, particularly those that provide financial incentives. This study describes rates of fraudulent applications to an online intervention trial of an Internet intervention for insomnia among older adults (ages ≥55). Applicants were recruited using traditional (e.g., flyers, health providers), online (e.g., Craigslist, Internet searches), and social media (e.g., Facebook) recruitment methods. Applicants first submitted an interest form that included identifying information (name, date of birth, address). This data was then queried against a national database (TransUnion's TLOxp) to determine the application's verification status. Applications were determined to be verified (i.e., information from interest form matched TLOxp report), potentially fraudulent (i.e., potential discrepancy in provided information on interest form versus TLOxp report), or fraudulent (i.e., confirmed discrepancy). Of 1766 total interest forms received, 125 (7.08%) were determined to be fraudulent. Enrollment attempts that were fraudulent were detected among 12.22% of applicants who reported learning of the study through online, 7.04% through social media, 4.58% through traditional, and 4.27% through other methods. Researchers conducting online trials should take precautions, as applicants may provide fraudulent information to gain access to their studies. Reviewing all applications and verifying the identities and eligibility of participants is critical to the integrity of online research trials.
Project description:The strong association between self-reported sleep difficulties and depressive symptoms is well documented. However, individuals who suffer from depressive symptoms could potentially interpret the values attached to a subjective scale differently from others, making comparisons of sleep difficulties across individuals with different depressive symptoms problematic. The objective of this study is to determine the existence and magnitude of reporting heterogeneity in subjective assessment of sleep difficulties by those who have depressive symptoms. We implement an online survey using Visual Analogue Scales and anchoring vignettes to study the comparability of subjective assessments of sleep difficulties among college students in Switzerland (N = 1, 813). Using multivariate linear regressions and double-index models, our analysis shows that reporting heterogeneity plays only a marginal role in moderating the association between sleep difficulties and depression, irrespective of the severity of the depressive symptoms of the individuals. This suggests that unadjusted comparisons of self-reported sleep difficulties between college students are meaningful, even among individuals with depressive symptoms.
Project description:People believe information more if they have encountered it before, a finding known as the illusory truth effect. But what is the evidence for the generality and pervasiveness of the illusory truth effect? Our preregistered systematic map describes the existing knowledge base and objectively assesses the quality, completeness and interpretability of the evidence provided by empirical studies in the literature. A systematic search of 16 bibliographic and grey literature databases identified 93 reports with a total of 181 eligible studies. All studies were conducted at Western universities, and most used convenience samples. Most studies used verbatim repetition of trivia statements in a single testing session with a minimal delay between exposure and test. The exposure tasks, filler tasks and truth measures varied substantially across studies, with no standardisation of materials or procedures. Many reports lacked transparency, both in terms of open science practices and reporting of descriptive statistics and exclusions. Systematic mapping resulted in a searchable database of illusory truth effect studies ( https://osf.io/37xma/ ). Key limitations of the current literature include the need for greater diversity of materials as stimuli (e.g., political or health contents), more participants from non-Western countries, studies examining effects of multiple repetitions and longer intersession intervals, and closer examination of the dependency of effects on the choice of exposure task and truth measure. These gaps could be investigated using carefully designed multi-lab studies. With a lack of external replications, preregistrations, data and code, verifying replicability and robustness is only possible for a small number of studies.
Project description:This introductory article frames our special issue in terms of how historicizing research integrity and fraud can benefit current discussions of scientific conduct and the need to improve public trust in science.
Project description:The Clinical Research Networks of the National Institute of Health Research have transformed clinical research in the UK, leading to a doubling in the number of patients involved in clinical research studies over the past 3 years. This has been achieved by streamlining the trials approvals process, by providing local infrastructure such as research nurse support for clinical trials recruitment and through recognition of the time and funding necessary for clinicians to contribute to clinical research. Here, we describe the structure and roles of the Comprehensive Clinical Research Networks in gastrointestinal disease and hepatology, particularly in England. We will explain how the networks have already accelerated clinical research in gastrointestinal and liver disease, as well as provide a simple guide about how individual clinicians can contribute to ongoing studies via the networks.
Project description:Despite the considerable amount of research devoted to understanding fraud, few studies have examined how the physical environment can influence the likelihood of committing fraud. One recent study found a link between room brightness and occurrence of human fraud behaviors. Therefore, the present study aims to investigate how temperature may affect fraud. Based on a power analysis using the effect size observed in a pilot study, we recruited 105 participants and randomly divided them into three temperature groups (warm, medium, and cool). We then counted fraud behaviors in each group and tested for potential significant differences with a Kruskal-Wallis test. Additionally, we used a correlation analysis to determine whether the perceived temperature affected fraud. As a result, regardless of participants' subjective sensory experience or their physical environment, we did not find that temperature-related factors influence the incidence of fraud. We discussed the potential reason for the results and suggested directions for future research.
Project description:The moral aspects of genetic counselling are explored in situations where the outcome of a DNA test does not lead to certain knowledge. The most frequent type of interaction between counsellor and counsellee is when factual information is given, but sometimes "factual" information is difficult to obtain. How do counsellors deal with "uncertain" knowledge in genetics? Arguments and assumptions are presented and the finding of a 27 CAG repeat in the Huntington gene is used as an example. However, the questions "how far does the duty to inform reach?" and "to what extent is the doctor responsible?" are important in the whole field of genetics, and will be even more important in the future. The aims of science and clinical practice are discussed; we conclude that counsellors run the risk of taking on an infinite responsibility.