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Biomedical subjects

D Tallon

Publications and source records attributed to D Tallon.

8 recordsLinked to original sources
PubMed2003

Socio-economic inequalities in diabetes complications, control, attitudes and health service use: a cross-sectional study.

AIMS: To investigate socio-economic inequalities in diabetes complications, and to examine factors that may explain these differences. METHODS: Cross-sectional questionnaire survey of 770 individuals with diabetes among 40 general practices in Avon and Somerset. General practice, optometrist and eye hospital records over time (median 7 years) were analysed. Slope indices of inequality, odds ratios and incidence rate ratios were calculated to estimate the magnitude of inequality between the most and least educated, and the highest and lowest earning patients, adjusted for age, sex and type of diabetes, and clustering of outcomes within practices. RESULTS: The least educated patients were more likely than the most educated patients to have diabetic retinopathy [adjusted odds ratio (OR) 4.3; 95% confidence interval 0.8, 23.7] and heart disease (adjusted OR 3.6; 1.1, 11.8), had higher HbA1c levels (adjusted slope index of inequality 0.9; 0.3, 1.5), felt that diabetes more adversely affected their social and personal lives (adjusted slope index of inequality 0.8; 0.5, 1.1 Diabetes Care Profile units), were more likely to be recorded as non-compliant by their health professionals, and had lower rates of hospital attendance (adjusted rate ratio 0.43; 0.26, 0.71). However, they did not see themselves as less compliant, and had higher general practice attendance rates (adjusted rate ratio 1.5; 1.1, 2.2). CONCLUSIONS: Less educated and lower earning individuals with diabetes bear a larger burden of morbidity but use hospital care less. Health service resource allocation should reflect the distribution of chronic illness.

Aged↗
PubMed2000

Relation between agendas of the research community and the research consumer.

BACKGROUND: Previous studies have suggested that research agendas can be biased. To determine whether there is a mismatch between available research evidence and the research preferences of consumers we examined research on interventions for the treatment of osteoarthritis of the knee joint. METHODS: We searched published and unpublished studies on interventions in this condition to assess the structure of the evidence base. Focus groups and a postal survey of research consumers were then undertaken to examine their views and research priorities. FINDINGS: Review of published and unpublished reports showed that the evidence base was dominated by studies of pharmaceutical (550, 59%) and surgical (238, 26%) interventions. 24 (36%) of 67 survey respondents ranked knee replacement as the highest priority for research, whereas 14 (21%) chose education and advice as their first choice. INTERPRETATION: There is a mismatch between the amount of published work on different interventions, and the degree of interest of consumers. We suggest that broadening of the research agenda would be more in line with current treatment patterns and consumer views. If this mismatch is not addressed, then evidence-based medicine will not be representative of consumer needs.

Acupuncture Therapy↗
PubMed2000

Exploring the priorities of patients with osteoarthritis of the knee.

OBJECTIVE: To explore the perceived importance of symptoms, treatment preferences, and research priorities of people with osteoarthritis (OA) of the knee. METHODS: Results of a focus group were used to facilitate the design of a questionnaire, distributed to 112 people with knee OA. RESULTS: Pain, disability, and instability in the joint were the most important symptoms, and anxiety about knee OA caused distress to many people. Oral drugs (90%), physical therapy (62%), and aids and adaptations (56%) were the most commonly used treatments. Surgery, oral drugs, and intra-articular injections were perceived as the most efficacious interventions. Patients' highest priorities for research were surgery and educational interventions, despite the fact that few had had surgery and education was not perceived as very effective. CONCLUSIONS: The lack of a patient-centered approach to care leads professionals to ignore key symptoms and issues for individuals, and to a preoccupation with pharmaceutical interventions, rather than the treatment options that their patients prefer.

Activities of Daily Living↗
PubMed2000

Epidemiology of research into interventions for the treatment of osteoarthritis of the knee joint.

OBJECTIVE: To assess the published research base for interventions for osteoarthritis of the knee, and to identify areas in need of further research. METHODS: Literature searches were conducted on electronic databases (Medline, Embase, ISI, and Cochrane library), bibliographies of existing review articles were hand searched, and a postal questionnaire was sent to members of the Osteoarthritis Research Society International. All relevant articles were copied and searched for treatment type, study methodology, statistical results, conclusions, funding source, researcher affiliations, and year of publication, using a predetermined data extraction form. RESULTS: There have been marked changes in the literature over the period studied (1950-98), with a recent rise in trials of physical therapy, educational interventions, and complementary treatments. However, overall, most research was either drug (59.1%) or surgically (25.6%) related. Most of the studies reported positive results (94%). Research on oral drugs was significantly more likely to provide a positive result than research on any other intervention (p<0.001 by chi(2) test). Commercially funded studies were significantly more likely to produce a positive result than non-commercially funded research (p=0.0027 by chi(2) test). CONCLUSIONS: Analysis of time trends indicates that the research agenda does shadow changes in consumer demands. However, there are significant gaps in the research base that need to be considered.

Complementary Therapies↗
PubMed1998

Reporting on quality of life in randomised controlled trials: bibliographic study.

OBJECTIVES: To examine the frequency and quality of reporting on quality of life in randomised controlled trials. DESIGN: Search of the Cochrane Controlled Trials Register 1980 to 1997 to identify trials from all disciplines, from oncology, and from cardiovascular medicine that reported on quality of life. Assessment of abstracts from articles published from 1993 to 1996. Assessment of a sample of full reports with a standardised instrument. MAIN OUTCOME MEASURES: Prevalence of reporting on quality of life. Conditions and interventions studied in trials reporting on quality of life. Quality of reporting on quality of life. RESULTS: During 1980-97 reporting on quality of life increased from 0.63% to 4.2% for trials from all disciplines, from 1.5% to 8.2% for cancer trials, and from 0.34% to 3.6% for cardiovascular trials. Of 364 abstracts, 65% reported on drug interventions. Of a sample of 67 full reports, authors of 48 (72%) used 62 established quality of life instruments. In 15 reports (22%) authors developed their own measures, and in 2 (3%) methods were unclear. Response rates were given in 38 (57%), and complete reporting on all items and scales occurred in 31 (46%). CONCLUSIONS: Less than 5% of all randomised controlled trials reported on quality of life, and this proportion was below 10% even for cancer trials. A plethora of instruments was used in different studies, and the reporting of methods and results was often inadequate. Standards for the measurement and reporting of quality of life in clinical trials research need to be developed.

Data Collection↗