Published in 2019

Night work during pregnancy and preterm birth-A large register-based cohort study

Specht, I. O., Hammer, P. E. C., Flachs, E. M., Begtrup, L. M., Larsen, A. D., Hougaard, K. S., Hansen, J., Hansen, Å. M., Kolstad, H. A., Rugulies, R., Garde, A. H. & Bonde, J. P., 2019, I : PLoS One. 14, 4, s. e0215748

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Melatonin stimulates the production of progesterone, which is essential for the maintenance of pregnancy. Since melatonin in blood is reduced due to work under illuminated conditions during night work, it has been hypothesized that night work may increase the risk of preterm birth. Previous meta-analyses have not revealed increased risk of preterm birth in women working night shifts during pregnancy. Still, these studies might have been limited by inaccurate self-reports of timing, intensity and duration of night work most likely causing bias towards the null. The aim of this is study was to investigate if the frequency and duration of night work during the first (week 1-12) and second (week 13-22) trimester of pregnancy were associated with risk of preterm birth when objective and prospective data on night work are used.

METHOD: In a register-based prospective cohort study, we obtained individual day-to-day information on working hours from The Danish Working Hour Database (DWHD, a payroll database including all public service employees in administrative Danish Regions from 2007-2013) and information on preterm birth from the Danish Medical Birth Registry. Night-shift was defined as at least three working hours between 23:00 and 06:00. Preterm birth was defined as giving birth during gestational weeks 23-37. Odds of preterm birth according to working night shifts were analysed by logistic regression.

RESULTS: We identified 16,501 pregnant women eligible for the study, of which 10,202 women (61.8%) had at least one night-shift during the first 22 gestational weeks. The risk of preterm birth was not elevated among women working night shifts compared to women working only day shifts during either the first or second trimester. Within night-shift workers, the risk was not related to the number of night shifts, the duration of night shifts, consecutive night shifts or quick returns defined as short intervals between shifts. Odds of preterm birth was not related to change of working schedule from the first to second trimester, although women changing from night shifts in the first trimester to day work only in the second trimester displayed a weak increased odds of preterm birth (OR 1.21, 95%CI 0.98-1.49) compared to women working night shifts in both trimesters.

CONCLUSION: Our results, which are without bias from self-report of either exposure or outcome, are in line with the results of previous meta-analyses. Due to the detailed information on hours worked during pregnancy, we were able to investigate several dimensions of night work not previously investigated, of which none were associated with elevated risk of preterm birth.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 14
Udgave nummer 4
Sider (fra-til) e0215748
ISSN 1932-6203
DOI
Status Udgivet - 2019

OMERACT Development of a Core Domain Set of Outcomes for Shared Decision-making Interventions

Toupin-April, K., Barton, J. L., Fraenkel, L., Meara, A., Li, L. C., Brooks, P., de Wit, M., Stacey, D., Légaré, F., Shea, B., Lyddiatt, A., Hofstetter, C., Christensen, R., Scholte Voshaar, M., Suarez-Almazor, M. E., Boonen, A., Meade, T., March, L., Jull, J. E., Campbell, W., Alten, R., Karuranga, S., Morgan, E. M., Kelly, A., Kaufman, J., Hill, S., Maxwell, L. J., Beaton, D., El-Miedany, Y., Mittoo, S., Bartlett, S. J., Singh, J. A. & Tugwell, P. S., okt. 2019, I : Journal of Rheumatology. 46, 10, s. 1409-1414 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Shared Decision Making (SDM) Working Group aims to determine the core outcome domain set for measuring the effectiveness of SDM interventions in rheumatology trials.

METHODS: A white paper was developed to clarify the draft core domain set. It was then used to prepare for interviews to investigate reasons for lack of consensus on it and to suggest further improvements.

RESULTS: OMERACT scientists/clinicians (n = 13) and patients (n = 10) suggested limiting the core domain set to outcome domains, removing process domains, and clarifying remaining domains.

CONCLUSION: A revised core domain set will undergo further consensus-building.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 10
Sider (fra-til) 1409-1414
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - okt. 2019

Opioid-Induced Reductions in Gait Variability in Healthy Volunteers and Individuals with Knee Osteoarthritis

Henriksen, M., Alkjær, T., Raffalt, P. C., Jørgensen, L., Bartholdy, C., Hansen, S. H. & Bliddal, H., 2019, I : Pain medicine (Malden, Mass.).

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Objective: To investigate differences in gait variability induced by two different single-dose opioid formulations and an inert placebo in healthy volunteers and knee osteoarthritis patients.

Design: Experimental, randomized, double-blinded, crossover study of inert placebo (calcium tablets), 50 mg of tapentadol, and 100 mg of tramadol.

Setting: Laboratory setting.

Subjects: Healthy volunteers and knee osteoarthritis patients.

Methods: At three visits, separated by seven days, one tablet was administered per visit according to the randomization code. At each visit, a baseline measurement was done before tablet administration, after which hourly measurements were performed for six hours, yielding a total of seven measurements per visit. Gait variability was measured by three-dimensional gait analysis, recorded during six minutes of continuous treadmill walking at self-selected speed. One hundred seventy gait cycles were identified from detection of clear events of the knee joint angle trajectories. Gait variability was assessed as average standard deviations over a gait cycle of the sacrum displacements and accelerations; sagittal plane ankle, knee, and hip joint angles; step widths; and stride times.

Results: Twenty-four opioid-naïve and neurologically intact participants (12 healthy volunteers and 12 knee osteoarthritis patients) were included and completed the experiment. Tapentadol reduced the variability of sacrum displacements and accelerations compared with placebo and tramadol. There were no differences between experimental conditions regarding the variability in lower-extremity joint angle variability, step widths, or stride times.

Conclusions: In opioid-naïve and neurologically intact individuals, tapentadol seems to reduce movement variability during treadmill walking, compared with placebo and tramadol. This can be interpreted as a loss of adaptability that might increase the risk of falling if the system is perturbed.

Originalsprog Engelsk
Tidsskrift Pain medicine (Malden, Mass.)
ISSN 1526-2375
DOI
Status Udgivet - 2019

Osteoarthritis phenotypes and novel therapeutic targets

Van Spil, W. E., Kubassova, O., Boesen, M., Bay-Jensen, A-C. & Mobasheri, A., jul. 2019, I : Biochemical Pharmacology. 165, s. 41-48 8 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

The success of disease-modifying osteoarthritis drug (DMOAD) development is still elusive. While there have been successes in preclinical and early clinical studies, phase 3 clinical trials have failed so far and there is still no approved, widely available DMOAD on the market. The latest research suggests that, among other causes, poor trial outcomes might be explained by the fact that osteoarthritis (OA) is a heterogeneous disease with distinct phenotypes. OA trials might be more successful if they would address and target a specific phenotype. The increasing availability of advanced techniques to detect particular OA characteristics expands the possibilities to distinguish between such potential OA phenotypes. Magnetic resonance imaging is among the key imaging techniques to stratify and monitor patients with changes in bone, cartilage and inflammation. Biochemical markers have mainly used as secondary parameters and could further delineate phenotypes. Moreover, post-hoc analyses of trial data have suggested the existence of distinct pain phenotypes and their relevance in the design of clinical trials. Although ongoing work in the field supports the concept of OA heterogeneity, this has not yet resulted in more effective treatment options. This paper reviews the current knowledge about potential OA phenotypes and suggests that combining patient clinical data, quantitative imaging, biochemical markers and utilizing data-driven approaches in patient selection and efficacy assessment will allow for more successful development of effective DMOADs.

Originalsprog Engelsk
Tidsskrift Biochemical Pharmacology
Vol/bind 165
Sider (fra-til) 41-48
Antal sider 8
ISSN 0006-2952
DOI
Status Udgivet - jul. 2019

Bibliografisk note

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

Pain Measurement in Rheumatic and Musculoskeletal Diseases: Where To Go from Here? Report from a Special Interest Group at OMERACT 2018

Chiarotto, A., Kaiser, U., Choy, E., Christensen, R., Conaghan, P. G., Cowern, M., Gill, M., de Wit, M., Gargon, E., Horgan, B., Kirkham, J. J., Simon, L. S., Singh, J. A., Tugwell, P., Turk, D. C. & Mease, P. J., okt. 2019, I : Journal of Rheumatology. 46, 10, s. 1355-1359 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Establishing a research agenda on standardizing pain measurement in clinical trials in rheumatic and musculoskeletal diseases (RMD).

METHODS: Discussion during a meeting at the Outcome Measures in Rheumatology (OMERACT) 2018, prepared by a systematic review of existing core outcome sets and a patient online survey.

RESULTS: Several key questions were debated: Is pain a symptom or a disease? Are pain core (sub)domains consistent across RMD? How to account for pain mechanistic descriptors (e.g., central sensitization) in pain measurement?

CONCLUSION: Characterizing and assessing the spectrum of pain experience across RMD in a standardized fashion is the objective of the OMERACT Pain Working Group.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 10
Sider (fra-til) 1355-1359
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - okt. 2019

OBJECTIVE: To study the prognostic value of widespread pain and of musculoskeletal ultrasound (US) examination for subsequent treatment outcomes in patients with psoriatic arthritis (PsA).

METHODS: An exploratory prospective cohort study enrolled patients with PsA initiating biologic or conventional synthetic disease-modifying antirheumatic drugs in routine care. Clinical, US, and patient-reported measures were collected at baseline and after 4 months. Widespread nonarthritic pain (WP) was defined as a Widespread Pain Index score of ≥4 with pain in ≥4 of 5 regions. PsA activity by US was defined as color Doppler (yes/no) in selected entheses, joints, or tendons. The main response criteria included the American College of Rheumatology 20% improvement, the Disease Activity in Psoriatic Arthritis 50% improvement, and minimal disease activity. The primary analyses were age- and sex-adjusted logistic regression.

RESULTS: WP was present in 24 of 69 included patients (35%) and was associated with worse patient-reported and composite baseline measures, while US and other objective findings were similar to those in patients without WP. The odds of reaching minimal disease activity after 4 months were significantly greater for patients enrolled without WP (odds ratio 18.43 [95% confidence interval 1.51, 224.41]; P = 0.022), while WP did not impair other response measures. Patients with baseline color Doppler activity (n = 42 [61%]) had a worse objective PsA burden, but their chance of treatment response was comparable to those without color Doppler.

CONCLUSION: More than one-third of patients with PsA presented with WP, which was associated with worse patient-reported scores and failure to achieve minimal disease activity following conventional synthetic or biologic disease-modifying antirheumatic drug therapy. PsA activity by color Doppler US had no influence on subsequent treatment response in this PsA cohort.

Originalsprog Engelsk
Tidsskrift Arthritis Care & Research
Vol/bind 71
Udgave nummer 6
Sider (fra-til) 798-810
Antal sider 13
ISSN 2151-464X
DOI
Status Udgivet - 1 jun. 2019

Bibliografisk note

© 2018, American College of Rheumatology.

Patient Perspectives on DMARD Safety Concerns in Rheumatology Trials: Results from Inflammatory Arthritis Patient Focus Groups and OMERACT Attendees Discussion

Andersen, K. M., Kelly, A., Lyddiatt, A., Bingham, C. O., Bykerk, V. P., Batterman, A., Westreich, J., Jones, M. K., Cross, M., Brooks, P. M., March, L., Shea, B., Tugwell, P., Simon, L. S., Christensen, R. & Bartlett, S. J., sep. 2019, I : Journal of Rheumatology. 46, 9, s. 1168-1172 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Safety Working Group is identifying core safety domains that matter most to patients with rheumatic disease.

METHODS: International focus groups were held with 39 patients with inflammatory arthritis to identify disease-modifying antirheumatic drug (DMARD) experiences and concerns. Themes were identified by pragmatic thematic coding and discussed in small groups by meeting attendees.

RESULTS: Patients view DMARD side effects as a continuum and consider the cumulative effect on day-to-day function. Disease and drug experiences, personal factors, and life circumstances influence tolerance of side effects and treatment persistence.

CONCLUSION: Patients weigh overall adverse effects and benefits over time in relation to experiences and life circumstances.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 9
Sider (fra-til) 1168-1172
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - sep. 2019

Patient-reported 1-year outcome not affected by body mass index in 3,327 total knee arthroplasty patients

Overgaard, A., Lidgren, L., Sundberg, M., Robertsson, O. & W-Dahl, A., aug. 2019, I : Acta Orthopaedica . 90, 4, s. 360-365 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background and purpose - Patient-reported outcome (PRO) in total knee arthroplasty (TKA) patients with high body mass index (BMI) is controversial. We compared pain, function, quality of life, general health, and satisfaction among different BMI categories preoperatively and 1 year after primary TKA. Patients and methods - 4,318 patients were operated with a TKA for knee osteoarthritis in the Region of Skane in 2013-2015. In all, 3,327 patients (77%) had complete PRO data and information on BMI and were included. Preoperatively the patients filled in the Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-VAS (general health). 1 year postoperatively the same questionnaires were filled in together with a question asking whether they were satisfied with the surgery. Information on age, sex, BMI, and ASA grade were obtained from the Swedish Knee Arthroplasty Register. Each patient was classified as Outcome Measures in Rheumatology- Osteoarthritis Research Society International (OMERACT-OARSI) responder or not based on a combination of absolute and relative changes in scores. Welch's t-test and a chi-square test were used in the statistical analysis. Results - Both preoperatively and 1 year postoperatively the obese patients reported somewhat worse scores than the normal weight and overweight. The differences were small with 1 exception, the KOOS sport- and recreation function postoperatively, where normal-weight and overweight patients reported fewer problems than obese patients with a BMI over 35 (40 and 39 points vs. 31 points, p < 0.001). Similar proportions of patients were satisfied and categorized as OMERACT-OARSI responders in the different BMI categories. Interpretation - The degree of improvement in PROs 1 year after TKA surgery does not seem to be affected by BMI.

Originalsprog Engelsk
Tidsskrift Acta Orthopaedica
Vol/bind 90
Udgave nummer 4
Sider (fra-til) 360-365
Antal sider 6
ISSN 1745-3674
DOI
Status Udgivet - aug. 2019

Physical demand at work and sick leave due to low back pain: a cross-sectional study

Petersen, J., Kirkeskov, L., Hansen, B. B., Begtrup, L. M., Flachs, E. M., Boesen, M., Hansen, P., Bliddal, H. & Kryger, A. I., 22 maj 2019, I : BMJ Open. 9, 5, s. e026917

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: To investigate if self-reported high physical demand at work, objective physical workload using a job exposure matrix (JEM) and fear-avoidance beliefs are associated with reported sick leave in the previous year in persons with low back pain (LBP). Second, to investigate if the effects of fear-avoidance and self-reported high physical demand at work on sick leave are modified by the objective physical workloads.

SETTINGS: Participants were recruited from general practice and by advertisement in a local newspaper.

PARTICIPANTS: 305participants with a current period of 2-4 weeks LBP and self-reported difficulty in maintaining physically demanding jobs due to LBP were interviewed, clinically examined and had an MRI at baseline.

MAIN OUTCOME MEASURES: Independent variables were high fear-avoidance, self-reported high physical demand at work and objective measures of physical workloads (JEM). Outcome was self-reported sick leave due to LBP in the previous year. Logistic regression and tests for interaction were used to identify risk factors and modifiers for the association with self-reported sick leave.

RESULTS: Self-reported physically demanding work and high fear-avoidance were significantly associated with prior sick leave due to LBP in the previous year with OR 1.75 95% CI (1.10 to 2.75) and 2.75 95% CI (1.61to 4.84), respectively. No objective physical workloads had significant associations. There was no modifying effect of objective physical workloads on the association between self-reported physical demand at work/high fear-avoidance and sick leave.

CONCLUSIONS: Occupational interventions to reduce sick leave due to LBP may have to focus more on those with high self-reported physical demands and high fear-avoidance, and less on individuals with the objectively highest physical workload.

TRIAL REGISTRATION NUMBER: NCT02015572; Post-results.

Originalsprog Engelsk
Tidsskrift BMJ Open
Vol/bind 9
Udgave nummer 5
Sider (fra-til) e026917
ISSN 2044-6055
DOI
Status Udgivet - 22 maj 2019

Bibliografisk note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Placebo: den mindst skadelige behandling ved artrose?

Bliddal, H., Henriksen, M. & Christensen, R., 24 jun. 2019, I : Ugeskrift for Laeger. 181, 26

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 181
Udgave nummer 26
ISSN 0041-5782
Status Udgivet - 24 jun. 2019

OBJECTIVE: To examine the reporting completeness of exercise-based interventions for knee osteoarthritis (OA) in studies that form the basis of current clinical guidelines, and examine if the clinical benefit (pain and disability) from exercise is associated with the intervention reporting completeness.

DESIGN: Review of clinical OA guidelines METHODS: We searched MEDLINE and EMBASE for guidelines published between 2006 and 2016 including recommendations about exercise for knee OA. The studies used to inform a recommendation were reviewed for exercise reporting completeness. Reporting completeness was evaluated using a 12-item checklist; a combination of the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT). Each item was scored 'YES' or 'NO' and summarized as a proportion of interventions with complete descriptions and each intervention's completeness was summarized as the percentage of completely described items. The association between intervention description completeness score and clinical benefits was analyzed with a multilevel meta-regression.

RESULTS: From 10 clinical guidelines, we identified 103 original studies of which 100 were retrievable (including 133 interventions with 6,926 patients). No interventions were completely described on all 12 items (median 33% of items complete; range 17-75%). The meta-regression analysis indicated that poorer reporting was associated with greater effects on pain and no association with effects on disability.

CONCLUSION: The inadequate description of recommended interventions for knee OA is a serious problem that precludes replication of effective interventions in clinical practice. By consequence, the relevance and usability of clinical guideline documents and original study reports are diminished.

PROSPERO: CRD42016039742.

Originalsprog Engelsk
Tidsskrift Osteoarthritis and Cartilage
Vol/bind 27
Udgave nummer 1
Sider (fra-til) 3-22
Antal sider 20
ISSN 1063-4584
DOI
Status Udgivet - jan. 2019

Positive pressure device treatment for Menière's disease: an overview of the current evidence and a meta-analysis

Devantier, L., Guldfred, F. L-A., Djurhuus, B. D., Händel, M. N., Schmidt, J. H., Hougaard, D. D. & Edemann-Callesen, H., maj 2019, I : European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 276, 5, s. 1263-1273 11 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The objective was to critically assess the current evidence investigating the efficacy of using a positive pressure device in patients with definite or probable Menière's disease.

METHODS: We performed a systematic literature search in MEDLINE, EMBASE and PsycINFO up to February 2018. We included both systematic reviews and primary literature [randomized controlled trials (RCTs)] investigating positive pressure treatment, in patients (≥ 18 years of age), with Menière's disease. We assessed the internal validity of systematic reviews using the AMSTAR tool and risk of bias of primary studies using the Cochrane Risk of bias tool. We performed a meta-analysis for each outcome based on the identified studies. The overall certainty of evidence for the outcomes was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

RESULTS: The search for systematic reviews identified four relevant reviews. These all included the same four RCTs. An updated search identified one additional RCT. In total, five RCTs were included in the data synthesis. Our data synthesis showed no effect of positive pressure treatment on primary nor secondary outcomes. No serious adverse events were reported. The overall certainty of evidence ranged from very low to low, due to the serious risk of bias and imprecision.

CONCLUSION: The current available evidence does not support positive pressure device treatment in patients with Menière's disease. However, the limitations of the current literature hinder the possibility of any solid conclusion. There remains a need for randomized controlled trials of high quality to fully access the utility of this treatment.

Originalsprog Engelsk
Tidsskrift European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
Vol/bind 276
Udgave nummer 5
Sider (fra-til) 1263-1273
Antal sider 11
ISSN 0003-9195
DOI
Status Udgivet - maj 2019

PURPOSE: Optic disc drusen (ODD) are calcified optic nerve head deposits. Objectives of this study were to examine the prevalence of ODD in eyes removed by enucleation and to describe related histopathological signatures of ODD and surrounding tissues.

METHODS: The study was a retrospective observational case series study assessing and re-evaluating enucleated eyes in Denmark from 1980 to 2015 by microscopy. Individual ODD were described based on size, number and location (superficial and/or deep) within the optic nerve. Optic nerve heads with ODD were assessed for elevated discs, retinal nerve fibre layer (RNFL) thickness, oedematous axons and presence of localized peripapillary axonal distension (LPAD) equivalent to the peripapillary hyperreflective ovoid mass-like structures seen on optical coherence tomography.

RESULTS: Microscopy of 1713 eyes revealed ODD in 31 eyes equivalent to a prevalence of 1.8%. Optic disc drusen (ODD) were seen as circular shapes of different sizes and varying number. Elevated discs were present in 15 (54%) of the cases. Thickening of the superficial RNFL was present in eyes with large deeply located ODD. For more superficial ODD of approximately same size, the RNFL was thinner. Oedematous axons were present in three eyes. Localized peripapillary axonal distension (LPAD) was seen in five eyes.

CONCLUSIONS: Prevalence of ODD in this study of histopathological signatures was higher than the prevalence found in clinical studies. Our results suggest that large, deep ODD might cause crowding and herniation of axons in the optic nerve head leading to a thickened superficial nerve fibre layer, pseudopapilledema and LPAD.

Originalsprog Engelsk
Tidsskrift Acta Ophthalmologica (Online)
ISSN 1755-3768
DOI
Status E-pub ahead of print - 1 jul. 2019

Bibliografisk note

© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Prevalence and risk of occult cancer in stroke

Tybjerg, A. J., Skyhøj Olsen, T. & Andersen, K. K., 7 nov. 2019, I : Acta Neurologica Scandinavica.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: Cancer is associated with higher risk of stroke. Whether this translates into higher risk of cancer in stroke of an extent calling for cancer screening in stroke is unclear. We investigated prevalence and risk of occult cancer in stroke compared to the background population without history of stroke.

MATERIALS AND METHODS: All patients >40 years of age with incident stroke in Denmark 2003-2015 were identified through the Danish Stroke Registry (n = 85 893) and matched 1:10 on age and sex to the Danish background population without history of stroke (n = 858 740). Linking data to the Danish Cancer Registry, we determined prevalence of occult cancer in stroke defined as the event of previously unknown cancer during a 1-year follow-up in the stroke and in the background population. Cox regression models were used to study risk in comparison to the background population.

RESULTS: Prevalence (per 1000) of occult cancer in the stroke/background cohorts was 25.0/15.8 in women and 29.8/20.4 in men. Prevalence was dependent on age and sex. Highest among stroke patients aged 70-80 years (35.6 in women, 42.4 in men); lowest in patients aged 40-50 years (8.3 in women, 6.8 in men). Stroke was associated with an overall 54% higher risk of occult cancer but risk increased significantly with smoking, hazard ratio (HR) 1.47, age HR 1.27 per 10 years, male sex HR 1.25, and diabetes HR 1.25.

CONCLUSIONS: Prevalence and risk of occult cancer in stroke is considerable and calls for attention when designing the stroke investigation program.

Originalsprog Engelsk
Tidsskrift Acta Neurologica Scandinavica
ISSN 0001-6314
DOI
Status E-pub ahead of print - 7 nov. 2019

Bibliografisk note

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies

Alinaghi, F., Calov, M., Kristensen, L. E., Gladman, D. D., Coates, L. C., Jullien, D., Gottlieb, A. B., Gisondi, P., Wu, J. J., Thyssen, J. P. & Egeberg, A., 1 jan. 2019, I : Journal of the American Academy of Dermatology. 80, 1, s. 251-265.e19

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background: Wide-ranging prevalence estimates of psoriatic arthritis (PsA) in patients with psoriasis have been reported. Objectives: To assess the prevalence and incidence of PsA in patients with psoriasis. Methods: Two authors independently searched 3 databases for studies reporting on the prevalence or incidence of PsA in patients with psoriasis. A proportion meta-analysis was performed to calculate the pooled proportion estimates of PsA in patients with psoriasis. Results: A total of 266 studies examining 976,408 patients with psoriasis were included. Overall, the pooled proportion (95% confidence interval [CI]) of PsA among patients with psoriasis was 19.7% (95% CI, 18.5%-20.9%). In children and adolescents (<18 years of age), the pooled prevalence was 3.3% (95% CI, 2.1%-4.9%). The PsA prevalence was 22.7% (95% CI, 20.6%-25.0%) in European patients with psoriasis, 21.5% (95% CI, 15.4%-28.2%) in South American patients with psoriasis, 19.5% (95% CI, 17.1%-22.1%) in North American patients with psoriasis, 15.5% (95% CI, 0.009%-51.5%) in African patients with psoriasis, and 14.0% (95% CI, 95% CI, 11.7%-16.3%) in Asian patients with psoriasis. The prevalence of PsA was 23.8% (95% CI, 20.1%-27.6%) in studies in which the Classification Criteria for Psoriatic Arthritis were applied. The incidence of PsA among patients with psoriasis ranged from 0.27 to 2.7 per 100 person-years. Limitations: Between-study heterogeneity may have affected the estimates. Conclusions: We found that 1 in 4 patients with psoriasis have PsA. With the growing recognition of the Classification Criteria for Psoriatic Arthritis, more homogenous and comparable prevalence estimates are expected to be reported.

Originalsprog Engelsk
Tidsskrift Journal of the American Academy of Dermatology
Vol/bind 80
Udgave nummer 1
Sider (fra-til) 251-265.e19
ISSN 0190-9622
DOI
Status Udgivet - 1 jan. 2019

INTRODUCTION: The Global Burden of Disease 2010 study ranked osteoarthritis (OA) as a leading cause of years lived with disability. With an ageing population, increasing body weight and sedentary lifestyle, a substantial increase especially in knee OA (KOA) is expected. Management strategies for KOA include non-pharmacological, pharmacological and surgical interventions. Meanwhile, over-the-counter pain medications have been discredited as they are associated with several risks with long-term usage. By consequence, the use of exercise and all sorts of complementary and alternative medicine (CAM) for joint pain has increased. The available self-management strategies are plenty, but there is no overview of their use at a population level and whether they are used along with doctors' prescriptions or replace these. The aim of this study is to estimate the population incidence of developing knee symptoms and analyse the association between (and impact of) the use of self-reported preventive measures and knee symptoms.

METHODS AND ANALYSIS: This prospective cohort study pragmatically recruits individuals from the municipality of Frederiksberg, Denmark. All citizens aged 60-69 years old will be contacted annually for 10 years and asked to participate in a web-based survey. The major outcomes are self-reported knee symptoms and their association with use of various management strategies, including use of non-pharmacological treatments and CAM. Secondary outcomes include the influence of treatments on use of healthcare system and surgical procedures. Descriptive and analytic statistics (eg, logistic regression) will be used to provide summaries about the sample and observations made and the associations between self-management and development of knee symptoms.

ETHICS AND DISSEMINATION: This study can be implemented without permission from the Health Research Ethics Committee. Permission has been obtained from the Danish Data Protection Agency. Study findings will be disseminated in peer-reviewed journals and presented at relevant conferences.

TRIAL REGISTRATION NUMBER: NCT03472300.

Originalsprog Engelsk
Tidsskrift BMJ Open
Vol/bind 9
Udgave nummer 9
Sider (fra-til) e028087
ISSN 2044-6055
DOI
Status Udgivet - 4 sep. 2019

Bibliografisk note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Processed meat intake and chronic disease morbidity and mortality: An overview of systematic reviews and meta-analyses

Händel, M. N., Cardoso, I., Rasmussen, K. M., Rohde, J. F., Jacobsen, R., Nielsen, S. M., Christensen, R. & Heitmann, B. L., 2019, I : PLoS One. 14, 10, s. e0223883

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Despite the nutritional value of meat, a large volume of reviews and meta-analyses suggests that processed meat intake is associated with an increased risk of chronic diseases. However, assessments of the quality of these published reviews internal validity are generally lacking. We systematically reviewed and assessed the quality alongside summarizing the results of previously published systematic reviews and meta-analyses that examined the association between processed meat intake and cancers, type II diabetes (T2D), and cardiovascular diseases (CVD). Reviews and meta-analyses published until May 2018 were identified through a systematic literature search in the databases MEDLINE and EMBASE, and reference lists of included reviews. The quality of the systematic reviews and meta-analyses was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). All eligible reviews had to comply with two quality requirements: providing sufficient information on quality assessment of the primary studies and a comprehensive search. The results were summarized for T2D, CVD, and each of the different cancer types. The certainty in the estimates of the individual outcomes was rated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method. In total, 22 systematic reviews were eligible and thus included in this review. More than 100 reviews were excluded because quality assessment of the primary studies had not been performed. The AMSTAR score of the included reviews ranged from 5 to 8 indicating moderate quality. Overall, the quality assessments of primary studies of the reviews are generally lacking; the scientific quality of the systematic reviews reporting positive associations between processed meat intake and risk of various cancers, T2D and CVD is moderate, and the results from case-control studies suggest more often a positive association than the results from cohort studies. The overall certainty in the evidence was very low across all individual outcomes, due to serious risk of bias and imprecision.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 14
Udgave nummer 10
Sider (fra-til) e0223883
ISSN 1932-6203
DOI
Status Udgivet - 2019

PsAID12 Provisionally Endorsed at OMERACT 2018 as Core Outcome Measure to Assess Psoriatic Arthritis-specific Health-related Quality of Life in Clinical Trials

Orbai, A-M., Holland, R., Leung, Y. Y., Tillett, W., Goel, N., Christensen, R., McHugh, N., Gossec, L., de Wit, M., Højgaard, P., Coates, L. C., Mease, P. J., Birt, J., Fallon, L., FitzGerald, O., Ogdie, A., Shea, B., Strand, V., Duffin, K. C., Tugwell, P., Beaton, D. & Gladman, D. D., aug. 2019, I : Journal of Rheumatology. 46, 8, s. 990-995 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and Outcome Measures in Rheumatology (OMERACT) psoriatic arthritis (PsA) working group is developing a Core Outcome Measurement Set for PsA clinical trials [randomized controlled trials (RCT) and longitudinal observational studies (LOS)] using the OMERACT Filter 2.1 instrument selection algorithm. Our objective was to assess the Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) for the measurement of the core domain PsA-specific health-related quality of life (HRQOL).

METHODS: PsAID12 measurement property evidence gathered in a systematic literature review, and additional analyses conducted in LOS, were used to inform a consensus process. Analyses that had not been published were independently reviewed by the OMERACT technical advisory group. Data and process were presented, discussed in breakout groups, and voted on at the OMERACT conference (Terrigal, Australia, May 2018).

RESULTS: PsAID12 fulfilled the green (good to go) OMERACT standards for domain match, feasibility, reliability, and construct/longitudinal construct validity. Discrimination and thresholds of meaning were amber (caution but good enough to go forward). The overall working group recommendation was amber/provisional endorsement of PsAID12 for measuring PsA-specific HRQOL in RCT and LOS. Of 96 participants who voted at the PsA OMERACT workshop, 87.5% (84) voted "yes" to endorse this recommendation; 14 of the 96 were patient research partners (PRP) and 93% of them (13) voted "yes"; 82 participants were not PRP and 87% of them (71) voted "yes."

CONCLUSION: At OMERACT 2018, PsAID12 was the first patient-reported outcome measure provisionally endorsed as a core outcome measure for disease-specific HRQOL in PsA clinical trials. PsAID12 discrimination and improvement thresholds will be studied in future RCT.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 8
Sider (fra-til) 990-995
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - aug. 2019

Quadriceps tendon rupture. Anchor or transosseous suture? A systematic review

Bartels, E. M., 2019, I : Muscles, Ligaments and Tendons Journal. s. 356 362 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Originalsprog Engelsk
Tidsskrift Muscles, Ligaments and Tendons Journal
Sider (fra-til) 356
Antal sider 362
ISSN 2240-4554
Status Udgivet - 2019

Response to: 'Mandatory, cost-driven switching from originator etanercept to its biosimilar SB4: possible fallout on non-medical switching' by Cantini and Benucci

Glintborg, B., Loft, A. G., Omerovic, E., Hendricks, O., Linauskas, A., Espesen, J., Danebod, K., Jensen, D. V., Nordin, H., Dalgaard, E. B., Chrysidis, S., Kristensen, S., Raun, J. L., Lindegaard, H., Manilo, N., Jakobsen, S. H., Hansen, I. M. J., Dalsgaard Pedersen, D., Sørensen, I. J., Andersen, L. S., Grydehøj, J., Mehnert, F., Krogh, N. S. & Hetland, M. L., 2019, I : Annals of the Rheumatic Diseases.

Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
ISSN 0003-4967
DOI
Status E-pub ahead of print - 2019

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