Tammy Hoffmann | Bond University (original) (raw)

Papers by Tammy Hoffmann

Research paper thumbnail of Exploring the use of graphics in written health information for people with aphasia

Research paper thumbnail of Do People With Aphasia Want Written Stroke and Aphasia Information? A Verbal Survey Exploring Preferences for When and How to Provide Stroke and Aphasia Information

Topics in Stroke Rehabilitation, 2010

Written health information can be better comprehended by people with aphasia if it is provided in... more Written health information can be better comprehended by people with aphasia if it is provided in an aphasia-friendly format. However, before pursuing research in the area of text-formatting for people with aphasia, it must be determined whether people with aphasia consider it helpful to receive health information in the written media. This study, therefore, aimed to determine the following: whether people with aphasia consider it important to receive written stroke and aphasia information; when people with aphasia prefer to receive this information; and what their preferences are for health information media. Surveys were administered in a face-to-face interview with 40 adults with aphasia. Participants were purposefully selected using maximum variation sampling for a variety of variables including aphasia severity, reading ability, and time post stroke. Participants thought it important to receive written information about both stroke and aphasia. They considered it helpful to receive written information at several stages post stroke, particularly from 1 month onwards. The largest proportion (97%) of participants identified 6 months post stroke as the most helpful time to receive this information. Written information was the most preferred media at participants' present time post stroke (M = 39 months; range, 2-178 months). Videos/DVDs were the most preferred media during the 6 months immediately following the stroke. Despite reading and language difficulties, participants considered written information to be important, hence people with aphasia should receive written information about both stroke and aphasia. This information should be easily accessible throughout the continuum of care.

Research paper thumbnail of Do people with aphasia receive written stroke and aphasia information?

Aphasiology, 2009

... identified as the health professional to provide this information. Address correspondence to:... more ... identified as the health professional to provide this information. Address correspondence to: Ms Tanya Rose, Division of Speech Pathology, The University of Queensland, Brisbane, Qld 4072, Australia. E-mail: t.rose@uq.edu.au The ...

Research paper thumbnail of What's in a name? The challenge of describing interventions in systematic reviews: analysis of a random sample of reviews of non-pharmacological stroke interventions

BMJ open, 2015

To assess, in a sample of systematic reviews of non-pharmacological interventions, the completene... more To assess, in a sample of systematic reviews of non-pharmacological interventions, the completeness of intervention reporting, identify the most frequently missing elements, and assess review authors' use of and beliefs about providing intervention information. Analysis of a random sample of systematic reviews of non-pharmacological stroke interventions; online survey of review authors. The Cochrane Library and PubMed were searched for potentially eligible systematic reviews and a random sample of these assessed for eligibility until 60 (30 Cochrane, 30 non-Cochrane) eligible reviews were identified. In each review, the completeness of the intervention description in each eligible trial (n=568) was assessed by 2 independent raters using the Template for Intervention Description and Replication (TIDieR) checklist. All review authors (n=46) were invited to complete a survey. Most reviews were missing intervention information for the majority of items. The most incompletely describ...

Research paper thumbnail of Reporting and replicating cardiac rehabilitation trials: Do we know what the researchers actually did?

Introduction: In order to translate complex interventions from research into practice, complete d... more Introduction: In order to translate complex interventions from research into practice, complete details about the essential components of the intervention are required. There appears however to be deficiencies in the reporting of these individual components in the cardiac rehabilitation literature. This study aimed to quantify the extent of incomplete reporting of these interventions and determine the extent that this problem can be rectified. Methods: Randomised controlled trials of exercise-based cardiac rehabilitation identified from a concurrent systematic review were included and assessed for completeness using the Template for Intervention Description and Replication (TIDieR) checklist, which captures the essential details of the intervention components for reporting and replication. Subsequently, attempts were made to complete intervention components identified as missing in each trial using methods such as reference tracking, online materials, web-based searching and email contact with authors. Results: Studies comprising 74 different interventions from 67 different authors were included. Only 6 (8%) interventions provided sufficient detail about all individual components to permit replication. Program duration, type and location were consistently well reported across studies; however exercise intensity was missing for half of all interventions (37/73). While a number of authors (41%) responded with supplementary information about missing components, a large number could not be contacted after numerous attempts leaving over half of all interventions (43/73; 67%) missing at least one procedural element, and some, several. Conclusion: Inadequate reporting of cardiac rehabilitation interventions remains a significant problem with much essential information about the individual components remaining unknown. These deficiencies in reporting are limiting the transferability of research into clinical practice and are contributing to significant waste in research.

Research paper thumbnail of Searches and content of the OTseeker database : informing research priorities

American Journal of Occupational Therapy, 2015

Research paper thumbnail of Delivery styles and format preferences for different stroke information: Patient and carer preferences

Patient Education and Counselling, 2011

Research paper thumbnail of Not in my backyard: a systematic review of clinicians' knowledge and beliefs about antibiotic resistance

Journal of Antimicrobial Chemotherapy

To systematically review clinicians' knowledge and beliefs about the importance and causes of... more To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance. Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data. There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11 593 clinicians. Most clinicians (69%, IQR 63%-72%, n = 5 studies) had heard of antibiotic resistance and 98% (IQR 93%-99%, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67%, IQR 65%-74%, n = 13 studies) was smaller than the proportion who believed...

Research paper thumbnail of Exploring primary caregivers’ expectations about the benefits and risks of treatment for acute respiratory infections in children and involvement in management decisions

Research paper thumbnail of Autoinflation: an effective nondrug intervention for glue ear

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 27, 2015

Research paper thumbnail of What do healthcare professionals know about antibiotic resistance? A systematic review

Research paper thumbnail of Reducing mortality with exercise-based cardiac rehabilitation: Is it what patients do or how well they stick with it?

Introduction: Cardiac rehabilitation provides significant benefit to patients with coronary heart... more Introduction: Cardiac rehabilitation provides significant benefit to patients with coronary heart disease however, there is significant variation between interventions in terms of program characteristics. Individual components of the intervention such as intensity, setting or duration may provide different relative contributions to the outcomes observed. This study aimed to examine evidence about cardiac rehabilitation interventions to determine the influence of individual components on clinical outcomes. Methods: A systematic review and meta-analysis were carried out to examine the effects of exercise-based cardiac rehabilitation on the clinical outcomes of all-cause and cardiovascular mortality. Subsequent subgroup meta-analysis and meta-regression have been conducted to examine the relative contribution of individual components such as compliance, provider, duration and exercise dose (intensity, frequency, time) to overall program outcome. Results: Forty-eight studies were identi...

Research paper thumbnail of Parents’ beliefs and knowledge about the management of acute otitis media: a qualitative study

BMC Family Practice, 2015

Research paper thumbnail of ‘TIDieR-ing up’ the reporting of interventions in stroke research: the importance of knowing what is in the ‘black box’

International Journal of Stroke, 2015

Research paper thumbnail of Faster title and abstract screening? Evaluating Abstrackr, a semi-automated online screening program for systematic reviewers

Systematic Reviews, 2015

Citation screening is time consuming and inefficient. We sought to evaluate the performance of Ab... more Citation screening is time consuming and inefficient. We sought to evaluate the performance of Abstrackr, a semi-automated online tool for predictive title and abstract screening. Four systematic reviews (aHUS, dietary fibre, ECHO, rituximab) were used to evaluate Abstrackr. Citations from electronic searches of biomedical databases were imported into Abstrackr, and titles and abstracts were screened and included or excluded according to the entry criteria. This process was continued until Abstrackr predicted and classified the remaining unscreened citations as relevant or irrelevant. These classification predictions were checked for accuracy against the original review decisions. Sensitivity analyses were performed to assess the effects of including case reports in the aHUS dataset whilst screening and the effects of using larger imbalanced datasets with the ECHO dataset. The performance of Abstrackr was calculated according to the number of relevant studies missed, the workload saving, the false negative rate, and the precision of the algorithm to correctly predict relevant studies for inclusion, i.e. further full text inspection. Of the unscreened citations, Abstrackr's prediction algorithm correctly identified all relevant citations for the rituximab and dietary fibre reviews. However, one relevant citation in both the aHUS and ECHO reviews was incorrectly predicted as not relevant. The workload saving achieved with Abstrackr varied depending on the complexity and size of the reviews (9 % rituximab, 40 % dietary fibre, 67 % aHUS, and 57 % ECHO). The proportion of citations predicted as relevant, and therefore, warranting further full text inspection (i.e. the precision of the prediction) ranged from 16 % (aHUS) to 45 % (rituximab) and was affected by the complexity of the reviews. The false negative rate ranged from 2.4 to 21.7 %. Sensitivity analysis performed on the aHUS dataset increased the precision from 16 to 25 % and increased the workload saving by 10 % but increased the number of relevant studies missed. Sensitivity analysis performed with the larger ECHO dataset increased the workload saving (80 %) but reduced the precision (6.8 %) and increased the number of missed citations. Semi-automated title and abstract screening with Abstrackr has the potential to save time and reduce research waste.

Research paper thumbnail of Can rasch analysis enhance the abstract ranking process in scientific conferences? Issues of interrater variability and abstract rating burden

The Journal of continuing education in the health professions, 2015

ranking processes for scientific conferences are essential but controversial. This study examined... more ranking processes for scientific conferences are essential but controversial. This study examined the validity of a structured abstract rating instrument, evaluated interrater variability, and modeled the impact of interrater variability on abstract ranking decisions. Additionally, we examined whether a more efficient rating process (abstracts rated by two rather than three raters) supported valid abstract rankings. Data were 4016 sets of abstract ratings from the 2011 and 2013 national scientific conferences for a health discipline. Many-faceted Rasch analysis procedures were used to examine validity of the abstract rating instrument and to identify and adjust for the presence of interrater variability. The two-rater simulation was created by the deletion of one set of ratings for each abstract in the 2013 data set. The abstract rating instrument demonstrated sound measurement properties. Although each rater applied the rating criteria consistently (intrarater reliability), there w...

Research paper thumbnail of Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke: a pilot randomized controlled trial

Topics in Stroke Rehabilitation, 2015

Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 a... more Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29%, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke. A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery andÅsberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor. Thirty (91%) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences. Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.

Research paper thumbnail of How Well Do Standard Stroke Outcome Measures Reflect Quality of Life?: A Retrospective Analysis of Clinical Trial Data

Stroke, 2013

Quality of life (QoL) is important to stroke survivors yet is often recorded as a secondary measu... more Quality of life (QoL) is important to stroke survivors yet is often recorded as a secondary measure in acute stroke randomized controlled trials. We examined whether commonly used stroke outcome measures captured aspects of QoL. We examined primary outcomes by National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI) and modified Rankin Scale (mRS), and QoL by Stroke Impact Scale (SIS) and European Quality of Life Scale (EQ-5D) from the Virtual International Stroke Trials Archive (VISTA). Using Spearman correlations and logistic regression, we described the relationships between QoL mRS, NIHSS, and BI at 3 months, stratified by respondent (patient or proxy). Using χ2 analyses, we examined the mismatch between good primary outcome (mRS ≤1, NIHSS ≤5, or BI ≥95) but poor QoL, and poor primary outcome (mRS ≥3, NIHSS ≥20, or BI ≤60) but good QoL. Patient-assessed QoL had a stronger association with mRS (EQ-5D weighted score n=2987, P<0.0001, r=-0.7, r2=0.53; SIS recovery n=2970, P<0.0001, r=-0.71, r2=0.52). Proxy responses had a stronger association with BI (EQ-5D weighted score n=837, P<0.0001, r=0.78, r2=0.63; SIS recovery n=867, P<0.0001, r=0.68, r2=0.48). mRS explained more of the variation in QoL (EQ-5D weighted score=53%, recovery by SIS v3.0=52%) than NIHSS or BI and resulted in fewer mismatches between good primary outcome and poor QoL (P<0.0001, EQ-5D weighted score=8.5%; SIS recovery=10%; SIS-16=4.4%). The mRS seemed to align closely with stroke survivors' interests, capturing more information on QoL than either NIHSS or BI. This further supports its recommendation as a primary outcome measure in acute stroke randomized controlled trials.

Research paper thumbnail of Prediction of outcome after stroke

Research paper thumbnail of Internet-Based Cognitive Behaviour Therapy for Tinnitus Patients Delivered in a Regular Clinical Setting: Outcome and Analysis of Treatment Dropout

Cognitive Behaviour Therapy, 2013

Cognitive behaviour therapy (CBT) can reduce tinnitus distress but is not available for most pati... more Cognitive behaviour therapy (CBT) can reduce tinnitus distress but is not available for most patients. Therapist guided, internet-based CBT (ICBT) increase availability and has been shown to be effective. However, the initial positive results need to be replicated in larger samples, and treatment dropout has not been thoroughly studied. Moreover, it has not been evaluated if a low-intensity version of ICBT without therapist contact could be an alternative for patients who do not need or are able to manage the full ICBT-program. This study evaluated two parallel interventions delivered in regular care: ICBT for tinnitus distress (n = 293) and a low-intensity version of ICBT (n = 81) for patients with lower levels of tinnitus distress. We also explored predictors of dropout from ICBT and if dropout influences outcome. Tinnitus Reaction Questionnaire (Wilson, Henry, Bowen, & Haralambous, 1991) was used as the primary outcome. Secondary outcomes were measures of depression, anxiety, sleep, and sound sensitivity. Significant reductions following ICBT were found on all measures after treatment and also at a three-month follow-up. Patients receiving low-intensity ICBT showed a significant reduction in distress, even when they had low levels of distress initially. Treatment dropout was preceded by an increase in days spent at each treatment step but not by an increased distress. Early dropout was related to worse outcome. ICBT can be used in a regular clinical setting to reduce tinnitus distress. Early dropouts may need additional management. For help-seeking patients with lower distress, a low-intensity version of ICBT can be used.

Research paper thumbnail of Exploring the use of graphics in written health information for people with aphasia

Research paper thumbnail of Do People With Aphasia Want Written Stroke and Aphasia Information? A Verbal Survey Exploring Preferences for When and How to Provide Stroke and Aphasia Information

Topics in Stroke Rehabilitation, 2010

Written health information can be better comprehended by people with aphasia if it is provided in... more Written health information can be better comprehended by people with aphasia if it is provided in an aphasia-friendly format. However, before pursuing research in the area of text-formatting for people with aphasia, it must be determined whether people with aphasia consider it helpful to receive health information in the written media. This study, therefore, aimed to determine the following: whether people with aphasia consider it important to receive written stroke and aphasia information; when people with aphasia prefer to receive this information; and what their preferences are for health information media. Surveys were administered in a face-to-face interview with 40 adults with aphasia. Participants were purposefully selected using maximum variation sampling for a variety of variables including aphasia severity, reading ability, and time post stroke. Participants thought it important to receive written information about both stroke and aphasia. They considered it helpful to receive written information at several stages post stroke, particularly from 1 month onwards. The largest proportion (97%) of participants identified 6 months post stroke as the most helpful time to receive this information. Written information was the most preferred media at participants' present time post stroke (M = 39 months; range, 2-178 months). Videos/DVDs were the most preferred media during the 6 months immediately following the stroke. Despite reading and language difficulties, participants considered written information to be important, hence people with aphasia should receive written information about both stroke and aphasia. This information should be easily accessible throughout the continuum of care.

Research paper thumbnail of Do people with aphasia receive written stroke and aphasia information?

Aphasiology, 2009

... identified as the health professional to provide this information. Address correspondence to:... more ... identified as the health professional to provide this information. Address correspondence to: Ms Tanya Rose, Division of Speech Pathology, The University of Queensland, Brisbane, Qld 4072, Australia. E-mail: t.rose@uq.edu.au The ...

Research paper thumbnail of What's in a name? The challenge of describing interventions in systematic reviews: analysis of a random sample of reviews of non-pharmacological stroke interventions

BMJ open, 2015

To assess, in a sample of systematic reviews of non-pharmacological interventions, the completene... more To assess, in a sample of systematic reviews of non-pharmacological interventions, the completeness of intervention reporting, identify the most frequently missing elements, and assess review authors' use of and beliefs about providing intervention information. Analysis of a random sample of systematic reviews of non-pharmacological stroke interventions; online survey of review authors. The Cochrane Library and PubMed were searched for potentially eligible systematic reviews and a random sample of these assessed for eligibility until 60 (30 Cochrane, 30 non-Cochrane) eligible reviews were identified. In each review, the completeness of the intervention description in each eligible trial (n=568) was assessed by 2 independent raters using the Template for Intervention Description and Replication (TIDieR) checklist. All review authors (n=46) were invited to complete a survey. Most reviews were missing intervention information for the majority of items. The most incompletely describ...

Research paper thumbnail of Reporting and replicating cardiac rehabilitation trials: Do we know what the researchers actually did?

Introduction: In order to translate complex interventions from research into practice, complete d... more Introduction: In order to translate complex interventions from research into practice, complete details about the essential components of the intervention are required. There appears however to be deficiencies in the reporting of these individual components in the cardiac rehabilitation literature. This study aimed to quantify the extent of incomplete reporting of these interventions and determine the extent that this problem can be rectified. Methods: Randomised controlled trials of exercise-based cardiac rehabilitation identified from a concurrent systematic review were included and assessed for completeness using the Template for Intervention Description and Replication (TIDieR) checklist, which captures the essential details of the intervention components for reporting and replication. Subsequently, attempts were made to complete intervention components identified as missing in each trial using methods such as reference tracking, online materials, web-based searching and email contact with authors. Results: Studies comprising 74 different interventions from 67 different authors were included. Only 6 (8%) interventions provided sufficient detail about all individual components to permit replication. Program duration, type and location were consistently well reported across studies; however exercise intensity was missing for half of all interventions (37/73). While a number of authors (41%) responded with supplementary information about missing components, a large number could not be contacted after numerous attempts leaving over half of all interventions (43/73; 67%) missing at least one procedural element, and some, several. Conclusion: Inadequate reporting of cardiac rehabilitation interventions remains a significant problem with much essential information about the individual components remaining unknown. These deficiencies in reporting are limiting the transferability of research into clinical practice and are contributing to significant waste in research.

Research paper thumbnail of Searches and content of the OTseeker database : informing research priorities

American Journal of Occupational Therapy, 2015

Research paper thumbnail of Delivery styles and format preferences for different stroke information: Patient and carer preferences

Patient Education and Counselling, 2011

Research paper thumbnail of Not in my backyard: a systematic review of clinicians' knowledge and beliefs about antibiotic resistance

Journal of Antimicrobial Chemotherapy

To systematically review clinicians' knowledge and beliefs about the importance and causes of... more To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance. Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data. There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11 593 clinicians. Most clinicians (69%, IQR 63%-72%, n = 5 studies) had heard of antibiotic resistance and 98% (IQR 93%-99%, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67%, IQR 65%-74%, n = 13 studies) was smaller than the proportion who believed...

Research paper thumbnail of Exploring primary caregivers’ expectations about the benefits and risks of treatment for acute respiratory infections in children and involvement in management decisions

Research paper thumbnail of Autoinflation: an effective nondrug intervention for glue ear

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 27, 2015

Research paper thumbnail of What do healthcare professionals know about antibiotic resistance? A systematic review

Research paper thumbnail of Reducing mortality with exercise-based cardiac rehabilitation: Is it what patients do or how well they stick with it?

Introduction: Cardiac rehabilitation provides significant benefit to patients with coronary heart... more Introduction: Cardiac rehabilitation provides significant benefit to patients with coronary heart disease however, there is significant variation between interventions in terms of program characteristics. Individual components of the intervention such as intensity, setting or duration may provide different relative contributions to the outcomes observed. This study aimed to examine evidence about cardiac rehabilitation interventions to determine the influence of individual components on clinical outcomes. Methods: A systematic review and meta-analysis were carried out to examine the effects of exercise-based cardiac rehabilitation on the clinical outcomes of all-cause and cardiovascular mortality. Subsequent subgroup meta-analysis and meta-regression have been conducted to examine the relative contribution of individual components such as compliance, provider, duration and exercise dose (intensity, frequency, time) to overall program outcome. Results: Forty-eight studies were identi...

Research paper thumbnail of Parents’ beliefs and knowledge about the management of acute otitis media: a qualitative study

BMC Family Practice, 2015

Research paper thumbnail of ‘TIDieR-ing up’ the reporting of interventions in stroke research: the importance of knowing what is in the ‘black box’

International Journal of Stroke, 2015

Research paper thumbnail of Faster title and abstract screening? Evaluating Abstrackr, a semi-automated online screening program for systematic reviewers

Systematic Reviews, 2015

Citation screening is time consuming and inefficient. We sought to evaluate the performance of Ab... more Citation screening is time consuming and inefficient. We sought to evaluate the performance of Abstrackr, a semi-automated online tool for predictive title and abstract screening. Four systematic reviews (aHUS, dietary fibre, ECHO, rituximab) were used to evaluate Abstrackr. Citations from electronic searches of biomedical databases were imported into Abstrackr, and titles and abstracts were screened and included or excluded according to the entry criteria. This process was continued until Abstrackr predicted and classified the remaining unscreened citations as relevant or irrelevant. These classification predictions were checked for accuracy against the original review decisions. Sensitivity analyses were performed to assess the effects of including case reports in the aHUS dataset whilst screening and the effects of using larger imbalanced datasets with the ECHO dataset. The performance of Abstrackr was calculated according to the number of relevant studies missed, the workload saving, the false negative rate, and the precision of the algorithm to correctly predict relevant studies for inclusion, i.e. further full text inspection. Of the unscreened citations, Abstrackr's prediction algorithm correctly identified all relevant citations for the rituximab and dietary fibre reviews. However, one relevant citation in both the aHUS and ECHO reviews was incorrectly predicted as not relevant. The workload saving achieved with Abstrackr varied depending on the complexity and size of the reviews (9 % rituximab, 40 % dietary fibre, 67 % aHUS, and 57 % ECHO). The proportion of citations predicted as relevant, and therefore, warranting further full text inspection (i.e. the precision of the prediction) ranged from 16 % (aHUS) to 45 % (rituximab) and was affected by the complexity of the reviews. The false negative rate ranged from 2.4 to 21.7 %. Sensitivity analysis performed on the aHUS dataset increased the precision from 16 to 25 % and increased the workload saving by 10 % but increased the number of relevant studies missed. Sensitivity analysis performed with the larger ECHO dataset increased the workload saving (80 %) but reduced the precision (6.8 %) and increased the number of missed citations. Semi-automated title and abstract screening with Abstrackr has the potential to save time and reduce research waste.

Research paper thumbnail of Can rasch analysis enhance the abstract ranking process in scientific conferences? Issues of interrater variability and abstract rating burden

The Journal of continuing education in the health professions, 2015

ranking processes for scientific conferences are essential but controversial. This study examined... more ranking processes for scientific conferences are essential but controversial. This study examined the validity of a structured abstract rating instrument, evaluated interrater variability, and modeled the impact of interrater variability on abstract ranking decisions. Additionally, we examined whether a more efficient rating process (abstracts rated by two rather than three raters) supported valid abstract rankings. Data were 4016 sets of abstract ratings from the 2011 and 2013 national scientific conferences for a health discipline. Many-faceted Rasch analysis procedures were used to examine validity of the abstract rating instrument and to identify and adjust for the presence of interrater variability. The two-rater simulation was created by the deletion of one set of ratings for each abstract in the 2013 data set. The abstract rating instrument demonstrated sound measurement properties. Although each rater applied the rating criteria consistently (intrarater reliability), there w...

Research paper thumbnail of Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke: a pilot randomized controlled trial

Topics in Stroke Rehabilitation, 2015

Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 a... more Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29%, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke. A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery andÅsberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor. Thirty (91%) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences. Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.

Research paper thumbnail of How Well Do Standard Stroke Outcome Measures Reflect Quality of Life?: A Retrospective Analysis of Clinical Trial Data

Stroke, 2013

Quality of life (QoL) is important to stroke survivors yet is often recorded as a secondary measu... more Quality of life (QoL) is important to stroke survivors yet is often recorded as a secondary measure in acute stroke randomized controlled trials. We examined whether commonly used stroke outcome measures captured aspects of QoL. We examined primary outcomes by National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI) and modified Rankin Scale (mRS), and QoL by Stroke Impact Scale (SIS) and European Quality of Life Scale (EQ-5D) from the Virtual International Stroke Trials Archive (VISTA). Using Spearman correlations and logistic regression, we described the relationships between QoL mRS, NIHSS, and BI at 3 months, stratified by respondent (patient or proxy). Using χ2 analyses, we examined the mismatch between good primary outcome (mRS ≤1, NIHSS ≤5, or BI ≥95) but poor QoL, and poor primary outcome (mRS ≥3, NIHSS ≥20, or BI ≤60) but good QoL. Patient-assessed QoL had a stronger association with mRS (EQ-5D weighted score n=2987, P<0.0001, r=-0.7, r2=0.53; SIS recovery n=2970, P<0.0001, r=-0.71, r2=0.52). Proxy responses had a stronger association with BI (EQ-5D weighted score n=837, P<0.0001, r=0.78, r2=0.63; SIS recovery n=867, P<0.0001, r=0.68, r2=0.48). mRS explained more of the variation in QoL (EQ-5D weighted score=53%, recovery by SIS v3.0=52%) than NIHSS or BI and resulted in fewer mismatches between good primary outcome and poor QoL (P<0.0001, EQ-5D weighted score=8.5%; SIS recovery=10%; SIS-16=4.4%). The mRS seemed to align closely with stroke survivors' interests, capturing more information on QoL than either NIHSS or BI. This further supports its recommendation as a primary outcome measure in acute stroke randomized controlled trials.

Research paper thumbnail of Prediction of outcome after stroke

Research paper thumbnail of Internet-Based Cognitive Behaviour Therapy for Tinnitus Patients Delivered in a Regular Clinical Setting: Outcome and Analysis of Treatment Dropout

Cognitive Behaviour Therapy, 2013

Cognitive behaviour therapy (CBT) can reduce tinnitus distress but is not available for most pati... more Cognitive behaviour therapy (CBT) can reduce tinnitus distress but is not available for most patients. Therapist guided, internet-based CBT (ICBT) increase availability and has been shown to be effective. However, the initial positive results need to be replicated in larger samples, and treatment dropout has not been thoroughly studied. Moreover, it has not been evaluated if a low-intensity version of ICBT without therapist contact could be an alternative for patients who do not need or are able to manage the full ICBT-program. This study evaluated two parallel interventions delivered in regular care: ICBT for tinnitus distress (n = 293) and a low-intensity version of ICBT (n = 81) for patients with lower levels of tinnitus distress. We also explored predictors of dropout from ICBT and if dropout influences outcome. Tinnitus Reaction Questionnaire (Wilson, Henry, Bowen, & Haralambous, 1991) was used as the primary outcome. Secondary outcomes were measures of depression, anxiety, sleep, and sound sensitivity. Significant reductions following ICBT were found on all measures after treatment and also at a three-month follow-up. Patients receiving low-intensity ICBT showed a significant reduction in distress, even when they had low levels of distress initially. Treatment dropout was preceded by an increase in days spent at each treatment step but not by an increased distress. Early dropout was related to worse outcome. ICBT can be used in a regular clinical setting to reduce tinnitus distress. Early dropouts may need additional management. For help-seeking patients with lower distress, a low-intensity version of ICBT can be used.