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Royal College of Obstetricians and Gynaecologists, London, UK
University of Amsterdam, the Netherlands
University of Granada, Spain
Professor Khalid Khan is a distinguished investigator (Beatriz Galindo programme) at the University of Granada, Spain. With an h-index >70, he has published over 400 peer-reviewed papers and supervised 25 higher-degree theses. Khalid has been a professor at the University of Birmingham and Queen Mary University of London, UK, and Spinoza professor at the University of Amsterdam, the Netherlands. Professor Khalid Khan graduated in medicine from the Aga Khan University in its first health faculty cohort. Higher training at McMaster University led him to an academic career, focusing on patient-oriented clinical research. Khalid has contributed to many trials and meta-analyses: has run 48 primary research trials, recruiting 979,242 participants, and has published 149 systematic reviews, collating data from 6415 studies with 68,798,079 participants. Professor Khalid Khan is the lead author of 'Systematic Reviews to Support Evidence-Based Medicine', which won a BMA Medical Book award. His Core Outcomes in Women’s and Newborn Health (CROWN) initiative was awarded a BMA Strutt and Harper grant to help reduce research waste. He is a former editor of BJOG, EBM-BMJ, and BMC Med Educ.
Khalid Saeed Khan. Flawed use of post-publication data fabrication tests. Journal of Clinical Epidemiology 2021, 1 .
AMA StyleKhalid Saeed Khan. Flawed use of post-publication data fabrication tests. Journal of Clinical Epidemiology. 2021; ():1.
Chicago/Turabian StyleKhalid Saeed Khan. 2021. "Flawed use of post-publication data fabrication tests." Journal of Clinical Epidemiology , no. : 1.
Breast cancer (BC) management care requires an increment in quality. An initiative to improve the BC quality care is registered, and quality indicators (QIs) are studied. We appraised the appearance of QIs and their standards systematically in Spain. A prospective systematic search (Prospero no: CRD42021228867) for clinical pathways and integrated breast cancer care processes was conducted through databases and the World Wide Web in February 2021. Duplicate data extraction was performed with 98% reviewer agreement. Seventy-four QIs (QI per document mean: 11; standard deviation: 10.59) were found in 15 documents. The Catalonian document had the highest number of QIs (n = 30). No QI appeared in all the documents. There were 9/74 QIs covering structure (12.16%), 53/74 covering process (71.62%), and 12/74 covering outcome (16.22%). A total of 22/66 (33.33%) process and outcome QIs did not set a minimum standard of care. QIs related to primary care, patient satisfaction, and shared decision making were deficient. Most of the documents established a BC QI standard for compliance, but the high variability hinders the comparison of outcomes. Establishing a consensus-based set of QIs needs urgent attention.
Marta Maes-Carballo; Yolanda Gómez-Fandiño; Carlos Estrada-López; Ayla Reinoso-Hermida; Khalid Khan; Manuel Martín-Díaz; Aurora Bueno-Cavanillas. Breast Cancer Care Quality Indicators in Spain: A Systematic Review. International Journal of Environmental Research and Public Health 2021, 18, 6411 .
AMA StyleMarta Maes-Carballo, Yolanda Gómez-Fandiño, Carlos Estrada-López, Ayla Reinoso-Hermida, Khalid Khan, Manuel Martín-Díaz, Aurora Bueno-Cavanillas. Breast Cancer Care Quality Indicators in Spain: A Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18 (12):6411.
Chicago/Turabian StyleMarta Maes-Carballo; Yolanda Gómez-Fandiño; Carlos Estrada-López; Ayla Reinoso-Hermida; Khalid Khan; Manuel Martín-Díaz; Aurora Bueno-Cavanillas. 2021. "Breast Cancer Care Quality Indicators in Spain: A Systematic Review." International Journal of Environmental Research and Public Health 18, no. 12: 6411.
Introduction Unsafe abortion is the cause of a substantial number of maternal mortalities and morbidities globally, but specifically in low‐ and middle‐income countries. Medical abortion methods provided by non‐physicians may be a way to reduce the burden of unsafe abortions. Currently, only one systematic review comparing non‐physicians with physicians for medical abortion exists. However, the review does not have any setting restrictions and newer evidence has since been published. Therefore, this review aims to evaluate the effectiveness, acceptability, and safety of first‐trimester abortion managed by non‐physicians compared with physicians in low‐ and middle‐income countries. Material and methods The databases PubMed, Cochrane Library, Global Health Library, and EMBASE were searched using a structured search strategy. Further, the trial registries clinicaltrials.gov and The International Clinical Trial Registry Platform were searched for published and unpublished trials. Randomized controlled trials comparing provision of medical abortion by non‐physicians with that by physicians in low‐ or middle‐income countries were included. Risk of bias was assessed using the Cochrane Risk of Bias tool. Trials that reported effect estimates on the effectiveness of medical methods on complete abortion were included in the meta‐analysis. The protocol was prospectively registered in the PROSPERO database, ID: CRD42020176811. Results Six papers from four different randomized controlled trials with a total of 4021 participants were included. Two of the four included trials were assessed to have overall low risk of bias. Four papers had outcome data on complete abortion and were included in the meta‐analyses. Medical management of first‐trimester abortion and medical treatment of incomplete abortion were found to be equally effective when provided by a non‐physician as when provided by a physician (risk ratio 1.00; 95% CI 0.99‐1.01). Further, the treatment was equally safe, and women were equally satisfied when a non‐physician provided the treatment compared with a physician. Conclusions Provision of medical abortion or medical treatment for incomplete abortion in the first trimester is equally effective, safe, and acceptable when provided by non‐physicians compared with physicians in low‐ and middle‐income countries. We recommend that the task of providing medical abortion and medical treatment for incomplete abortion in low‐ and middle‐income countries should be shared with non‐physicians.
Marianne Bogen Kristiansen; Benjamin C. Shayo; Rune Philemon; Khalid Saeed Khan; Vibeke Rasch; Ditte Søndergaard Linde. Medical management of induced and incomplete first‐trimester abortion by non‐physicians in low‐ and middle‐income countries: A systematic review and meta‐analysis of randomized controlled trials. Acta Obstetricia et Gynecologica Scandinavica 2021, 100, 718 -726.
AMA StyleMarianne Bogen Kristiansen, Benjamin C. Shayo, Rune Philemon, Khalid Saeed Khan, Vibeke Rasch, Ditte Søndergaard Linde. Medical management of induced and incomplete first‐trimester abortion by non‐physicians in low‐ and middle‐income countries: A systematic review and meta‐analysis of randomized controlled trials. Acta Obstetricia et Gynecologica Scandinavica. 2021; 100 (4):718-726.
Chicago/Turabian StyleMarianne Bogen Kristiansen; Benjamin C. Shayo; Rune Philemon; Khalid Saeed Khan; Vibeke Rasch; Ditte Søndergaard Linde. 2021. "Medical management of induced and incomplete first‐trimester abortion by non‐physicians in low‐ and middle‐income countries: A systematic review and meta‐analysis of randomized controlled trials." Acta Obstetricia et Gynecologica Scandinavica 100, no. 4: 718-726.
Mucosal dryness and dyspareunia are symptoms that may significantly affect women with primary Sjӧgren syndrome (pSS). We investigated whether vaginal dryness is correlated with sexual function, and the impact may have on the quality of life (QoL) and mental health well-being in pSS patients. Ethically approved comparative cross-sectional study was designed to assess sexual function using the Female Sexual Function Index (FSFI) in 65 pSS female patients vs 62 sex-matched controls. The effect of vaginal dryness and fatigue on sexual function was investigated. Vaginal dryness was correlated with oral dryness estimated by salivary flow rate and the Clinical Oral Dryness Score to investigate whether genital dryness is indicative of general mucosal dryness in pSS. Validated questionnaires were used to investigate the effect of sexual function on QoL and mental health well-being. The number of sexually active pSS participants was significantly less than in the control group (28/65 vs 42/62, p < 0.05). The sexual function was significantly impaired in the pSS group (mean FSFI = 19 vs 28.3, p < 0.05). There was no significant association between self-reported vaginal dryness and oral dryness or sexual function. The open-ended questions showed that the most troublesome symptom reported by pSS patients was oral dryness (43%, n = 28/65) followed by fatigue (31%, n = 20/65). Sexual dysfunction had a negative impact on QoL and the mental health well-being of pSS patients in all aspects, especially on the quality of social life (β = 0.7, p = 0.02). Addressing sexual dysfunction can potentially improve the QoL of pSS patients significantly, especially their social well-being.
Minan Al-Ezzi; Anwar R. Tappuni; Khalid Saeed Khan. The impact of Sjӧgren’s syndrome on the quality of sexual life of female patients in the UK: a controlled analysis. Rheumatology International 2021, 1 -7.
AMA StyleMinan Al-Ezzi, Anwar R. Tappuni, Khalid Saeed Khan. The impact of Sjӧgren’s syndrome on the quality of sexual life of female patients in the UK: a controlled analysis. Rheumatology International. 2021; ():1-7.
Chicago/Turabian StyleMinan Al-Ezzi; Anwar R. Tappuni; Khalid Saeed Khan. 2021. "The impact of Sjӧgren’s syndrome on the quality of sexual life of female patients in the UK: a controlled analysis." Rheumatology International , no. : 1-7.
Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.
Marta Maes-Carballo; Manuel Martín-Díaz; Luciano Mignini; Khalid Khan; Rubén Trigueros; Aurora Bueno-Cavanillas. Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey. International Journal of Environmental Research and Public Health 2021, 18, 2128 .
AMA StyleMarta Maes-Carballo, Manuel Martín-Díaz, Luciano Mignini, Khalid Khan, Rubén Trigueros, Aurora Bueno-Cavanillas. Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey. International Journal of Environmental Research and Public Health. 2021; 18 (4):2128.
Chicago/Turabian StyleMarta Maes-Carballo; Manuel Martín-Díaz; Luciano Mignini; Khalid Khan; Rubén Trigueros; Aurora Bueno-Cavanillas. 2021. "Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey." International Journal of Environmental Research and Public Health 18, no. 4: 2128.
Introduction Maternal near miss is a major global health issue and approximately seven million women worldwide experience it each year. Maternal near miss can have several different health consequences and affect the women’s quality of life, yet little is known about the size and magnitude of this association. The aim of this study was to assess the evidence of the association between women who have experienced maternal near miss and quality of life compared to women who had an uncomplicated pregnancy and delivery. Material and methods Cochrane library, Embase, CINAHL, Web of science, Medline, Scopus and PubMed were searched for published studies. Studies were selected according to the PECO model (population, exposure, control, and outcome), and were included if they investigated quality of life as an outcome after maternal near miss among women of all ages with no limitation on country or time (up to June 2020). Maternal near miss was defined as a life‐threatening condition arising from complications related to pregnancy and/or childbirth. The quality of the studies was assessed according to the Newcastle‐Ottawa scale and a forest plot was constructed based on quality of life outcomes and study quality. PROSPERO registration number: CRD42020169232. Results Fifteen studies were included in the review with a total of 31,558 women. Quality of life was reported in various ways, and 25 different confounders were controlled for. Compared to women who did not experience maternal near miss, women exposed to maternal near miss had an overall lower quality of life (n=2/2), had poorer mental (n=6/10) and social health (n=2/3) and maternal near miss had negative economic consequences (n=4/4). Maternal near miss was not associated with sexual dysfunction (n=1/5). Ten out of fifteen studies were assessed as being of poor quality. Conclusions Evidence shows that maternal near miss is negatively associated with various aspects of quality of life. This highlights the importance of addressing the adverse effects associated with maternal near miss and follow up maternal near miss after discharge. Quality of life is a multidimensional concept that is assessed in various ways, and the literature on the field is heterogenous. More high‐quality studies are needed.
Ida Erika Wieborg Von Rosen; Rayan Mohamud Shiekh; Bariki Mchome; Wu Chunsen; Khalid S. Khan; Vibeke Rasch; Ditte Søndergaard Linde. Quality of life after maternal near miss: A systematic review. Acta Obstetricia et Gynecologica Scandinavica 2021, 100, 704 -714.
AMA StyleIda Erika Wieborg Von Rosen, Rayan Mohamud Shiekh, Bariki Mchome, Wu Chunsen, Khalid S. Khan, Vibeke Rasch, Ditte Søndergaard Linde. Quality of life after maternal near miss: A systematic review. Acta Obstetricia et Gynecologica Scandinavica. 2021; 100 (4):704-714.
Chicago/Turabian StyleIda Erika Wieborg Von Rosen; Rayan Mohamud Shiekh; Bariki Mchome; Wu Chunsen; Khalid S. Khan; Vibeke Rasch; Ditte Søndergaard Linde. 2021. "Quality of life after maternal near miss: A systematic review." Acta Obstetricia et Gynecologica Scandinavica 100, no. 4: 704-714.
Introduction Unintended pregnancy, a major global health issue resulting in unsafe abortions and maternal deaths in low‐ and middle‐income countries, could be significantly reduced through increased use of modern contraception, including long‐acting reversible contraceptives (LARC). Training of healthcare providers to administer such contraceptives may improve uptake. We conducted a systematic review to collate the end‐user uptake data following training of health care providers in low‐ and middle‐income countries. Material and methods We searched PubMed, Embase, the Global Health Library, and the Cochrane Library up to 23 May 2020. The review was restricted to low‐ and middle‐income countries and focused on healthcare providers who had received training in LARC. Studies that reported contraceptive uptake among women, preference of LARC amongst health care workers and/or women, and unplanned pregnancies within 12 months of LARC initiation were included. All included studies underwent quality assessment using either the Cochrane’s risk of bias tool or the Newcastle‐Ottawa Scale. PROSPERO registration number CRD42020185291. Results A total of 28 studies (end‐users n= 6.112.544) were included (27 cohort studies and one randomised trial). 19 studies were set in Africa, 5 in Asia, one in Central America and 4 were multi‐country studies. 28 studies reported LARC use among women, and 25 studies found an increase in uptake of LARC either by women using short acting methods switching to longer acting methods or by recruiting new users of LARC. The randomised controlled trial was assessed as high quality and reported positive findings, however there was great heterogeneity in the type of intervention and of how outcomes were measured amongst the other included studies. Further, the quality of these studies varied, although it should be noted that the poor quality studies reflected the trends of those of higher quality. Conclusions Despite heterogeneity, current evidence indicates that training of healthcare providers in LARC may increase the uptake amongst women in low‐ and middle‐income countries. More robust studies are warranted to inform policy.
Rasmus Stokholm Bækgaard; Eirik Gjærevold Damhaugh; Dorah Mrema; Vibeke Rasch; Khalid Saeed Khan; Ditte S. Linde. Training of healthcare providers and use of long‐acting reversible contraception in low‐ and middle‐income countries: A systematic review. Acta Obstetricia et Gynecologica Scandinavica 2021, 100, 619 -628.
AMA StyleRasmus Stokholm Bækgaard, Eirik Gjærevold Damhaugh, Dorah Mrema, Vibeke Rasch, Khalid Saeed Khan, Ditte S. Linde. Training of healthcare providers and use of long‐acting reversible contraception in low‐ and middle‐income countries: A systematic review. Acta Obstetricia et Gynecologica Scandinavica. 2021; 100 (4):619-628.
Chicago/Turabian StyleRasmus Stokholm Bækgaard; Eirik Gjærevold Damhaugh; Dorah Mrema; Vibeke Rasch; Khalid Saeed Khan; Ditte S. Linde. 2021. "Training of healthcare providers and use of long‐acting reversible contraception in low‐ and middle‐income countries: A systematic review." Acta Obstetricia et Gynecologica Scandinavica 100, no. 4: 619-628.
Background: Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. Methods: A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. Results: A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6–78%), as did psychological IPV (1.8–67.4%). Conclusions: Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy.
Rosario Román-Gálvez; Sandra Martín-Peláez; Juan Martínez-Galiano; Khalid Khan; Aurora Bueno-Cavanillas. Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review. International Journal of Environmental Research and Public Health 2021, 18, 707 .
AMA StyleRosario Román-Gálvez, Sandra Martín-Peláez, Juan Martínez-Galiano, Khalid Khan, Aurora Bueno-Cavanillas. Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review. International Journal of Environmental Research and Public Health. 2021; 18 (2):707.
Chicago/Turabian StyleRosario Román-Gálvez; Sandra Martín-Peláez; Juan Martínez-Galiano; Khalid Khan; Aurora Bueno-Cavanillas. 2021. "Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review." International Journal of Environmental Research and Public Health 18, no. 2: 707.
Background CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China. Methods This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2–5 provinces were selected from each region. 2–3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. Finally, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results The questionnaire consisted of four sections: knowledge of methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P < 0.001; the west P = 0.02; the middle P < 0.001 compared with the east), hospital grades (P = 0.028), length of practitioners’ practice (P = 0.006), education background (Ph.D., P = 0.027; Master, P = 0.002), evidence-based medicine skills acquired in work unit (P = 0.012), and medical specialty of practitioner (General Practice, P = 0.006; Surgery, P = 0.043). Conclusion Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.
Ying-Hui Jin; Li-Ming Tan; Khalid S. Khan; Tong Deng; Chao Huang; Fei Han; Jing Zhang; Qiao Huang; Di Huang; Dan-Qi Wang; Yu Wang; Xian-Tao Zeng; Qiang Wang; Xing-Huan Wang. Determinants of successful guideline implementation: a national cross-sectional survey. BMC Medical Informatics and Decision Making 2021, 21, 1 -11.
AMA StyleYing-Hui Jin, Li-Ming Tan, Khalid S. Khan, Tong Deng, Chao Huang, Fei Han, Jing Zhang, Qiao Huang, Di Huang, Dan-Qi Wang, Yu Wang, Xian-Tao Zeng, Qiang Wang, Xing-Huan Wang. Determinants of successful guideline implementation: a national cross-sectional survey. BMC Medical Informatics and Decision Making. 2021; 21 (1):1-11.
Chicago/Turabian StyleYing-Hui Jin; Li-Ming Tan; Khalid S. Khan; Tong Deng; Chao Huang; Fei Han; Jing Zhang; Qiao Huang; Di Huang; Dan-Qi Wang; Yu Wang; Xian-Tao Zeng; Qiang Wang; Xing-Huan Wang. 2021. "Determinants of successful guideline implementation: a national cross-sectional survey." BMC Medical Informatics and Decision Making 21, no. 1: 1-11.
Background Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. Objectives To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. Design This was an individual participant data meta-analysis of cohort studies. Setting Source data from secondary and tertiary care. Predictors We identified predictors from systematic reviews, and prioritised for importance in an international survey. Primary outcomes Early-onset (delivery at < 34 weeks’ gestation), late-onset (delivery at ≥ 34 weeks’ gestation) and any-onset pre-eclampsia. Analysis We externally validated existing prediction models in UK cohorts and reported their performance in terms of discrimination and calibration. We developed and validated 12 new models based on clinical characteristics, clinical characteristics and biochemical markers, and clinical characteristics and ultrasound markers in the first and second trimesters. We summarised the data set-specific performance of each model using a random-effects meta-analysis. Discrimination was considered promising for C-statistics of ≥ 0.7, and calibration was considered good if the slope was near 1 and calibration-in-the-large was near 0. Heterogeneity was quantified using I 2 and τ2. A decision curve analysis was undertaken to determine the clinical utility (net benefit) of the models. We reported the unadjusted prognostic value of individual predictors for pre-eclampsia as odds ratios with 95% confidence and prediction intervals. Results The International Prediction of Pregnancy Complications network comprised 78 studies (3,570,993 singleton pregnancies) identified from systematic reviews of tests to predict pre-eclampsia. Twenty-four of the 131 published prediction models could be validated in 11 UK cohorts. Summary C-statistics were between 0.6 and 0.7 for most models, and calibration was generally poor owing to large between-study heterogeneity, suggesting model overfitting. The clinical utility of the models varied between showing net harm to showing minimal or no net benefit. The average discrimination for IPPIC models ranged between 0.68 and 0.83. This was highest for the second-trimester clinical characteristics and biochemical markers model to predict early-onset pre-eclampsia, and lowest for the first-trimester clinical characteristics models to predict any pre-eclampsia. Calibration performance was heterogeneous across studies. Net benefit was observed for International Prediction of Pregnancy Complications first and second-trimester clinical characteristics and clinical characteristics and biochemical markers models predicting any pre-eclampsia, when validated in singleton nulliparous women managed in the UK NHS. History of hypertension, parity, smoking, mode of conception, placental growth factor and uterine artery pulsatility index had the strongest unadjusted associations with pre-eclampsia. Limitations Variations in study population characteristics, type of predictors reported, too few events in some validation cohorts and the type of measurements contributed to heterogeneity in performance of the International Prediction of Pregnancy Complications models. Some published models were not validated because model predictors were unavailable in the individual participant data. Conclusion For models that could be validated, predictive performance was generally poor across data sets. Although the International Prediction of Pregnancy Complications models show good predictive performance on average, and in the singleton nulliparous population, heterogeneity in calibration performance is likely across settings. Future work Recalibration of model parameters within populations may improve calibration performance. Additional strong predictors need to be identified to improve model performance and consistency. Validation, including examination of calibration heterogeneity, is required for the models we could not validate. Study registration This study is registered as PROSPERO CRD42015029349. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 72. See the NIHR Journals Library website for further project information.
John Allotey; Hannele Laivuori; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter Von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio Da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis. Health Technology Assessment 2020, 24, 1 -252.
AMA StyleJohn Allotey, Hannele Laivuori, Kym Ie Snell, Melanie Smuk, Richard Hooper, Claire L Chan, Asif Ahmed, Lucy C Chappell, Peter Von Dadelszen, Julie Dodds, Marcus Green, Louise Kenny, Asma Khalil, Khalid S Khan, Ben W Mol, Jenny Myers, Lucilla Poston, Basky Thilaganathan, Anne C Staff, Gordon Cs Smith, Wessel Ganzevoort, Anthony O Odibo, Javier A Ramírez, John Kingdom, George Daskalakis, Diane Farrar, Ahmet A Baschat, Paul T Seed, Federico Prefumo, Fabricio Da Silva Costa, Henk Groen, Francois Audibert, Jacques Masse, Ragnhild B Skråstad, Kjell Å Salvesen, Camilla Haavaldsen, Chie Nagata, Alice R Rumbold, Seppo Heinonen, Lisa M Askie, Luc Jm Smits, Christina A Vinter, Per M Magnus, Kajantie Eero, Pia M Villa, Anne K Jenum, Louise B Andersen, Jane E Norman, Akihide Ohkuchi, Anne Eskild, Sohinee Bhattacharya, Fionnuala M McAuliffe, Alberto Galindo, Ignacio Herraiz, Lionel Carbillon, Kerstin Klipstein-Grobusch, SeonAe Yeo, Helena J Teede, Joyce L Browne, Karel Gm Moons, Richard D Riley, Shakila Thangaratinam. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis. Health Technology Assessment. 2020; 24 (72):1-252.
Chicago/Turabian StyleJohn Allotey; Hannele Laivuori; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter Von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio Da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam. 2020. "Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis." Health Technology Assessment 24, no. 72: 1-252.
Evidence-based sexual and reproductive health is a global endeavor without borders. Inter-sectorial collaboration is essential for identifying and addressing gaps in evidence. Health research funders and regulators are promoting patient and public involvement in research, but there is a lack of quality tools for involving patients. Partnerships with patients are necessary to produce and promote robust, relevant and timely research. Without the active participation of women as stakeholders, not just as research subjects, the societal benefits of research cannot be realized. Creating and developing platforms and opportunities for public involvement in sexual and reproductive health research should be a key international objective. Cooperation between healthcare professionals, academic institutions and the community is essential to promote quality research and significant developments in women’s health. This cooperation will be improved when involvement of citizens in the research process becomes standard.
García-Martín M; Amezcua-Prieto C; H Al Wattar B; Jørgensen Js; Bueno-Cavanillas A; Khan Ks. Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen’s Input into Science. International Journal of Environmental Research and Public Health 2020, 17, 8048 .
AMA StyleGarcía-Martín M, Amezcua-Prieto C, H Al Wattar B, Jørgensen Js, Bueno-Cavanillas A, Khan Ks. Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen’s Input into Science. International Journal of Environmental Research and Public Health. 2020; 17 (21):8048.
Chicago/Turabian StyleGarcía-Martín M; Amezcua-Prieto C; H Al Wattar B; Jørgensen Js; Bueno-Cavanillas A; Khan Ks. 2020. "Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen’s Input into Science." International Journal of Environmental Research and Public Health 17, no. 21: 8048.
Objective The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results. Materials and Methods MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093). Results Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds. Conclusions There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
Jesper Bonde; Fabio Bottari; Anna D. Iacobone; Clementina E. Cocuzza; Maria-Teresa Sandri; Fabrizio Bogliatto; Khalid S. Khan; Ditte M. Ejegod; Devin S. Gary; Jeffrey C. Andrews. Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review. Journal of Lower Genital Tract Disease 2020, 25, 27 -37.
AMA StyleJesper Bonde, Fabio Bottari, Anna D. Iacobone, Clementina E. Cocuzza, Maria-Teresa Sandri, Fabrizio Bogliatto, Khalid S. Khan, Ditte M. Ejegod, Devin S. Gary, Jeffrey C. Andrews. Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review. Journal of Lower Genital Tract Disease. 2020; 25 (1):27-37.
Chicago/Turabian StyleJesper Bonde; Fabio Bottari; Anna D. Iacobone; Clementina E. Cocuzza; Maria-Teresa Sandri; Fabrizio Bogliatto; Khalid S. Khan; Ditte M. Ejegod; Devin S. Gary; Jeffrey C. Andrews. 2020. "Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review." Journal of Lower Genital Tract Disease 25, no. 1: 27-37.
Objectives To evaluate the effectiveness of Hydroxychloroquine Phosphate/Sulfate (200 mg orally 8 hourly thrice a day for 5 days), versus oseltamivir (75 mg orally twice a day for 5 days), and versus Azithromycin (500 mg orally daily on day 1, followed by 250 mg orally twice a day on days 2-5) alone and in combination (in all seven groups), in clearing the coronavirus (COVID-19) nucleic acid from throat and nasal swab and in bringing about clinical improvement on day 7 of follow-up (primary outcomes). Trial Design An adaptive design, set within a comprehensive cohort study, to permit flexibility in this fast-changing clinical and public health scenario. The randomized study will be a multicenter, multiarm, multistage, randomized controlled trial with a parallel design. An observation only cohort will emerge from those not consenting to randomization. Participants Eligible will be newly diagnosed patients, either hospitalized or in self-isolation, without any comorbidities or with controlled chronic medical conditions like diabetes mellitus and hypertension. Participants of any gender or age group having tested positive for COVID-19 on Real-Time qRT-PCR (Quantitative Reverse Transcription PCR) will be invited to take part in study at twelve centers across eight cities in Pakistan. Those pregnant or lactating, severely dyspneic or with respiratory distress, already undergoing treatment, and with serious comorbidities like liver or kidney failure will be excluded. Intervention and Comparator There will be a total of seven comparator groups: Each drug (Hydroxychloroquine Phosphate/Sulfate, Oseltamivir and Azithromycin) given as monotherapy (three groups); combinations of each of two drugs (three groups); and a final group on triple drug regimen. Main Outcomes The laboratory-based primary outcome will be turning the test negative for COVID-19 on qRT-PCR on day 7 of follow-up. The clinical primary outcome will be improvement from baseline of two points on a seven-category ordinal scale of clinical status on day 7 of follow-up. Randomization Participants will be randomized, maintaining concealment of allocation sequence, using a computer-generated random number list of variable block size into multiple intervention groups in the allocation ratio of 1:1 for all groups. Blinding (masking) This is an open label study, neither physician nor participants will be blinded. Numbers to be randomized (sample size) This is an adaptive design and parameters for formal sample size calculation in a new disease of a previously unknown virus are not available. Thus, the final sample size will be subjected to periodic reviews at each stage of adaptive design and subsequent advice of National Data Safety & Management Board (NDSMB) notified by Drug Regulatory Authority of Pakistan. Trial Status Protocol Version 1.7 dated July 5, 2020. By July 03, 2020, the trial had recruited a total of about 470 participants across 12 centers after approval from the National Bioethics Committee and Drug Regulatory Authority of Pakistan. Recruitment started on April 20, 2020. The recruitment is expected to continue for at least three months subject to review by the National Data Safety and Management Board (NDSMB) notified by Drug Regulatory Authority of Pakistan. Trial Registration Prospectively registered on 8 April 2020 at clinicaltrials.gov ID: NCT04338698 The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1 ). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2 ).
Javed Akram; Shehnoor Azhar; Muhammad Shahzad; Waqas Latif; Khalid Saeed Khan. Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection who have no comorbidities like diabetes mellitus: A structured summary of a study protocol for a randomized controlled trial. Trials 2020, 21, 1 -3.
AMA StyleJaved Akram, Shehnoor Azhar, Muhammad Shahzad, Waqas Latif, Khalid Saeed Khan. Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection who have no comorbidities like diabetes mellitus: A structured summary of a study protocol for a randomized controlled trial. Trials. 2020; 21 (1):1-3.
Chicago/Turabian StyleJaved Akram; Shehnoor Azhar; Muhammad Shahzad; Waqas Latif; Khalid Saeed Khan. 2020. "Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection who have no comorbidities like diabetes mellitus: A structured summary of a study protocol for a randomized controlled trial." Trials 21, no. 1: 1-3.
Background It is not clear whether clinical practice guidelines (CPGs) and consensus statements (CSs) are adequately promoting shared decision making (SDM). Objective To evaluate the recommendations about SDM in CPGs and CSs concerning breast cancer (BC) treatment. Search strategy Following protocol registration (Prospero no.: CRD42018106643), CPGs and CSs on BC treatment were identified, without language restrictions, through systematic search of bibliographic databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR) and online sources (12 guideline databases and 51 professional society websites) from January 2010 to December 2019. Inclusion criteria CPGs and CSs on BC treatment were selected whether published in a journal or in an online document. Data extraction and synthesis A 31‐item SDM quality assessment tool was developed and used to extract data in duplicate. Main results There were 167 relevant CPGs (139) and CSs (28); SDM was reported in only 40% of the studies. SDM was reported more often in recent publications after 2015 (42/101 (41.6 %) vs 46/66 (69.7 %), P = .0003) but less often in medical journal publications (44/101 (43.5 %) vs 17/66 (25.7 %), P = .009). In CPGs and CSs with SDM, only 8/66 (12%) met one‐fifth (6 of 31) of the quality items; only 14/66 (8%) provided clear and precise SDM recommendations. Discussion and conclusions SDM descriptions and recommendations in CPGs and CSs concerning BC treatment need improvement. SDM was more frequently reported in CPGs and CSs in recent years, but surprisingly it was less often covered in medical journals, a feature that needs attention.
Marta Maes‐Carballo; Isabel Muñoz‐Núñez; Manuel Martín‐Díaz; Luciano Mignini; Aurora Bueno‐Cavanillas; Khalid Saeed Khan. Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review. Health Expectations 2020, 23, 1045 -1064.
AMA StyleMarta Maes‐Carballo, Isabel Muñoz‐Núñez, Manuel Martín‐Díaz, Luciano Mignini, Aurora Bueno‐Cavanillas, Khalid Saeed Khan. Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review. Health Expectations. 2020; 23 (5):1045-1064.
Chicago/Turabian StyleMarta Maes‐Carballo; Isabel Muñoz‐Núñez; Manuel Martín‐Díaz; Luciano Mignini; Aurora Bueno‐Cavanillas; Khalid Saeed Khan. 2020. "Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review." Health Expectations 23, no. 5: 1045-1064.
Objective To evaluate the effectiveness of virtual reality as a distraction technique in the management of acute pain and anxiety during outpatient hysteroscopy. Design Parallel group, prospective randomised controlled trial. Setting UK University Hospital. Methods Forty consenting, eligible women were randomised to virtual reality intervention (immersive video content as a distraction method) or standard care during outpatient hysteroscopy from August to October 2018. Main Outcome Measures Pain and anxiety outcomes were measured as a numeric rating score (scale of 0‐10). Results Compared to standard care, women with virtual reality intervention experienced less average pain (score 6.0 vs. 3.7, mean difference 2.3, 95% CI 0.61‐3.99, p=0.009) and anxiety (score 5.45 vs. 3.3, mean difference 2.15, 95% CI 0.38‐3.92, p=0.02). Conclusion Virtual Reality was effective in reducing pain and anxiety during outpatient hysteroscopy in a mixed‐methods randomised control trial. Its wide potential role in ambulatory gynaecologic procedures needs further evaluation.
Nandita Deo; Khalid Saeed Khan; Jonathan Mak; John Allotey; Francisoco Jose Gonzalez Carreras; Gianpaolo Fusari; Jonathan Benn. Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology 2020, 128, 87 -95.
AMA StyleNandita Deo, Khalid Saeed Khan, Jonathan Mak, John Allotey, Francisoco Jose Gonzalez Carreras, Gianpaolo Fusari, Jonathan Benn. Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2020; 128 (1):87-95.
Chicago/Turabian StyleNandita Deo; Khalid Saeed Khan; Jonathan Mak; John Allotey; Francisoco Jose Gonzalez Carreras; Gianpaolo Fusari; Jonathan Benn. 2020. "Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial." BJOG: An International Journal of Obstetrics & Gynaecology 128, no. 1: 87-95.
Background Adnexal torsion (AT), a serious gynaecological emergency, often presents with non‐specific symptoms leading to delayed diagnosis. Objective To compare the test accuracy of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose AT. Search strategy We searched EMBASE, MEDLINE and Cochrane CENTRAL until December 2019. Selection criteria Studies reporting on the accuracy of any imaging modality (Index Test) in female patients (paediatric and adult) suspected of AT compared with surgical diagnosis and/or standard clinical/radiological follow‐up period until resolution of symptoms (Reference Standard). Data collection and analysis We assessed study quality using QUADAS‐2. We conducted test accuracy meta‐analysis using a univariate model or a hierarchical model. Main results We screened 3836 citations, included 18 studies (1654 women, 665 cases), and included 15 in the meta‐analyses. Ultrasound pooled sensitivity (n = 12, 1187 women) was 0.79 (95% CI 0.63–0.92) and specificity was 0.76 (95% CI 0.54–0.93), with negative and positive likelihood ratios of 0.29 (95% CI 0.13–0.66) and 4.35 (95% CI 2.03–9.32), respectively. Using Doppler with ultrasound (n = 7, 845 women) yielded similar sensitivity (0.80, 95% CI 0.67–0.93) and specificity (0.88, 95% CI 0.72–1.00). For MRI (n = 3, 99 women), the pooled sensitivity was 0.81 (95% CI 0.63–0.91) and specificity was 0.91 (95% CI 0.80–0.96). A meta‐analysis for CT was not possible with two case‐control studies and one cohort study (n = 3, 232 women). Its sensitivity range was 0.74–0.95 and specificity was 0.80–0.90. Conclusions Ultrasound has good performance as a first‐line diagnostic test for suspected AT. Magnetic resonance imaging could offer improved specificity to investigate complex ovarian morphology, but more evidence is needed. Tweetable abstract To investigate adnexal torsion, ultrasound is a good first‐line diagnostic test with a pooled sensitivity of 0.79 and specificity of 0.76.
Baihas Wattar; Michael Rimmer; Ewelina Rogozinska; Mark MacMillian; Khalid S Khan; Bassel H Al Wattar. Accuracy of imaging modalities for adnexal torsion: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology 2020, 128, 37 -44.
AMA StyleBaihas Wattar, Michael Rimmer, Ewelina Rogozinska, Mark MacMillian, Khalid S Khan, Bassel H Al Wattar. Accuracy of imaging modalities for adnexal torsion: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 2020; 128 (1):37-44.
Chicago/Turabian StyleBaihas Wattar; Michael Rimmer; Ewelina Rogozinska; Mark MacMillian; Khalid S Khan; Bassel H Al Wattar. 2020. "Accuracy of imaging modalities for adnexal torsion: a systematic review and meta‐analysis." BJOG: An International Journal of Obstetrics & Gynaecology 128, no. 1: 37-44.
IntroductionThe incidence of severe postpartum haemorrhage (PPH) that requires blood transfusion is on the increase. Fibrinogen levels have been shown to drop early and significantly during PPH, which is associated with worse outcomes. Early fibrinogen replacement could potentially improve outcomes. No studies have investigated the clinical impact of early cryoprecipitate transfusion in PPH. Prior to performing a full-scale trial, a pilot study is needed to determine feasibility of the intervention and recruitment.MethodsACROBAT is a cluster-randomised pilot study with a qualitative evaluation. Four large London maternity units are randomised to either the intervention or control group. The intervention group will adapt their major obstetric haemorrhage procedures to administer cryoprecipitate early for primary PPH. The control group will retain their standard of care.We include women at >24 weeks gestation who are actively bleeding within 24 hours of delivery and for whom transfusion of red blood cells (RBCs) has been started. We exclude women who decline blood transfusions in advance or have inherited Factor XIII or fibrinogen deficiency. Due to the emergency nature of the intervention, informed consent for administering the intervention is waived.The primary objective is to assess the feasibility of administering cryoprecipitate within 90 min of RBC request, as compared with standard treatment where cryoprecipitate is given later or not at all. Secondary objectives include the feasibility of recruitment and data collection, reasons for and barriers to consent, preliminary maternal clinical outcomes, identification of the optimal infrastructure pathways for study delivery, and acceptability of the intervention and outcomes.Ethics and disseminationThe trial has approvals from the London—Brighton & Sussex Research Ethics Committee (ref. 18/LO/2062), the Confidentiality Advisory Group (ref. 18/CAG/0199) and Health Research Authority (IRAS number 237959). Data analysis and publication of manuscripts will start in Q3 2020.Trial registration numberISRCTN12146519.
Laura Green; Jahnavi Daru; Julie Dodds; Francisco Jose Gonzalez Carreras; Doris Lanz; Javier Zamora; Maria Del Carmen Pardo Llorente; Teresa Pérez Pérez; Lorna Sweeney; Shakila Thangaratinam; Amy Thomas; Khalid Saeed Khan. Effect of early cryoprecipitate transfusion versus standard care in women who develop severe postpartum haemorrhage (ACROBAT) in the UK: a protocol for a pilot cluster randomised trial. BMJ Open 2020, 10, e036416 .
AMA StyleLaura Green, Jahnavi Daru, Julie Dodds, Francisco Jose Gonzalez Carreras, Doris Lanz, Javier Zamora, Maria Del Carmen Pardo Llorente, Teresa Pérez Pérez, Lorna Sweeney, Shakila Thangaratinam, Amy Thomas, Khalid Saeed Khan. Effect of early cryoprecipitate transfusion versus standard care in women who develop severe postpartum haemorrhage (ACROBAT) in the UK: a protocol for a pilot cluster randomised trial. BMJ Open. 2020; 10 (6):e036416.
Chicago/Turabian StyleLaura Green; Jahnavi Daru; Julie Dodds; Francisco Jose Gonzalez Carreras; Doris Lanz; Javier Zamora; Maria Del Carmen Pardo Llorente; Teresa Pérez Pérez; Lorna Sweeney; Shakila Thangaratinam; Amy Thomas; Khalid Saeed Khan. 2020. "Effect of early cryoprecipitate transfusion versus standard care in women who develop severe postpartum haemorrhage (ACROBAT) in the UK: a protocol for a pilot cluster randomised trial." BMJ Open 10, no. 6: e036416.
Generating translatable evidence to improve patient care has proved challenging in reproductive medicine, with many ‘add-on' treatments in routine assisted conception clinical practice that have not been reliably tested. This has consequences for patient care; specifically, IVF pregnancy rates have not improved. A change of culture is required in our profession, from indiscriminately applying the latest ‘add-on' to large-scale participation in generating reliable translatable evidence.
Masoud A.M. Afnan; Khalid Saeed Khan; Ben Willem Mol. Generating translatable evidence to improve patient care: the contribution of human factors. Reproductive BioMedicine Online 2020, 41, 353 -356.
AMA StyleMasoud A.M. Afnan, Khalid Saeed Khan, Ben Willem Mol. Generating translatable evidence to improve patient care: the contribution of human factors. Reproductive BioMedicine Online. 2020; 41 (3):353-356.
Chicago/Turabian StyleMasoud A.M. Afnan; Khalid Saeed Khan; Ben Willem Mol. 2020. "Generating translatable evidence to improve patient care: the contribution of human factors." Reproductive BioMedicine Online 41, no. 3: 353-356.
Chronic pelvic pain (CPP) in women is defined variably, but for clinical use it is cyclical or non-cyclical pain of at least 3-6 months' duration. It has major impacts on individuals and society. There are both structural and idiopathic causes. Whereas CPP is not curable in many cases, it is treatable. The most promising approach is multidisciplinary patient-centered care including cause-directed therapy, lifestyle changes, talking therapies, meditation, acupuncture, and physiotherapy (this is not a complete list). One of the most common structural causes for CPP is endometriosis. This review investigates current scientific concepts and recent innovations in this field as well as for CPP in general.
Elizabeth Ball; Khalid S Khan. Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis. F1000Research 2020, 9, 83 .
AMA StyleElizabeth Ball, Khalid S Khan. Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis. F1000Research. 2020; 9 ():83.
Chicago/Turabian StyleElizabeth Ball; Khalid S Khan. 2020. "Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis." F1000Research 9, no. : 83.
B H Al Wattar; K S Khan. Upgrading Bartholin’s abscess management using novel technologies? A challenge for generating knowledge through research that translates well. BJOG: An International Journal of Obstetrics & Gynaecology 2020, 127, 679 -679.
AMA StyleB H Al Wattar, K S Khan. Upgrading Bartholin’s abscess management using novel technologies? A challenge for generating knowledge through research that translates well. BJOG: An International Journal of Obstetrics & Gynaecology. 2020; 127 (6):679-679.
Chicago/Turabian StyleB H Al Wattar; K S Khan. 2020. "Upgrading Bartholin’s abscess management using novel technologies? A challenge for generating knowledge through research that translates well." BJOG: An International Journal of Obstetrics & Gynaecology 127, no. 6: 679-679.