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  1. Article ; Online: Deceptive shifts in cancer stage distribution.

    Oke, Jason L / Welch, H Gilbert

    BMJ evidence-based medicine

    2024  Volume 29, Issue 1, Page(s) 47–49

    MeSH term(s) Humans ; Neoplasms/therapy ; Neoplasm Staging
    Language English
    Publishing date 2024-01-19
    Publishing country England
    Document type Journal Article
    ISSN 2515-4478
    ISSN (online) 2515-4478
    DOI 10.1136/bmjebm-2023-112238
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  2. Article ; Online: Breast cancer: conflating case fatality with mortality.

    Oke, Jason L / Welch, H Gilbert

    BMJ (Clinical research ed.)

    2023  Volume 382, Page(s) 2086

    MeSH term(s) Female ; Humans ; Breast Neoplasms/mortality
    Language English
    Publishing date 2023-09-12
    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.p2086
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  3. Article ; Online: Propensity scores in surgery: Don't believe the hype.

    Stevens, Richard J / Oke, Jason L

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2022  Volume 24, Issue 8, Page(s) 896–898

    MeSH term(s) Humans ; Propensity Score
    Language English
    Publishing date 2022-08-30
    Publishing country England
    Document type Editorial
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16279
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    Zs.A 5799: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article ; Online: Adequacy of clinical guideline recommendations for patients with low-risk cancer managed with monitoring: systematic review.

    Collins, Kiana K / Smith, Claire Friedemann / Ford, Tori / Roberts, Nia / Nicholson, Brian D / Oke, Jason L

    Journal of clinical epidemiology

    2024  Volume 169, Page(s) 111280

    Abstract: Objectives: The aim of this systematic review was to summarize national and international guidelines that made recommendations for monitoring patients diagnosed with low-risk cancer. It appraised the quality of guidelines and determined whether the ... ...

    Abstract Objectives: The aim of this systematic review was to summarize national and international guidelines that made recommendations for monitoring patients diagnosed with low-risk cancer. It appraised the quality of guidelines and determined whether the guidelines adequately identified patients for monitoring, specified which tests to use, defined monitoring intervals, and stated triggers for further intervention. It then assessed the evidence to support each recommendation.
    Study design and setting: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched PubMed and Turning Research into Practice databases for national and international guidelines' that were written in English and developed or updated between 2012 and 2023. Quality of individual guidelines was assessed using the AGREE II tool.
    Results: Across the 41 published guidelines, 48 different recommendations were identified: 15 (31%) for prostate cancer, 11 (23%) for renal cancer, 6 (12.5%) for thyroid cancer, and 10 (21%) for blood cancer. The remaining 6 (12.5%) were for brain, gastrointestinal, oral cavity, bone and pheochromocytoma and paraganglioma cancer. When combining all guidelines, 48 (100%) stated which patients qualify for monitoring, 31 (65%) specified which tests to use, 25 (52%) provided recommendations for surveillance intervals, and 23 (48%) outlined triggers to initiate intervention. Across all cancer sites, there was a strong positive trend with higher levels of evidence being associated with an increased likelihood of a recommendation being specific (P = 0.001) and the evidence for intervals was based on expert opinion or other guidance.
    Conclusion: With the exception of prostate cancer, the evidence base for monitoring low-risk cancer is weak and consequently recommendations in clinical guidelines are inconsistent. There is a lack of direct evidence to support monitoring recommendations in the literature making guideline developers reliant on expert opinion, alternative guidelines, or indirect or nonspecific evidence.
    Language English
    Publishing date 2024-02-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639306-8
    ISSN 1878-5921 ; 0895-4356
    ISSN (online) 1878-5921
    ISSN 0895-4356
    DOI 10.1016/j.jclinepi.2024.111280
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  5. Article ; Online: The Accuracy of Computed Tomography Angiography Compared With Technetium-99m Labelled Red Blood Cell Scintigraphy for the Diagnosis and Localization of Acute Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis.

    Yaxley, Kaspar L / Mulhem, Ali / Godfrey, Sean / Oke, Jason L

    Current problems in diagnostic radiology

    2023  Volume 52, Issue 6, Page(s) 546–559

    Abstract: Imaging tests are commonly used as an initial or early investigation for patients presenting with suspected acute gastrointestinal bleeding (AGIB). However, controversy remains regarding which of two frequently used modalities, computed tomography ... ...

    Abstract Imaging tests are commonly used as an initial or early investigation for patients presenting with suspected acute gastrointestinal bleeding (AGIB). However, controversy remains regarding which of two frequently used modalities, computed tomography angiography (CTA) or technetium-99m labelled red blood cell scintigraphy (RBCS), is most accurate. This systematic review and meta-analysis was performed to compare the accuracy of CTA and RBCS for the detection and localization of AGIB. Five electronic databases were searched with additional manual searching of reference lists of relevant publications identified during the search. Two reviewers independently performed screening, data extraction and methodological assessments. Where appropriate, the bivariate model was used for meta-analysis of sensitivities and specificities for the detection of bleeding and Freeman-Tukey double-arcsine transformation used for meta-analysis of proportions of correctly localized bleeding sites. Forty-four unique primary studies were included: twenty-two investigating CTA, seventeen investigating RBCS and five investigating both modalities. Meta-analysis produced similar pooled sensitivities; 0.83 (95% CI 0.74-0.90) and 0.84 (0.68-0.92) for CTA and RBCS respectively. Pooled specificity for CTA was higher than RBCS; 0.90 (0.72-0.97) and 0.84 (0.71-0.91) respectively. However, differences were not statistically significant. CTA was superior to RBCS in correctly localizing bleeding; pooled proportions of 1.00 (0.98-1.00) and 0.90 (0.83-0.96) respectively (statistically significant difference, P < 0.001). There is no evidence that CTA and RBCS have different diagnostic performance with respect to the detection of AGIB. However, CTA is superior to RBCS in terms of correctly localising the bleeding site, supporting usage of CTA over RBCS as the first line imaging investigation.
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 198954-6
    ISSN 1535-6302 ; 0363-0188
    ISSN (online) 1535-6302
    ISSN 0363-0188
    DOI 10.1067/j.cpradiol.2023.05.004
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  6. Article ; Online: Deceptive measures of progress in the NHS long-term plan for cancer: case-based vs. population-based measures.

    Oke, Jason L / Brown, Sarah Jo / Senger, Chris / Welch, H Gilbert

    British journal of cancer

    2023  Volume 129, Issue 1, Page(s) 3–7

    Abstract: The NHS Long Term Plan for cancer aims to increase early-stage diagnoses from 50% to 75% and to have 55,000 more people each year survive their cancer for at least 5 years following diagnosis. The targets measures are flawed and could be met without ... ...

    Abstract The NHS Long Term Plan for cancer aims to increase early-stage diagnoses from 50% to 75% and to have 55,000 more people each year survive their cancer for at least 5 years following diagnosis. The targets measures are flawed and could be met without improving outcomes that really matter to patients. The proportion of early-stage diagnoses could increase, while the number of patients presenting at a late-stage remains the same. More patients could survive their cancer for longer, but lead time and overdiagnosis bias make it impossible to know whether anyone had their life prolonged. The target measures should switch from biased case-based measures to unbiased population-based measures that reflect the key objectives in cancer care: reducing late-stage incidence and mortality.
    MeSH term(s) Humans ; State Medicine ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/therapy ; Incidence
    Language English
    Publishing date 2023-06-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80075-2
    ISSN 1532-1827 ; 0007-0920
    ISSN (online) 1532-1827
    ISSN 0007-0920
    DOI 10.1038/s41416-023-02308-9
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  7. Article ; Online: Effect of an artificial intelligence tool on management decisions for indeterminate pulmonary nodules.

    Kim, Roger Y / Oke, Jason L / Dotson, Travis L / Bellinger, Christina R / Vachani, Anil

    Respirology (Carlton, Vic.)

    2023  Volume 28, Issue 6, Page(s) 582–584

    MeSH term(s) Humans ; Artificial Intelligence ; Multiple Pulmonary Nodules/diagnostic imaging ; Multiple Pulmonary Nodules/therapy ; Lung Neoplasms/diagnosis ; Lung Neoplasms/therapy
    Language English
    Publishing date 2023-04-05
    Publishing country Australia
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1435849-9
    ISSN 1440-1843 ; 1323-7799
    ISSN (online) 1440-1843
    ISSN 1323-7799
    DOI 10.1111/resp.14502
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    Zs.A 4957: Show issues Location:
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  8. Article ; Online: Cancer survival figures are misleading.

    Oke, Jason L

    BMJ (Clinical research ed.)

    2014  Volume 348, Page(s) g3315

    MeSH term(s) Humans ; Neoplasms/diagnosis ; Neoplasms/mortality ; Prognosis ; Research Design ; Survival Analysis ; Survival Rate ; United Kingdom/epidemiology
    Language English
    Publishing date 2014-05-19
    Publishing country England
    Document type Letter
    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.g3315
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    Ua VI Zs.10: Show issues Location:
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  9. Article ; Online: Weight regain and mental health outcomes following behavioural weight management programmes: A systematic review with meta-analyses.

    Theodoulou, Annika / Hartmann-Boyce, Jamie / Gorenberg, Jordan / Oke, Jason L / Butler, Ailsa R / Bastounis, Anastasios / Jebb, Susan A / Aveyard, Paul

    Clinical obesity

    2023  Volume 13, Issue 3, Page(s) e12575

    Abstract: Behavioural weight management programmes (BWMPs) lead to weight loss but subsequent weight regain may harm mental health outcomes. We searched for randomised trials of BWMPs in adults with overweight/obesity with follow-up ≥12 months from baseline that ... ...

    Abstract Behavioural weight management programmes (BWMPs) lead to weight loss but subsequent weight regain may harm mental health outcomes. We searched for randomised trials of BWMPs in adults with overweight/obesity with follow-up ≥12 months from baseline that measured weight change both at and after programme-end. We included only studies reporting mental health at or after programme-end. We meta-analysed changes in various mental health outcomes using a random-effects model by nature of the comparator group and by time since programme end. Subgroup analysis explored heterogeneity. We used mixed models and meta-regression to analyse the association between change in weight and change in depression and/or anxiety over time, with higher scores indicating greater depression and/or anxiety. We included 47 studies. When comparing BWMPs (diet and/or exercise) to control, most estimates included the possibility of no difference, but pooled estimates for psychological wellbeing, self-esteem and mental-health composite scores at programme-end, anxiety at 1-6 months, and depression at 7-12 months after programme-end suggested improvements in intervention arms relative to control, with 95% CIs excluding no difference. Pooled estimates found no evidence that BWMPs harmed mental health at programme end or beyond. Mental health composite scores at programme-end favoured diet and exercise interventions over diet alone, with 95% CIs excluding no difference. All other measures and timepoints included the possibility of no difference or could not be meta-analysed due to high heterogeneity or a paucity of data. Mixed models and meta-regression of the association between change in depression and/or anxiety scores over time, and change in weight, were inconclusive. Despite weight regain after BWMPs, our meta-analyses found no evidence of mental health harm and some evidence that BWMPs may improve some dimensions of mental health at and after programme-end.
    MeSH term(s) Adult ; Humans ; Exercise ; Obesity/therapy ; Outcome Assessment, Health Care ; Weight Gain ; Weight Reduction Programs
    Language English
    Publishing date 2023-01-09
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 2625816-X
    ISSN 1758-8111 ; 1758-8103
    ISSN (online) 1758-8111
    ISSN 1758-8103
    DOI 10.1111/cob.12575
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  10. Article: The Association between Blood Test Trends and Undiagnosed Cancer: A Systematic Review and Critical Appraisal.

    Virdee, Pradeep S / Collins, Kiana K / Friedemann Smith, Claire / Yang, Xin / Zhu, Sufen / Roberts, Sophie E / Roberts, Nia / Oke, Jason L / Bankhead, Clare / Perera, Rafael / Hobbs, F D Richard / Nicholson, Brian D

    Cancers

    2024  Volume 16, Issue 9

    Abstract: Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient's individual baseline and ... ...

    Abstract Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient's individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer. We used descriptive summaries and narratively synthesised studies. We included 29 articles. Common blood tests were haemoglobin (24%, n = 7), C-reactive protein (17%, n = 5), and fasting blood glucose (17%, n = 5), and common cancers were pancreatic (29%, n = 8) and colorectal (17%, n = 5). Of the 30 blood tests studied, an increasing trend in eight (27%) was associated with eight cancer types, and a decreasing trend in 17 (57%) with 10 cancer types. No association was reported between trends in 11 (37%) tests and breast, bile duct, glioma, haematological combined, liver, prostate, or thyroid cancers. Our review highlights trends in blood tests that could facilitate the identification of individuals at increased risk of undiagnosed cancer. For most possible combinations of tests and cancers, there was limited or no evidence.
    Language English
    Publishing date 2024-04-26
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16091692
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