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  1. Article ; Online: COVID-19: estimated number of deaths if Australia had experienced a similar outbreak to England and Wales.

    Stanaway, Fiona / Irwig, Les M / Teixeira-Pinto, Armando / Bell, Katy Jl

    The Medical journal of Australia

    2021  Volume 214, Issue 2, Page(s) 95–95.e1

    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Australia/epidemiology ; COVID-19/mortality ; Cause of Death ; Child ; Child, Preschool ; England/epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Pandemics ; Risk ; SARS-CoV-2 ; Wales/epidemiology ; Young Adult
    Language English
    Publishing date 2021-01-13
    Publishing country Australia
    Document type Letter
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.50909
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    Ua VI Zs.398: Show issues Location:
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  2. Article ; Online: I need an exact margin measurement for this basal cell carcinoma!

    Katz, Ian / Irwig, Les / McGeehan, Kevin / Bell, Katy

    Journal of clinical pathology

    2021  Volume 75, Issue 12, Page(s) 857–860

    Abstract: Background/objectives: Pathology laboratories are required to determine or estimate the measurement uncertainty for all quantitative results, but there is no literature on the uncertainty in margin measurements for skin cancer excisions.: Methods: ... ...

    Abstract Background/objectives: Pathology laboratories are required to determine or estimate the measurement uncertainty for all quantitative results, but there is no literature on the uncertainty in margin measurements for skin cancer excisions.
    Methods: Six pathologists measured 4-14 histological margins in each of 10 basal cell carcinoma.
    Results: The mean of measurements from all the margins from all the cases was 1.8 mm (range 0 and 6 mm). Regarding the overall variance in margin measurements across the ten cases, 25% was from variation within cases (differences in margin measurement for a given case, because of different margins and different pathologists measuring each margin, SD 0.7 mm). For a given case, we estimate that 95% of margin measurements would fall approximately within±1.4 mm of the mean measurement for that case. When only pathologists' closest margin for each case were included (for the six cases with uninvolved margins), 6% of the overall variance was from differences within cases (because of different pathologists' measurements of the closest margin, SD 0.2 mm). For a given case without an involved margin, 95% of closest margin measurements would fall approximately within±0.5 mm of the mean closest measurement for that case.
    Conclusions: Clinicians should be aware there is uncertainty in reported histological margins.
    MeSH term(s) Humans ; Carcinoma, Basal Cell/surgery ; Carcinoma, Basal Cell/pathology ; Margins of Excision ; Skin Neoplasms/surgery ; Skin Neoplasms/pathology ; Skin/pathology
    Language English
    Publishing date 2021-12-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 80261-x
    ISSN 1472-4146 ; 0021-9746
    ISSN (online) 1472-4146
    ISSN 0021-9746
    DOI 10.1136/jclinpath-2021-208030
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  3. Article ; Online: Red flags to screen for vertebral fracture in patients presenting with low-back pain.

    Williams, Christopher M / Henschke, Nicholas / Maher, Christopher G / van Tulder, Maurits W / Koes, Bart W / Macaskill, Petra / Irwig, Les

    The Cochrane database of systematic reviews

    2023  Volume 11, Page(s) CD008643

    Abstract: Editorial note: See https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014461.pub2/full for a more recent review that covers this topic and has superseded this review.: Background: Low-back pain (LBP) is a common condition seen in primary ... ...

    Abstract Editorial note: See https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014461.pub2/full for a more recent review that covers this topic and has superseded this review.
    Background: Low-back pain (LBP) is a common condition seen in primary care. A principal aim during a clinical examination is to identify patients with a higher likelihood of underlying serious pathology, such as vertebral fracture, who may require additional investigation and specific treatment. All 'evidence-based' clinical practice guidelines recommend the use of red flags to screen for serious causes of back pain. However, it remains unclear if the diagnostic accuracy of red flags is sufficient to support this recommendation.
    Objectives: To assess the diagnostic accuracy of red flags obtained in a clinical history or physical examination to screen for vertebral fracture in patients presenting with LBP.
    Search methods: Electronic databases were searched for primary studies between the earliest date and 7 March 2012. Forward and backward citation searching of eligible studies was also conducted.
    Selection criteria: Studies were considered if they compared the results of any aspect of the history or test conducted in the physical examination of patients presenting for LBP or examination of the lumbar spine, with a reference standard (diagnostic imaging). The selection criteria were independently applied by two review authors.
    Data collection and analysis: Three review authors independently conducted 'Risk of bias' assessment and data extraction. Risk of bias was assessed using the 11-item QUADAS tool. Characteristics of studies, patients, index tests and reference standards were extracted. Where available, raw data were used to calculate sensitivity and specificity with 95% confidence intervals (CI). Due to the heterogeneity of studies and tests, statistical pooling was not appropriate and the analysis for the review was descriptive only. Likelihood ratios for each test were calculated and used as an indication of clinical usefulness.
    Main results: Eight studies set in primary (four), secondary (one) and tertiary care (accident and emergency = three) were included in the review. Overall, the risk of bias of studies was moderate with high risk of selection and verification bias the predominant flaws. Reporting of index and reference tests was poor. The prevalence of vertebral fracture in accident and emergency settings ranged from 6.5% to 11% and in primary care from 0.7% to 4.5%. There were 29 groups of index tests investigated however, only two featured in more than two studies. Descriptive analyses revealed that three red flags in primary care were potentially useful with meaningful positive likelihood ratios (LR+) but mostly imprecise estimates (significant trauma, older age, corticosteroid use; LR+ point estimate ranging 3.42 to 12.85, 3.69 to 9.39, 3.97 to 48.50 respectively). One red flag in tertiary care appeared informative (contusion/abrasion; LR+ 31.09, 95% CI 18.25 to 52.96). The results of combined tests appeared more informative than individual red flags with LR+ estimates generally greater in magnitude and precision.
    Authors' conclusions: The available evidence does not support the use of many red flags to specifically screen for vertebral fracture in patients presenting for LBP. Based on evidence from single studies, few individual red flags appear informative as most have poor diagnostic accuracy as indicated by imprecise estimates of likelihood ratios. When combinations of red flags were used the performance appeared to improve. From the limited evidence, the findings give rise to a weak recommendation that a combination of a small subset of red flags may be useful to screen for vertebral fracture. It should also be noted that many red flags have high false positive rates; and if acted upon uncritically there would be consequences for the cost of management and outcomes of patients with LBP. Further research should focus on appropriate sets of red flags and adequate reporting of both index and reference tests.
    MeSH term(s) Humans ; Spinal Fractures/complications ; Spinal Fractures/diagnosis ; Low Back Pain/diagnosis ; Low Back Pain/etiology ; Physical Examination ; Sensitivity and Specificity
    Language English
    Publishing date 2023-11-28
    Publishing country England
    Document type Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 1469-493X
    ISSN (online) 1469-493X
    DOI 10.1002/14651858.CD008643.pub3
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  4. Article ; Online: Equity and evidence during vaccine rollout: stepped wedge cluster randomised trials could help.

    Bell, Katy J L / Glasziou, Paul / Stanaway, Fiona / Bossuyt, Patrick / Irwig, Les

    BMJ (Clinical research ed.)

    2021  Volume 372, Page(s) n435

    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Humans ; Resource Allocation ; SARS-CoV-2 ; Sample Size
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-02-12
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.n435
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    Ua VI Zs.10: Show issues Location:
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  5. Article ; Online: Reply.

    Bell, Katy / Doust, Jenny / McGeechan, Kevin / Horvath, Andrea R / Barratt, Alexandra / Hayen, Andrew / Semsarian, Christopher / Irwig, Les

    Journal of hypertension

    2021  Volume 39, Issue 5, Page(s) 1045–1046

    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000002781
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    Zs.A 1885: Show issues Location:
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    Zs.MO 614: Show issues

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  6. Article ; Online: Mammography screening for breast cancer-the UK Age trial.

    Bell, Katy J L / Irwig, Les / Nickel, Brooke / Hersch, Jolyn / Hayen, Andrew / Barratt, Alexandra

    The Lancet. Oncology

    2020  Volume 21, Issue 11, Page(s) e504

    MeSH term(s) Breast ; Breast Neoplasms ; Early Detection of Cancer ; Humans ; Mammography ; United Kingdom
    Language English
    Publishing date 2020-12-17
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(20)30528-3
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    Zs.A 5696: Show issues Location:
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    Zs.MO 460: Show issues

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  7. Article ; Online: A novel methodological framework was described for detecting and quantifying overdiagnosis.

    Bell, Katy / Doust, Jenny / Sanders, Sharon / Buchbinder, Rachelle / Glasziou, Paul / Irwig, Les / Jones, Mark / Moynihan, Ray / Kazda, Luise / Barratt, Alexandra

    Journal of clinical epidemiology

    2022  Volume 148, Page(s) 146–159

    Abstract: Objectives: Methods to quantify overdiagnosis of screen detected cancer have been developed, but methods for quantifying overdiagnosis of noncancer conditions (whether symptomatic or asymptomatic) have been lacking. We aimed to develop a methodological ... ...

    Abstract Objectives: Methods to quantify overdiagnosis of screen detected cancer have been developed, but methods for quantifying overdiagnosis of noncancer conditions (whether symptomatic or asymptomatic) have been lacking. We aimed to develop a methodological framework for quantifying overdiagnosis that may be used for asymptomatic or symptomatic conditions and used gestational diabetes mellitus as an example of how it may be applied.
    Study design and setting: We identify two earlier definitions for overdiagnosis, a narrower prognosis-based definition and a wider utility-based definition. Building on the central importance of the concepts of prognostic information and clinical utility of a diagnosis, we consider the following questions: within a target population, do people found to have a disease using one diagnostic strategy but found not to have the disease using another diagnostic strategy (so called 'additional diagnoses'), have an increased risk of adverse clinical outcomes without treatment (prognosis evidence), and/or a decreased risk of adverse outcomes with treatment (utility evidence)?
    Results: Using Causal Directed Acyclic Graphs and fair umpires, we illuminate the relationships between diagnostics strategies and the frequency of overdiagnosis. We then use the example of gestational diabetes mellitus to demonstrate how the Fair Umpire framework may be applied to estimate overdiagnosis.
    Conclusion: Our framework may be used to quantify overdiagnosis in noncancer conditions (and in cancer conditions) and to guide further studies on this topic.
    MeSH term(s) Female ; Pregnancy ; Humans ; Medical Overuse ; Diabetes, Gestational/diagnosis ; Overdiagnosis ; Neoplasms ; Early Detection of Cancer
    Language English
    Publishing date 2022-04-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639306-8
    ISSN 1878-5921 ; 0895-4356
    ISSN (online) 1878-5921
    ISSN 0895-4356
    DOI 10.1016/j.jclinepi.2022.04.022
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  8. Article ; Online: Correction to: Estimation of treatment preference effects in clinical trials when some participants are indifferent to treatment choice.

    Walter, Stephen D / Turner, Robin M / Macaskill, Petra / McCaffery, Kirsten J / Irwig, Les

    BMC medical research methodology

    2020  Volume 20, Issue 1, Page(s) 82

    Abstract: In the original publication of this article [1], the number "- 0.49" in the below sentence in the Results section should be changed to "-3.23", and this typo does not affect the wider conclusions. ...

    Abstract In the original publication of this article [1], the number "- 0.49" in the below sentence in the Results section should be changed to "-3.23", and this typo does not affect the wider conclusions.
    Language English
    Publishing date 2020-04-14
    Publishing country England
    Document type Published Erratum
    ISSN 1471-2288
    ISSN (online) 1471-2288
    DOI 10.1186/s12874-020-00967-3
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  9. Article ; Online: How to use imperfect tests for COVID-19 (SARS-CoV-2) to make clinical decisions.

    Bell, Katy Jl / Stanaway, Fiona F / Irwig, Les M / Horvath, Andrea R / Teixeira-Pinto, Armando / Loy, Clement

    The Medical journal of Australia

    2021  Volume 214, Issue 2, Page(s) 69–73.e1

    MeSH term(s) COVID-19/diagnosis ; COVID-19 Testing/standards ; Clinical Decision-Making ; Humans ; Medical History Taking ; SARS-CoV-2 ; Sensitivity and Specificity
    Language English
    Publishing date 2021-01-07
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.50907
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  10. Article ; Online: Correction to

    Stephen D. Walter / Robin M. Turner / Petra Macaskill / Kirsten J. McCaffery / Les Irwig

    BMC Medical Research Methodology, Vol 20, Iss 1, Pp 1-

    Estimation of treatment preference effects in clinical trials when some participants are indifferent to treatment choice

    2020  Volume 1

    Abstract: In the original publication of this article [1], the number “− 0.49” in the below sentence in the Results section should be changed to “-3.23”, and this typo does not affect the wider conclusions. ...

    Abstract In the original publication of this article [1], the number “− 0.49” in the below sentence in the Results section should be changed to “-3.23”, and this typo does not affect the wider conclusions.
    Keywords Medicine (General) ; R5-920
    Language English
    Publishing date 2020-04-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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