kasia bera | University of Oxford (original) (raw)

Papers by kasia bera

Pilot study on large language models for risk-of-bias assessments in systematic reviews: A(I) new type of bias?

BMJ evidence-based medicine, May 23, 2024

Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. ... more Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. Developed by Cochrane, it is considered the gold standard of assessing RoB for studies included within systematic reviews, representing a key part of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.1 The RoB tool comprises six domains that may signify bias: random sequence generation, allocation concealment, blinding of participants and personnel, attrition bias, reporting bias and other potential biases.2 This assessment is an integral component of evaluating the quality of evidence; however, it is a time-consuming and labour-intensive process.

Pilot study on large language models for risk-of-bias assessments in systematic reviews: A(I) new type of bias?

BMJ Evidence-Based Medicine, 2024

Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. ... more Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. Developed by Cochrane, it is considered the gold standard of assessing RoB for studies included within systematic reviews, representing a key part of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.1 The RoB tool comprises six domains that may signify bias: random sequence generation, allocation concealment, blinding of participants and personnel, attrition bias, reporting bias and other potential biases.2 This assessment is an integral component of evaluating the quality of evidence; however, it is a time-consuming and labour-intensive process.

JNDS, 2023

Carotid web is a focal form of fibromuscular dysplasia characterised by an ... more Carotid web is a focal form of fibromuscular dysplasia characterised by an abnormal shelf-like projection of fibrous tissue into the lumen of the carotid artery. It is a rare but important cause of recurrent ischemic stroke particularly in younger patients with few traditional risk factors. Despite that it may cause up to 37% of strokes of uncertain aetiology, an optimal evidenced-based management strategy has not been developed. This case report provides us with the opportunity to highlight this under-recognised cause of recurrent stroke and review the current evidence for its diagnosis and management

Organ donation after brain death (DBD) is an important source of transplanted organs as chronic u... more Organ donation after brain death (DBD) is an important source of transplanted organs as chronic undersupply means many patients die whilst awaiting a transplant. Improving organ quality and graft survival is key to reducing waiting lists. The interval between brain death confirmation and organ procurement offers an opportunity to reduce organ injury or encourage repair, yet data is lacking on the effects of brain injury on future grafts and which pathways to target. In fact, the consensus view has been that brain death exposes organs to a progressively pro-inflammatory environment, suggesting organ procurement must occur within a limited time window. Here, we developed a novel method of studying time-course changes in serum proteins in a DBD cohort from a UK biobank. Individual donor trajectories were combined to determine the time course of pro-inflammatory (Tumour Necrosis Factor alpha, Interleukin 6, Complement) mediators and markers of central nervous injury (Neuron Specific Eno...

Safety of Carotid Endarterectomy for Symptomatic Stenosis by Age: Meta-Analysis With Individual Patient Data

Stroke

Background: There is uncertainty whether elderly patients with symptomatic carotid stenosis have ... more Background: There is uncertainty whether elderly patients with symptomatic carotid stenosis have higher rates of adverse events following carotid endarterectomy. In trials, recurrent stroke risk on medical therapy alone increased with age, whereas operative stroke risk was not related. Few octogenarians were included in trials and there has been no systematic analysis of all study types. We aimed to evaluate the safety of carotid endarterectomy in symptomatic elderly patients, particularly in octogenarians. Methods: We did a systematic review and meta-analysis of studies (from January 1, 1980 through March 1, 2022) reporting post carotid endarterectomy risk of stroke, myocardial infarction, and death in patients with symptomatic carotid stenosis. We included observational studies and interventional arms of randomized trials if the outcome rates (or the raw data to calculate these) were provided. Individual patient data from 4 prospective cohorts enabled multivariate analysis. Result...

Anaesthesia, 2020

Mortality remains high for patients on the waiting list for organ transplantation. A marked imbal... more Mortality remains high for patients on the waiting list for organ transplantation. A marked imbalance between the number of available organs and recipients that need to be transplanted persists. Organs from deceased donors are often declined due to perceived and actual suboptimal quality. Adequate donor management offers an opportunity to reduce organ injury and maximise the number of organs than can be offered in order to respect the donor's altruistic gift. The cornerstones of management include: correction of hypovolaemia; maintenance of organ perfusion; prompt treatment of diabetes insipidus; corticosteroid therapy; and lung protective ventilation. The interventions used to deliver these goals are largely based on pathophysiological rationale or extrapolations from general critical care patients. There is currently insufficient high-quality evidence that has assessed whether any interventions in the donor after brain death may actually improve immediate post-transplant function and long-term graft survival or recipient survival after transplantation. Improvements in our understanding of the underlying mechanisms following brain death, in particular the role of immunological and metabolic changes in donors, offer promising future therapeutic opportunities to increase organ utilisation. Establishing a UK donor management research programme involves consideration of ethical, logistical and legal issues that will benefit transplanted patients while respecting the wishes of donors and their families.

British Journal of Surgery

Background Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and r... more Background Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and research. Self-reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. Methods Patients completed the WHQ (self-assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face-to-face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's α examined scale structure and internal consistency. Test–retest and self- versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face-to-face r...

Outcome measures in solid organ donor management research: a systematic review

British Journal of Anaesthesia

Background: Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and ... more Background: Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and research. Self-reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. Methods: Patients completed the WHQ (self-assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face-to-face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's í µí»‚ examined scale structure and internal consistency. Test-retest and self-versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face-to-face reference diagnosis (using Centers for Disease Control and Prevention criteria) were examined. Results: Some 561 of 792 self-assessments (70⋅8 per cent) and 597 of 791 observer assessments (75⋅5 per cent) were completed, with few missing data or problems reported. Data supported a single-scale structure with strong internal consistency (í µí»‚ greater than 0⋅8). Reliability between test-retest and self-versus observer assessments was good (í µí»‹ 0⋅6 or above for the majority of items). Sensitivity and specificity for SSI discrimination was high (area under the receiver operating characteristic (ROC) curve 0⋅91). Conclusion: The Bluebelle WHQ is acceptable, reliable and valid with a single-scale structure for post-discharge patient or observer assessment of SSI in closed primary wounds.

Background: Wound healing after surgery may be complicated by surgical site infection (SSI). SSI ... more Background: Wound healing after surgery may be complicated by surgical site infection (SSI). SSI development may be influenced by surgical techniques surrounding primary wound closure; for example, the standard to which surgical wounds are closed at the end of an operation.

word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledg... more word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledgements: With thanks to Mustafa S Rashid and the BOTA Council for their support in the conception of the Lost Tribe study and design of the study tool, and Adam P Williams and the ASiT Council for provision of infrastructural support, including survey management and communications software. Abstract word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledgements: With thanks to Mustafa S Rashid and the BOTA Council for their support in the conception of the Lost Tribe study and design of the study tool, and Adam P Williams and the ASiT Council for provision of infrastructural support, including survey management and communications software.

Novel pathogenic antibodies give insight into the role of GABA A receptors in the central nervous system (Journal Review)

Advances in Clinical Neuroscience Rehabilitation Acnr, Aug 1, 2014

ABSTRACT Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified... more ABSTRACT Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patients with thymomas. – Spectrum of autoimmune encephalitides extended with discovery of pathogenic antibodies to inhibitory channel. – Identification of antibodies involved a comprehensive characterisation of pathogenicity. – Clinically, improvement is observed but coincides with multiple interventions and does not directly address whether this may be due to a depression in autoantibody titres. – Binding of antibodies may alter network excitability, as inhibitory neurotransmission is likely to be impaired.

Why right is never left: the systemic right ventricle in transposition of the great arteries

The Journal of Physiology, 2015

Early and Continued Treatment of N-Methyl D-Aspartate Receptor-Antibody Encephalitis Optimises Outcome of a Predominantly Non-Paraneoplastic Disease

Novel pathogenic antibodies give insight into the role of GABA A receptors in the central nervous system (Journal Review)

Advances in clinical neuroscience & rehabilitation: ACNR

Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patie... more Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patients with thymomas. – Spectrum of autoimmune encephalitides extended with discovery of pathogenic antibodies to inhibitory channel. – Identification of antibodies involved a comprehensive characterisation of pathogenicity. – Clinically, improvement is observed but coincides with multiple interventions and does not directly address whether this may be due to a depression in autoantibody titres. – Binding of antibodies may alter network excitability, as inhibitory neurotransmission is likely to be impaired.

Pilot study on large language models for risk-of-bias assessments in systematic reviews: A(I) new type of bias?

BMJ evidence-based medicine, May 23, 2024

Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. ... more Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. Developed by Cochrane, it is considered the gold standard of assessing RoB for studies included within systematic reviews, representing a key part of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.1 The RoB tool comprises six domains that may signify bias: random sequence generation, allocation concealment, blinding of participants and personnel, attrition bias, reporting bias and other potential biases.2 This assessment is an integral component of evaluating the quality of evidence; however, it is a time-consuming and labour-intensive process.

Pilot study on large language models for risk-of-bias assessments in systematic reviews: A(I) new type of bias?

BMJ Evidence-Based Medicine, 2024

Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. ... more Risk-of-bias (RoB) assessment is used to assess randomised control trials for systematic errors. Developed by Cochrane, it is considered the gold standard of assessing RoB for studies included within systematic reviews, representing a key part of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.1 The RoB tool comprises six domains that may signify bias: random sequence generation, allocation concealment, blinding of participants and personnel, attrition bias, reporting bias and other potential biases.2 This assessment is an integral component of evaluating the quality of evidence; however, it is a time-consuming and labour-intensive process.

JNDS, 2023

Carotid web is a focal form of fibromuscular dysplasia characterised by an ... more Carotid web is a focal form of fibromuscular dysplasia characterised by an abnormal shelf-like projection of fibrous tissue into the lumen of the carotid artery. It is a rare but important cause of recurrent ischemic stroke particularly in younger patients with few traditional risk factors. Despite that it may cause up to 37% of strokes of uncertain aetiology, an optimal evidenced-based management strategy has not been developed. This case report provides us with the opportunity to highlight this under-recognised cause of recurrent stroke and review the current evidence for its diagnosis and management

Organ donation after brain death (DBD) is an important source of transplanted organs as chronic u... more Organ donation after brain death (DBD) is an important source of transplanted organs as chronic undersupply means many patients die whilst awaiting a transplant. Improving organ quality and graft survival is key to reducing waiting lists. The interval between brain death confirmation and organ procurement offers an opportunity to reduce organ injury or encourage repair, yet data is lacking on the effects of brain injury on future grafts and which pathways to target. In fact, the consensus view has been that brain death exposes organs to a progressively pro-inflammatory environment, suggesting organ procurement must occur within a limited time window. Here, we developed a novel method of studying time-course changes in serum proteins in a DBD cohort from a UK biobank. Individual donor trajectories were combined to determine the time course of pro-inflammatory (Tumour Necrosis Factor alpha, Interleukin 6, Complement) mediators and markers of central nervous injury (Neuron Specific Eno...

Safety of Carotid Endarterectomy for Symptomatic Stenosis by Age: Meta-Analysis With Individual Patient Data

Stroke

Background: There is uncertainty whether elderly patients with symptomatic carotid stenosis have ... more Background: There is uncertainty whether elderly patients with symptomatic carotid stenosis have higher rates of adverse events following carotid endarterectomy. In trials, recurrent stroke risk on medical therapy alone increased with age, whereas operative stroke risk was not related. Few octogenarians were included in trials and there has been no systematic analysis of all study types. We aimed to evaluate the safety of carotid endarterectomy in symptomatic elderly patients, particularly in octogenarians. Methods: We did a systematic review and meta-analysis of studies (from January 1, 1980 through March 1, 2022) reporting post carotid endarterectomy risk of stroke, myocardial infarction, and death in patients with symptomatic carotid stenosis. We included observational studies and interventional arms of randomized trials if the outcome rates (or the raw data to calculate these) were provided. Individual patient data from 4 prospective cohorts enabled multivariate analysis. Result...

Anaesthesia, 2020

Mortality remains high for patients on the waiting list for organ transplantation. A marked imbal... more Mortality remains high for patients on the waiting list for organ transplantation. A marked imbalance between the number of available organs and recipients that need to be transplanted persists. Organs from deceased donors are often declined due to perceived and actual suboptimal quality. Adequate donor management offers an opportunity to reduce organ injury and maximise the number of organs than can be offered in order to respect the donor's altruistic gift. The cornerstones of management include: correction of hypovolaemia; maintenance of organ perfusion; prompt treatment of diabetes insipidus; corticosteroid therapy; and lung protective ventilation. The interventions used to deliver these goals are largely based on pathophysiological rationale or extrapolations from general critical care patients. There is currently insufficient high-quality evidence that has assessed whether any interventions in the donor after brain death may actually improve immediate post-transplant function and long-term graft survival or recipient survival after transplantation. Improvements in our understanding of the underlying mechanisms following brain death, in particular the role of immunological and metabolic changes in donors, offer promising future therapeutic opportunities to increase organ utilisation. Establishing a UK donor management research programme involves consideration of ethical, logistical and legal issues that will benefit transplanted patients while respecting the wishes of donors and their families.

British Journal of Surgery

Background Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and r... more Background Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and research. Self-reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. Methods Patients completed the WHQ (self-assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face-to-face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's α examined scale structure and internal consistency. Test–retest and self- versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face-to-face r...

Outcome measures in solid organ donor management research: a systematic review

British Journal of Anaesthesia

Background: Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and ... more Background: Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and research. Self-reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. Methods: Patients completed the WHQ (self-assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face-to-face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's í µí»‚ examined scale structure and internal consistency. Test-retest and self-versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face-to-face reference diagnosis (using Centers for Disease Control and Prevention criteria) were examined. Results: Some 561 of 792 self-assessments (70⋅8 per cent) and 597 of 791 observer assessments (75⋅5 per cent) were completed, with few missing data or problems reported. Data supported a single-scale structure with strong internal consistency (í µí»‚ greater than 0⋅8). Reliability between test-retest and self-versus observer assessments was good (í µí»‹ 0⋅6 or above for the majority of items). Sensitivity and specificity for SSI discrimination was high (area under the receiver operating characteristic (ROC) curve 0⋅91). Conclusion: The Bluebelle WHQ is acceptable, reliable and valid with a single-scale structure for post-discharge patient or observer assessment of SSI in closed primary wounds.

Background: Wound healing after surgery may be complicated by surgical site infection (SSI). SSI ... more Background: Wound healing after surgery may be complicated by surgical site infection (SSI). SSI development may be influenced by surgical techniques surrounding primary wound closure; for example, the standard to which surgical wounds are closed at the end of an operation.

word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledg... more word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledgements: With thanks to Mustafa S Rashid and the BOTA Council for their support in the conception of the Lost Tribe study and design of the study tool, and Adam P Williams and the ASiT Council for provision of infrastructural support, including survey management and communications software. Abstract word count: 265 Word count: 2961 Declaration of interests: None Funding received: None Acknowledgements: With thanks to Mustafa S Rashid and the BOTA Council for their support in the conception of the Lost Tribe study and design of the study tool, and Adam P Williams and the ASiT Council for provision of infrastructural support, including survey management and communications software.

Novel pathogenic antibodies give insight into the role of GABA A receptors in the central nervous system (Journal Review)

Advances in Clinical Neuroscience Rehabilitation Acnr, Aug 1, 2014

ABSTRACT Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified... more ABSTRACT Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patients with thymomas. – Spectrum of autoimmune encephalitides extended with discovery of pathogenic antibodies to inhibitory channel. – Identification of antibodies involved a comprehensive characterisation of pathogenicity. – Clinically, improvement is observed but coincides with multiple interventions and does not directly address whether this may be due to a depression in autoantibody titres. – Binding of antibodies may alter network excitability, as inhibitory neurotransmission is likely to be impaired.

Why right is never left: the systemic right ventricle in transposition of the great arteries

The Journal of Physiology, 2015

Early and Continued Treatment of N-Methyl D-Aspartate Receptor-Antibody Encephalitis Optimises Outcome of a Predominantly Non-Paraneoplastic Disease

Novel pathogenic antibodies give insight into the role of GABA A receptors in the central nervous system (Journal Review)

Advances in clinical neuroscience & rehabilitation: ACNR

Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patie... more Journal Review Article - Antibodies against the β3 subunit of GABAA receptors identified in patients with thymomas. – Spectrum of autoimmune encephalitides extended with discovery of pathogenic antibodies to inhibitory channel. – Identification of antibodies involved a comprehensive characterisation of pathogenicity. – Clinically, improvement is observed but coincides with multiple interventions and does not directly address whether this may be due to a depression in autoantibody titres. – Binding of antibodies may alter network excitability, as inhibitory neurotransmission is likely to be impaired.