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Attrition from longitudinal ageing studies and performance across domains of cognitive functioning: an individual participant data meta-analysis

Por: Hernandez · R. · Jin · H. · Lee · P.-J. · Schneider · S. · Junghaenel · D. U. · Stone · A. A. · Meijer · E. · Gao · H. · Maupin · D. · Zelinski · E. M.
Objectives

This paper examined the magnitude of differences in performance across domains of cognitive functioning between participants who attrited from studies and those who did not, using data from longitudinal ageing studies where multiple cognitive tests were administered.

Design

Individual participant data meta-analysis.

Participants

Data are from 10 epidemiological longitudinal studies on ageing (total n=209 518) from several Western countries (UK, USA, Mexico, etc). Each study had multiple waves of data (range of 2–17 waves), with multiple cognitive tests administered at each wave (range of 4–17 tests). Only waves with cognitive tests and information on participant dropout at the immediate next wave for adults aged 50 years or older were used in the meta-analysis.

Measures

For each pair of consecutive study waves, we compared the difference in cognitive scores (Cohen’s d) between participants who dropped out at the next study wave and those who remained. Note that our operationalisation of dropout was inclusive of all causes (eg, mortality). The proportion of participant dropout at each wave was also computed.

Results

The average proportion of dropouts between consecutive study waves was 0.26 (0.18 to 0.34). People who attrited were found to have significantly lower levels of cognitive functioning in all domains (at the wave 2–3 years before attrition) compared with those who did not attrit, with small-to-medium effect sizes (overall d=0.37 (0.30 to 0.43)).

Conclusions

Older adults who attrited from longitudinal ageing studies had lower cognitive functioning (assessed at the timepoint before attrition) across all domains as compared with individuals who remained. Cognitive functioning differences may contribute to selection bias in longitudinal ageing studies, impeding accurate conclusions in developmental research. In addition, examining the functional capabilities of attriters may be valuable for determining whether attriters experience functional limitations requiring healthcare attention.

Clinical efficacy of ablative laser combined with pulsed dye laser in the treatment of pathological scars: A systematic review and meta‐analysis

Abstract

Objective

A systematic review and meta-analysis were conducted to evaluate the efficacy and safety of ablative laser combined with pulsed dye laser to treat pathological scars.

Methods

A systematic literature review was conducted to identify all blind, randomized, controlled trials of ablative laser and pulsed dye laser for treating pathological scars. The databases PubMed, Embase, and Cochrane were used. All research on ablative laser combined with PDL in treating pathological scars with ablative laser or no treatment as controls were included in the meta-analysis. The retrieved studies' reference lists were thoroughly examined.

Results

POSAS and VSS were used as evaluation criteria in seven studies involving 189 patients. Effect of combined laser group therapy (−1.259 95% confidence interval, −1.515 to −1.003; p < 0.0001). The difference between the combined treatment and control groups was (−1.375; 95% CI, −1.727 to −1.023; p < 0.0001) and (−1.150; 95% CI, −1.523 to −0.777; p < 0.0001).

Conclusions

Ablative laser combined with PDL is more effective and safer than ablative laser or PDL alone in the treatment of pathological scars.

Haematological dynamics following treatment of visceral leishmaniasis: a protocol for systematic review and individual participant data (IPD) meta-analysis

Por: Munir · A. · Dahal · P. · Kumar · R. · Singh-Phulgenda · S. · Siddiqui · N. A. · Naylor · C. · Wilson · J. · Buck · G. · Rahi · M. · Alves · F. · Malaviya · P. · Sundar · S. · Ritmeijer · K. · Stepniewska · K. · Pandey · K. · Guerin · P. J. · Musa · A.
Introduction

Visceral leishmaniasis (VL) is a parasitic disease with an estimated 30 000 new cases occurring annually. Despite anaemia being a common haematological manifestation of VL, the evolution of different haematological characteristics following treatment remains poorly understood. An individual participant data meta-analysis (IPD-MA) is planned to characterise the haematological dynamics in patients with VL.

Methods and analysis

The Infectious Diseases Data Observatory (IDDO) VL data platform is a global repository of IPD from therapeutic studies identified through a systematic search of published literature (PROSPERO registration: CRD42021284622). The platform currently holds datasets from clinical trials standardised to a common data format. Corresponding authors and principal investigators of the studies indexed in the IDDO VL data platform meeting the eligibility criteria for inclusion were invited to be part of the collaborative IPD-MA. Mixed-effects multivariable regression models will be constructed to identify determinants of haematological parameters by taking clustering within study sites into account.

Ethics and dissemination

This IPD-MA meets the criteria for waiver of ethical review as defined by the Oxford Tropical Research Ethics Committee (OxTREC) granted to IDDO, as the research consists of secondary analysis of existing anonymised data (exempt granted on 29 March 2023, OxTREC REF: IDDO). Ethics approval was granted by the ICMR-Rajendra Memorial Research Institute of Medical Sciences ethics committee (letter no.: RMRI/EC/30/2022) on 4 July 2022. The results of this analysis will be disseminated at conferences, the IDDO website and peer-reviewed publications in open-access journals. The findings of this research will be critically important for control programmes at regional and global levels, policymakers and groups developing new VL treatments.

PROSPERO registration number

CRD42021284622.

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