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☐ ☆ ✇ BMJ Open

Are client and provider preferences for HIV care coordination programme features concordant? Discrete choice experiments in Ryan White part A-funded New York City care coordination programmes

Por: Zimba · R. · Fong · C. · Conte · M. · Guarino · H. · Avoundjian · T. · Carmona · J. · Herndon · G. · Gambone · G. · Irvine · M. K. · Nash · D. — Junio 25th 2025 at 01:50
Objectives

The New York City (NYC) HIV Care Coordination Programme (CCP) is designed to help people with HIV (PWH) overcome barriers to care and treatment engagement. We assessed preferences for CCP components among programme enrollees (’clients’) and providers. Our objective is to compare client and provider preferences, which were previously analysed separately.

Design

We used a discrete choice experiment to assess preferences for four CCP features (‘attributes’): Help with Adherence to Antiretroviral Therapy (ART), Help with Primary Care Appointments, Help with Issues other than Primary Care and Where Programme Visits Happen. Each of these attributes had 3–4 variants (‘levels’). In the original surveys, levels within Where Programme Visits Happen varied by participant type (client vs provider). We recoded the levels by visit location (VL) or by travel time (TT) to make them comparable and report results from both approaches.

Setting

25 Ryan White Part A-funded NYC CCPs participated.

Participants

152 providers and 181 clients completed the survey.

Primary and secondary outcome measures

Preferences were quantified using the relative importance of the attributes and utility of the levels.

Results

From January 2020 to March 2021, 152 providers and 181 clients completed the survey. Most of the providers (52%) were

Conclusions

Client and provider preferences clearly diverged regarding CCP service intensity: in the aggregate, clients tended to prefer lower-intensity services, whereas providers endorsed higher-intensity services. These results highlight the importance of engaging clients as partners in decisions about programme services to facilitate alignment with client values.

☐ ☆ ✇ BMJ Open

Efficacy of deep brain stimulation in treating monogenic dystonia symptoms: protocol for a systematic review

Por: Carmona-Hidalgo · B. · Quintero · J. · Rodriguez-Lopez · R. · Blasco-Amaro · J. A. · Boesch · S. · Reinhard · C. — Abril 9th 2025 at 21:14
Introduction

Complexity leads to some dystonias being considered as rare diseases with scarce synthesised evidence. Despite the deficit of scientific evidence, deep brain stimulation (DBS) is currently an effective treatment for dystonias using different brain targets, providing significant improvement of dystonic symptoms regardless of their cause. However, there is considerable variability and non-response rate due to factors such as classification, semiology, duration, aetiology and genetic cause of the disease. This protocol presents the methodology of a planned systematic review to assess the efficacy of DBS as a treatment for monogenic dystonia symptoms, a broad spectrum of pathogenic dystonias due to variants in single genes not yet explored.

Methods and analysis

This protocol follows the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols guidelines. With the aim to test the efficacy of DBS in monogenic dystonias, the research question in population, intervention, comparator and outcomes format will cover patients with monogenic dystonia treated with DBS with a minimum of 3 months' follow-up after surgery. The outcomes will be assessed using generic and specific scales to measure the efficacy and safety of the intervention. The search will be performed in generic and specific databases and bibliographic resources from 2000. We will include systematic reviews, randomised controlled trials and primary studies in English. In this protocol, the initial search strategy in MEDLINE is presented. Additionally, the protocol provides a description of the prospective assessment of the risk of bias in the selected studies. If studies appear homogeneous and the sample of patients is sufficiently large, a meta-analysis and a subgroup analysis are planned.

Ethics and dissemination

Ethics committee approval is not required. The results of the review will be published through an open access journal.

PROSPERO registration number

CRD42023448145

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