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Indicators for effective glaucoma care coverage in adults: protocol for a scoping review

Por: Matayan · E. Y. · Burn · H. · Gordon · I. · Evans · J. · Toews · I. · Ramke · J. · Burton · M. J. · Philippin · H. · Mtuy · T. · Hu · V. H.
Introduction

Glaucoma is the leading cause of irreversible blindness worldwide and the number of people with glaucoma is expected to increase to more than 112 million by the year 2040, making it a disease of public health interest. However, there is no consensus on public health indicators to monitor glaucoma care coverage. This scoping review aims to summarise published indicators for monitoring effective glaucoma care coverage globally, focusing on care needs, use of care services and outcomes achieved.

Methods and analysis

We will include studies that report the development and use of public health indicators for effective glaucoma care coverage in patients aged 18 years and older. Studies published from 1 January 2000, in all languages, will be included, provided they can be accurately and easily translated into English using Google Translate. Searches will be conducted by an information specialist on MEDLINE, Embase, Global Health and CENTRAL in the Cochrane Library. Two reviewers working independently will screen the search results, select studies for inclusion and extract data; any disagreements will be discussed with or resolved by a third reviewer. Data will be presented in tabular form, followed by a narrative synthesis based on the review objectives.

Ethics and dissemination

Ethical approval is not required as the review will use published data. Results will be published in a peer-reviewed journal, and summarised results will be available and contribute to the development of standardised glaucoma care indicators.

Registration

OSF registration on 19 May 2025: https://osf.io/zsyw9/

Survival and factors associated with mortality among people with tuberculosis in Medellin, Colombia (2018-2023): a retrospective cohort study

Objective

To determine the survival rate and prognostic factors associated with tuberculosis (TB) mortality in Medellín between 2018 and 2023.

Design

Quantitative observational analytical study of a retrospective cohort.

Setting

Based on notifications made to the Public Health Surveillance System and managed by the Secretary of Health of Medellín—Colombia between 2018 and 2023.

Participants

A total of 11 202 individuals diagnosed with TB, aged between 1 and 103 years.

Primary and secondary outcome measures

The Kaplan-Meier method was employed to determine survival and risk functions, as well as median survival. Crude HRs and adjusted HRs (aHRs) were estimated using Cox proportional hazards regression models.

Results

A median overall survival of 1410 days (3.86 years) and an adjusted mortality rate of 40 cases per 100 000 population were estimated for the study period (6 years). Factors associated with TB mortality were age (>59 years) (aHR 5.53; 95% CI 3.17 to 9.65), renal disease (aHR 2.98; 95% CI 2.27 to 3.90), HIV infection (aHR 2.82; 95% CI 1.39 to 3.32) and cancer (aHR 2.56; 95% CI 1.95 to 3.34).

Conclusions

TB survival is influenced by age and comorbidities, indicating the need for targeted strategies to protect high-risk groups. Strengthening comprehensive TB control through timely diagnosis, integrated management of chronic conditions and patient-centred care is essential to reduce preventable deaths. Furthermore, improving case notification and follow-up through integrated information platforms will contribute to more effective public health interventions.

Global prioritised indicators for measuring WHOs quality-of-care standards for small and/or sick newborns in health facilities: development, global consultation and expert consensus

Por: Day · L. T. · Vaz · L. M. E. · Semrau · K. E. A. · Moxon · S. · Niermeyer · S. · Khadka · N. · Chitashvili · T. · Valentine · G. C. · Drake · M. · Ehret · D. E. Y. · Sheffel · A. · Sacks · E. · Greenspan · L. · Shaver · T. R. · Kak · L. · Hailegebriel · T. D. · Gupta · G. · Hill · K. · Jac
Objectives

The aim of this study was to prioritise a set of indicators to measure World Health Organization (WHO) quality-of-care standards for small and/or sick newborns (SSNB) in health facilities. The hypothesis is that monitoring prioritised indicators can support accountability mechanisms, assess and drive progress, and compare performance in quality-of-care (QoC) at subnational levels.

Design

Prospective, iterative, deductive, stepwise process to prioritise a list of QoC indicators organised around the WHO Standards for improving the QoC for small and sick newborns in health facilities. A technical working group (TWG) used an iterative four-step deductive process: (1) articulation of conceptual framework and method for indicator development; (2) comprehensive review of existing global SSNB-relevant indicators; (3) development of indicator selection criteria; and (4) selection of indicators through consultations with a wide range of stakeholders at country, regional and global levels.

Setting

The indicators are prioritised for inpatient newborn care (typically called level 2 and 3 care) in high mortality/morbidity settings, where most preventable poor neonatal outcomes occur.

Participants

The TWG included 24 technical experts and leaders in SSNB QoC programming selected by WHO. Global perspectives were synthesised from an online survey of 172 respondents who represented different countries and levels of the health system, and a wide range of perspectives, including ministries of health, research institutions, technical and implementing partners, health workers and independent experts.

Results

The 30 prioritised SSNB QoC indicators include 27 with metadata and 3 requiring further development; together, they cover all eight standard domains of the WHO quality framework. Among the established indicators, 10 were adopted from existing indicators and 17 adapted. The list contains a balance of indicators measuring inputs (n=6), processes (n=12) and outcome/impact (n=9).

Conclusions

The prioritised SSNB QoC indicators can be used at health facility, subnational and national levels, depending on the maturity of a country’s health information system. Their use in implementation, research and evaluation across diverse contexts has the potential to help drive action to improve quality of SSNB care. WHO and others could use this list for further prioritisation of a core set.

International guidelines for the imaging investigation of suspected child physical abuse (IGISPA): a protocol for a modified Delphi consensus study

Por: Sidpra · J. · Kemp · A. M. · Nour · A. S. · Christian · C. W. · Robinson · C. · Mirsky · D. M. · Holmes · H. · Chesters · H. · Nurmatov · U. · Pizzo · E. · Kan · E. Y. · Wawrzkowicz · E. · Bliss · H. · Knight · L. · Lucato · L. T. · Kvist · O. · Kelly · P. · Servaes · S. · Rosendahl · K. · A
Introduction

Radiological imaging is a central facet of the multidisciplinary evaluation of suspected child physical abuse. Current guidelines for the imaging of suspected child physical abuse are often unclear, incomplete and highly variable regarding recommendations on critical questions, thereby risking clinical heterogeneity, unstructured decision-making and missed diagnoses. We, therefore, aim to develop and report an evidence-based and consensus-derived international guideline for the radiological investigation of index and contact children in the context of suspected physical abuse and to ascertain areas of scientific uncertainty to inform future research priorities.

Methods and analysis

The international guidelines for the imaging investigation of suspected child physical abuse (IGISPA) consensus group includes formal representation from 127 recognised experts across 14 subspecialties, six continents and 32 national and/or international organisations. Participants will be divided into five longitudinal subgroups (indications for imaging, skeletal imaging, visceral imaging, neuroimaging and postmortem imaging) with three cross-cutting themes (radiography, genetics and adaptations for low- and lower-middle-income countries). Each subgroup will develop preliminary consensus statements via integration of current evidence-based guidelines, systematic literature review and the clinical expertise of a multinational group of experts. Statements will then undergo anonymised voting in a modified e-Delphi process and iterative revision until consensus (≥80% agreement) is achieved. Final statements will undergo both internal and external peer review prior to endorsement.

Ethics and dissemination

As an anonymous survey of consenting healthcare professionals, this study did not require ethical approval. Experts provided written informed consent to participate prior to commencement of the modified Delphi process. The IGISPA consensus statement and any subsequent guidance will be published open access in peer-reviewed medical journals.

Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial

Por: Page · A. T. · Mangin · D. · Almutairi · H. · Chen · E. Y. H. · Lee · K. · Ailabouni · N. · Johnson · J. · Potter · K. · Mavaddat · N. · Clifford · R. M. · Lobo · E. · Baldassar · L. · Seubert · L. · Petrie · D. · Wang · K. · Hosking · S. · Tasker · J. · Etherton-Beer · C.
Introduction

Most older adults living in residential aged care facilities (RACFs) have at least one marker of potentially suboptimal prescribing. Pharmacists play a crucial role in medication management, with their effectiveness enhanced by using computerised decision support tools. The Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC) study aims to optimise medicine use by providing pharmacists in RACFs with an electronic medicine management app with integrated decision support (AusTAPER App/Pathway) to use as part of medication reviews they undertake.

Methods and analysis

The PROMPT-RC study is a parallel cluster randomised controlled trial design involving Australian RACFs. It will assess if pharmacists’ use of the AusTAPER App/Pathway for medication reviews improves medication regimens for RACF residents compared with usual care. Pharmacists in RACFs randomised to the intervention arm will be trained to use the AusTAPER App/Pathway, which flags potentially inappropriate medicines (PIMs) across a person’s entire medicine regimen. Pharmacists in RACFs randomised to the control arm will not have access to the AusTAPER App/Pathway—they will continue to provide usual care. The primary outcome is the difference in the number of regular medicines between treatment arms at 12 months. Secondary outcomes will measure the number of regular and pro re nata medicines, PIMs, medicine administration times, medicine regimen complexity, use of antipsychotics, antidepressants, and benzodiazepines, quality of life, mortality, instances of physical restraint, and the number of falls, hospitalisations and general practitioner/health professional visits. The cost-effectiveness of the AusTAPER App/Pathway compared with usual care will be calculated. Data collection will occur at baseline, 3, 6, 9 and 12 months postrandomisation and 3 and 6 months prebaseline. We aim to recruit 668 participants to adjust for an estimated 10% loss to follow-up, giving 334 participants in each arm. Data analysis will follow an intention-to-treat approach using a linear mixed model.

Ethics and dissemination

Ethical approval was obtained from The University of Western Australia Human Research Ethics Committee (Reference: 2024/ET000525; approved 14 August 2024). Reciprocal approval was also obtained in other states. This study is registered on the Australian New Zealand Clinical Trials Registry (https://anzctr.org.au). Trial findings will be disseminated through national and international peer-reviewed publications and conferences.

Trial registration number

ACTRN12624001409561.

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