Moiz Lakhani

Background: Timely access to cardiovascular procedures and specialist care is clinically important, yet methods used to establish wait-time benchmarks are not well characterized. This systematic review aims to identify, characterize, and critically appraise methods used to derive wait-time benchmarks for cardiovascular procedures and specialist cardiovascular care. It will assess whether benchmarks are supported by empirical outcome data, developed through transparent consensus processes, and informed by patient-specific risk stratification. It will also examine associations between waiting duration and outcomes and whether methods from other specialties are transferable to cardiovascular care. Methods: This systematic review will include adults awaiting cardiovascular procedures or specialist care and studies from other specialties describing transferable benchmark-development methods. Eligible sources will include guidelines, consensus statements, policy documents, health technology assessments, empirical studies, systematic reviews, and reports describing benchmark derivation, justification, or validation. MEDLINE, PubMed, Embase, Scopus, Web of Science, the Cochrane Library, Google Scholar, guideline repositories, health technology assessment databases, government and professional society websites, and grey literature will be searched from inception to the final search date, without language restrictions. Two reviewers will independently screen records, extract data, and assess quality, with disagreements resolved by consensus or a third reviewer. Primary outcomes will include derivation method, evidentiary basis, consensusprocess characteristics, benchmark structure, and associations between waiting duration and outcomes. Secondary outcomes will include methodological quality, clinical validation, implementation, practice concordance, stakeholder involvement, benchmark updating, and geographic and temporal variation. Findings will be synthesized narratively using descriptive statistics, summary tables, and evidence maps. Meta-analysis may be undertaken if at least three sufficiently homogeneous studies are available. Discussion: This review will clarify how cardiovascular wait-time benchmarks have been developed and validated, identify methodological gaps, and assess the transferability of approaches from other specialties. The findings may inform more transparent, evidence-based, risk-sensitive, and clinically meaningful wait-time benchmarks. Ethics approval and patient consent are not required because the review will use publicly available literature and documents. Findings will be disseminated through peer-reviewed publication, conference presentations, and engagement with cardiovascular and health-policy stakeholders.

Ischaemic optic neuropathy (ION) is a rare but vision-threatening complication recently linked to GLP-1 receptor agonists, particularly semaglutide. Using over 30 million reports from the FDA Adverse Event Reporting System (2017–2024), we evaluated formulation- and sex-specific associations. Among 31 774 semaglutide cases, Wegovy demonstrated the strongest signal for ION (reporting odds ratio (ROR)=74.89) compared with Ozempic (ROR=18.81). Sex-stratified analyses showed higher odds in men (ROR=116.37), and multivariable regression confirmed greater risk with Wegovy versus Ozempic (adjusted OR (AOR)=4.74) and in men versus women (AOR=3.33). These findings highlight a potential dose-dependent safety concern that warrants urgent prospective evaluation to guide prescribing and regulatory policy.

Background/aims Patient-reported outcomes (PROs) evaluate health and functional status, and PRO measures (PROMs) are standardised tools for measuring PROs. Together, they provide valuable insights into treatment efficacy, safety and practicality not captured by traditional clinical endpoints. This cross-sectional analysis with a systematic search component aims to investigate the use, interpretation and reporting of PROs and PROMs in ophthalmic randomised controlled trials (RCTs). Methods Ophthalmic RCTs published in the top 10 highest impact factor ophthalmic and medical journals between 2014 and 2023 were systematically reviewed. The frequency of PRO inclusion and adherence to Consolidated Standards of Reporting Trials (CONSORT) PRO guidelines was assessed. The relationship between PRO utilisation and study-level and journal-level characteristics was explored with multivariable regression. Results Among 9436 records screened, 333 RCTs met eligibility criteria. Of these, 87 (26.1%) included PROs, and 28 (8.4%) used them as primary outcomes. Most studies (83/87, 95.4%) leveraged PROMs, with ophthalmology-specific tools predominating (73.5%). Minimal important differences (MIDs) were rarely used (2.3%) for PRO interpretation. At least 8/13 CONSORT PRO Extension items were reported in 33.3% studies, and trials with primary PRO endpoints had better adherence (pConclusions PRO integration and interpretation remain limited in high-impact ophthalmic RCTs, despite offering a meaningful adjunct to objective endpoints. Future trials should adopt validated and condition-specific PROMs and establish MIDs to enhance interpretation.