Aidan Christopher Tan

Purpose: Our aims were to investigate in adults, as we have shown in three paediatric samples, associations between a history of iron deficiency (whenever acquired and treated) and history (> 3 months) of primary, overlapping and multisite chronic pain conditions, and to investigate associations between history of iron deficiency, anxiety, and depression. Participants and Methods: We recruited adult twins and their families from the Australian Twin Registry database. Responders addressed questionnaires about lifetime history of iron deficiency > 3 months, diagnosed and treated by a physician, and a history > 3 months of listed pain conditions, anxiety and depression. The emphasis was on life history, not current status, of each of these conditions and such questions were the only practical method. Logistic regression, using generalized estimating equation to account for correlations within twin families, was employed to assess relationships between iron deficiency and pain conditions and the psychological conditions. Results: Of the 1519 adult responders, 1326 addressed the criteria for iron deficiency, and the prevalence was 38.7% in females and 2.4% in males. Iron deficiency as statistical predictor was significantly associated with migraine (Odds ratio (OR)=1.70, p=0.001), headache (OR=1.37, p=0.03), recurrent abdominal pain (OR=1.97, p< 0.001), dysmenorrhea (OR=2.18, p< 0.001), anxiety (OR=1.88, p< 0.001) and depression (OR=2.06, p< 0.001). Iron deficiency, anxiety and depression, as statistical predictors, were univariately and multivariately associated with the number of pain conditions (all p< 0.05). Conclusion: A history of iron deficiency in a community sample of adults was associated with most individual, primary, overlapping and multisite pain conditions tested, and multivariately associated with the number of pain conditions, and with anxiety and depression. We hypothesize, consistent with these results, that previous or current iron deficiency, even when treated, influences pain sensitivity and multiplicity directly and through known effects on anxiety and depression.

Interventional studies are intended to provide robust evidence. Yet poorly designed or conducted studies may bias research results and skew resulting evidence. While there have been advances in the assessment of risk of bias, it is unclear how to intervene against risks of bias during study design and conduct. To identify interventions to reduce or predict risk of bias in interventional studies during their design and conduct. For this scoping review, we searched three electronic bibliographic databases (MEDLINE, Embase, and Cochrane Library) and nine grey literature sources and Google from in September 2024. This was supplemented by a natural language processing fuzzy matching search of the top 2000 relevant publications in the electronic bibliographic databases. Publications were included if they described the implementation and effectiveness of an intervention during study design or conduct aimed at reducing risk of bias in interventional studies. The characteristics and effect of the interventions were recorded. We identified, and reviewed the title and abstracts of, a total of 41,793 publications, reports, documents and grey literature, with 24,677 from electronic bibliographic databases and 17,140 from grey literature sources. There were 67 publications from bibliographic databases and 24 items from grey literature that were considered potentially eligible for inclusion, and the full-text of these were reviewed. Only three studies met the inclusion criteria. The first intervention was offering education and training to researchers during study design. This training included the implementation of a more rigorous participant screening process and systematic participant tracking program that reduced loss to follow-up and missing data, particularly for long-term follow-up trials. The second intervention was introducing an independent clinical events committee during study conduct. This was intended to mitigate bias due to conflicts of interest affecting the analysis and interpretation of results. The third intervention was to provide participants with financial incentives in randomized controlled trials, so that participants could more actively accomplish the requirements of the trials. Despite the major impact of risk of bias on study outcomes, there are few empirical interventions to address this during study design or conduct.

Objectives This study aimed to describe how health researchers identify and counteract fraudulent responses when recruiting participants online. Design Scoping review. Eligibility criteria Peer-reviewed studies published in English; studies that report on the online recruitment of participants for health research; and studies that specifically describe methodologies or strategies to detect and address fraudulent responses during the online recruitment of research participants. Sources of evidence Nine databases, including Medline, Informit, AMED, CINAHL, Embase, Cochrane CENTRAL, IEEE Xplore, Scopus and Web of Science, were searched from inception to April 2024. Charting methods Two authors independently screened and selected each study and performed data extraction, following the Joanna Briggs Institute’s methodological guidance for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A predefined framework guided the evaluation of fraud identification and mitigation strategies within the studies included. This framework, adapted from a participatory mapping study that identified indicators of fraudulent survey responses, allowed for systematic assessment and comparison of the effectiveness of various antifraud strategies across studies. Results 23 studies were included. 18 studies (78%) reported encountering fraudulent responses. Among the studies reviewed, the proportion of participants excluded for fraudulent or suspicious responses ranged from as low as 3% to as high as 94%. Survey completion time was used in six studies (26%) to identify fraud, with completion times under 5 min flagged as suspicious. 12 studies (52%) focused on non-confirming responses, identifying implausible text patterns through specific questions, consistency checks and open-ended questions. Four studies examined temporal events, such as unusual survey completion times. Seven studies (30%) reported on geographical incongruity, using IP address verification and location screening. Incentives were reported in 17 studies (73%), with higher incentives often increasing fraudulent responses. Mitigation strategies included using in-built survey features like Completely Automated Public Turing test to tell Computers and Humans Apart (34%), manual verification (21%) and video checks (8%). Most studies recommended multiple detection methods to maintain data integrity. Conclusion There is insufficient evaluation of strategies to mitigate fraud in online health research, which hinders the ability to offer evidence-based guidance to researchers on their effectiveness. Researchers should employ a combination of strategies to counteract fraudulent responses when recruiting online to optimise data integrity.

Background: Data sharing improves the value, synthesis, and integrity of research, but rates are low. Data sharing might be improved if data sharing policies were prominent and actionable at every stage of research. We aimed to systematically describe the epidemiology of data sharing policies across the health research lifecycle.Methods: This was a cross‐sectional analysis of the data sharing policies of the largest health research funders, all national ethics committees, all clinical trial registries, the highest‐impact medical journals, and all medical research data repositories. Stakeholders' official websites, online reports, and other records were reviewed up to May 2022. The strength and characteristics of their data sharing policies were assessed, including their policies on data sharing intention statements (a.k.a. data accessibility statements) and on data sharing specifically for coronavirus disease studies. Data were manually extracted in duplicate, and policies were descriptively analysed by their stakeholder and characteristics.Results: Nine hundred and thirty‐five eligible stakeholders were identified: 110 funders, 124 ethics committees, 18 trial registries, 273 journals, and 410 data repositories. Data sharing was required by 41% (45/110) of funders, no ethics committees or trial registries, 19% (52/273) of journals and 6% (24/410) of data repositories. Among funder types, a higher proportion of private (63%, 35/55) and philanthropic (67%, 4/6) funders required data sharing than public funders (12%, 6/49).Conclusion: Data sharing requirements, and even recommendations, were insufficient across health research. Where data sharing was required or recommended, there was limited guidance on implementation. We describe multiple pathways to improve the implementation of data sharing. Public funders and ethics committees are two stakeholders with particularly important untapped opportunities.

Introduction: Although the number of published systematic reviews and meta‐analyses in dermatology has increased over the past decade, their quality is unknown. Objective: The objective of this study was to determine the change in risk of bias, methodological quality and reporting quality of systematic reviews and meta‐analyses in dermatology between 2010 and 2019. Methods: We conducted a comparative study of systematic reviews and meta‐analyses published in the 10 highest‐ranked dermatology journals in 2010 and 2019. Studies were identified through electronic searches of MEDLINE, Embase, and eight other bibliographic databases. Risk of bias and methodological quality were assessed in duplicate with the risk of bias in systematic reviews (ROBIS) and A MeaSurement Tool to Assess systematic Reviews‐2 (AMSTAR‐2) tools, respectively, with the latter only applied to studies of interventions. Reporting quality was assessed with the Preferred Reporting Items of systematic reviews and Meta‐Analyses (PRISMA) 2009 and PRISMA for abstracts (PRISMA‐A) 2013 statements. Results: We included 27 systematic reviews and meta‐analyses published in 2010 and 127 published in 2019. There was no evidence of a difference in the proportion of systematic reviews and meta‐analyses at high/unclear risk of bias with ROBIS (Fisher's exact test = 1.00) or critically low methodological quality using AMSTAR‐2 (Fisher's exact test = 0.456), between 2010 and 2019. There was evidence of a difference in proportion of PRISMA ( t (26) = 2.7, p = 0.01), and very strong evidence of a difference in proportion of PRISMA‐A ( t (26) = 4.2, p < 0.001) checklist items adequately reported between 2010 and 2019. The difference in mean proportion of PRISMA checklist items adequately reported was 3.6 items more (95% confidence interval [CI]: 1.8–5.4 items more) in 2019 (mean = 10.7 items, SD = 2.4 items) than in 2010 (mean = 7.1 items, SD = 2.9 items), and of PRISMA‐A checklist items adequately reported was 1.1 items more (95% CI: 0.2–2.0 items more) in 2019 (mean = 5.6 items, SD = 1.5 items) than in 2010 (mean = 4.4 items, SD = 1.7 items). Conclusions: No improvement was observed in the overall methodological quality of included systematic reviews and meta‐analyses; however, there was strong evidence of improvement in the overall reporting quality.

Introduction: Although there is a large proportion of people from culturally and linguistically diverse backgrounds within Australia, their rate of access to disability services is disproportionately low. This review aims to understand the service needs of people from culturally and linguistically diverse backgrounds with disability to facilitate engagement in meaningful occupations.Methods: Arksey and O'Malley's scoping review framework was employed. Ten databases were searched for Australian studies. A deductive content analysis framework was applied in the synthesis.Results: Fourteen papers were included. Themes that emerged include language and cultural needs and considerations, which highlights the need for information sharing to take account of intergenerational, intercultural and sociolinguistic differences. It also identified the need for improved training and skills of existing interpreters. Culturally competent and responsive services was another theme identified, which emphasised the need to enhance the workforces' understanding of cultural practices. There is also a strong call for a more culturally diverse workforce to reduce the use of some interpreters and to build a more culturally competent workforce. The last theme was responsive service delivery, which requires the governance to support the development of a nurturing trusting therapeutic relationship.Conclusions: Service providers should be trained on the inequities and intersectionality of this population. Further research is required to explore current disability policy in Australia with an intersectionality lens to ensure recommendations can be made to address barriers and ensure this population receives services in a manner that enhances their ability to engage in occupations meaningfully.

Background: There are few randomized controlled trials (RCTs) in pediatric surgery, and their risk of bias is unknown. There is also little known about the methodological or reporting quality of systematic reviews (with or without meta‐analyses) in pediatric surgery. Therefore, we conducted a cross‐sectional meta‐research study to determine the risk of bias and reporting quality of RCTs and systematic reviews and meta‐analyses in pediatric surgery, and the associations between these outcomes and study characteristics.Methods: We searched MEDLINE, Embase, Cochrane Library, JBI EBP Database, Centre for Reviews and Dissemination and Web of Science for all RCTs and systematic reviews in pediatric surgery published in 2021. We also searched the 2021 indexes of high‐impact pediatric surgery journals. We assessed the risk of bias and reporting quality of RCTs using the RoB 2 and CONSORT tools respectively. We assessed the same parameters for systematic reviews and meta‐analyses using the ROBIS and Preferred Reporting Items for Systematic Reviews and Meta‐analyses tools.Findings: We found 82 RCTs and 289 systematic reviews/meta‐analyses published in 2021. More than half (n = 46, 56%) of RCTs and almost all (n = 278, 96%) systematic reviews and meta‐analyses were at high risk of bias. Only one (1%) RCT and four (1%) systematic reviews and meta‐analyses were adequately reported. Less than half (n = 40, 49%) of RCTs and just over a quarter (n = 77, 27%) of systematic reviews and meta‐analyses had a registered protocol. Surprisingly, we found that more than half of systematic reviews and meta‐analyse (n = 162, 56.1%), had no risk of bias assessment.Conclusions: Recently published RCTs and systematic reviews in pediatric surgery are at high risk of bias and have poor reporting quality. Journals, universities, and research institutions should train authors to conduct and report higher quality studies and develop strategies to reduce risk of bias. However, research with high bias and low reporting does not necessarily lack value.

Background: Sharing of individual participant data enhances the value of existing data to generate new evidence and inform decision‐making. While there is strong in‐principle support for data sharing, in practice study data are often difficult to find, access, and re‐use. Currently, there is no consensus statement to guide the data‐sharing process. In particular, more guidance is needed on the responsibilities of data recipients for re‐using individual participant data.Purpose: To determine views on the responsibilities of recipients of study data, and to propose how these responsibilities could be met.Methods: A 2‐h online focus group was conducted at the 2021 Association for Interdisciplinary Meta‐research and Open Science conference. Three example data‐sharing scenarios were discussed (evidence synthesis, study reproducibility, and secondary analyses). Notes and audio transcripts were collated using thematic analysis and shared with attendees for further iterative input.Results: A purposive sample of 16 conference delegates attended the focus group. Analyses revealed four recurring themes that were synthesized into recommendations. The “privacy and ethics” theme described the need for data recipients to prioritize the protection of participant privacy, and the recommendation to proactively share a secure data management plan and evidence of ethical oversight with the data provider. The “capability and resourcing” theme required recipients to demonstrate sufficient capacity to process and analyze study data. The “recognition and collaboration” theme asserted the responsibility to acknowledge the contributions of data providers and invite them to contribute to the secondary project. Last, the “compliance” theme focused on the responsibility to adhere to local data sharing regulations.Conclusions: Successful data sharing and re‐use requires cooperation from multiple stakeholders. We identified the responsibilities of recipients of study data to the individual from whom data arose and the research team who collected the data. Implementation of these in practice could facilitate increased data sharing.

Background: There are few randomised controlled trials (RCTs) in paediatric surgery, and the risk of bias of these studies is unknown. There is also little known about the methodological or reporting quality of systematic reviews and meta-analyses in paediatric surgery. We aimed to determine the risk of bias and reporting quality of recent RCTs, systematic reviews and meta-analyses in paediatric surgery, and the associations with study characteristics. Methods: We searched MEDLINE, Embase, Cochrane Library, JBI EBP Database, Centre for Reviews and Dissemination, Web of Science and high-impact journals for all RCTs, systematic reviews and meta-analyses in paediatric surgery published in 2021. We assessed the risk of bias and reporting quality of RCTs using the RoB 2 and CONSORT tools, respectively. We assessed the same parameters for systematic reviews and meta-analyses using the ROBIS and PRISMA tools. Findings: We identified 82 RCTs and 289 systematic reviews or meta-analyses in paediatric surgery published in 2021. More than half (n=46, 56%) of RCTs and almost all (n=278, 96%) systematic reviews and meta-analyses were at high risk of bias. Only one (1%) RCT and 4 (1%) systematic reviews and meta-analyses were adequately reported. We found that lower risk of bias and higher reporting quality in RCTs, systematic reviews, and meta-analyses were associated with the presence of a published protocol. For systematic reviews and meta-analyses, a higher PRISMA score was associated with being a Cochrane review. Surprisingly, we found that more than half of systematic reviews and meta-analyses (n=162, 56.1%) had no risk of bias assessments. Conclusions: Recently published RCTs, systematic reviews, and meta-analyses in paediatric surgery are at high risk of bias and have poor reporting quality. We suggest strategies for how trialists, systematic reviewers and other stakeholders across the research lifecycle can design, conduct and report higher quality research in paediatric surgery.

Background: There are few randomised controlled trials (RCTs) in paediatric surgery, and the risk of bias of these studies is unknown. There is also little known about the methodological or reporting quality of systematic reviews and meta-analyses in paediatric surgery. We aimed to determine the risk of bias and reporting quality of recent RCTs, systematic reviews and meta-analyses in paediatric surgery, and the associations with study characteristics. Methods: We searched MEDLINE, Embase, Cochrane Library, JBI EBP Database, Centre for Reviews and Dissemination, Web of Science and high-impact journals for all RCTs, systematic reviews and meta-analyses in paediatric surgery published in 2021. We assessed the risk of bias and reporting quality of RCTs using the RoB 2 and CONSORT tools, respectively. We assessed the same parameters for systematic reviews and meta-analyses using the ROBIS and PRISMA tools. Findings: We identified 82 RCTs and 289 systematic reviews or meta-analyses in paediatric surgery published in 2021. More than half (n=46, 56%) of RCTs and almost all (n=278, 96%) systematic reviews and meta-analyses were at high risk of bias. Only one (1%) RCT and 4 (1%) systematic reviews and meta-analyses were adequately reported. We found that lower risk of bias and higher reporting quality in RCTs, systematic reviews, and meta-analyses were associated with the presence of a published protocol. For systematic reviews and meta-analyses, a higher PRISMA score was associated with being a Cochrane review. Surprisingly, we found that more than half of systematic reviews and meta-analyses (n=162, 56.1%) had no risk of bias assessments. Conclusions: Recently published RCTs, systematic reviews, and meta-analyses in paediatric surgery are at high risk of bias and have poor reporting quality. We suggest strategies for how trialists, systematic reviewers and other stakeholders across the research lifecycle can design, conduct and report higher quality research in paediatric surgery.