COVID-19: First Do No Harm.
Ontology highlight
ABSTRACT:
SUBMITTER: Waterer GW
PROVIDER: S-EPMC7258628 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description: Not available
| S-BSST563 | biostudies-other
Project description:ObjectiveTo investigate the presence of white hat bias in Covid-19 treatment research by evaluating the effects of citation and reporting bias.Study design and settingCitation bias was investigated by assessing the degree of agreement between evidence provided by a remdesivir randomized controlled trial and its citing articles. The dissimilarity of outcomes derived from nonrandomized and randomized studies was tested by a meta-analysis of hydroxychloroquine effects on mortality. The differential influence of studies with beneficial over those with neutral results was evaluated by a bibliometric analysis.ResultsThe articles citing the ACTT-1 remdesivir trial preferentially presented its positive outcomes in 55.83% and its negative outcomes in 6.43% of cases. The hydroxychloroquine indicated no significant effect by randomized studies, but a significant survival benefit by nonrandomized ones. Citation mapping revealed that the study reporting survival benefit from the hydroxychloroquine-azithromycin combination was the most influential, despite subsequent studies reporting potential harmful effects.ConclusionThe present study raises concerns about citation bias and a predilection of reporting beneficial over harmful effects in the Covid-19 treatment research, potentially in the context of white hat bias. Preregistration, data sharing and avoidance of selective reporting are crucial to ensure the credibility of future research.
| S-EPMC7997163 | biostudies-literature
Project description: Not available
| S-BSST677 | biostudies-other
Project description: Not available
| S-BSST416 | biostudies-other
Project description:ObjectivesA substantial reduction in self-harm recorded in primary care occurred during the first wave of COVID-19 but effects on primary care management of self-harm are unknown. Our objectives were to examine the impact of COVID-19 on clinical management within 3 months of an episode of self-harm.DesignRetrospective cohort study.SettingUK primary care.Participants4238 patients with an index episode of self-harm recorded in UK primary care during the COVID-19 first-wave period (10 March 2020-10 June 2020) compared with 48 739 patients in a prepandemic comparison period (10 March-10 June, 2010-2019).Outcome measuresUsing data from the UK Clinical Practice Research Datalink, we compared cohorts of patients with an index self-harm episode recorded during the prepandemic period versus the COVID-19 first-wave period. Patients were followed up for 3 months to capture subsequent general practitioner (GP)/practice nurse consultation, referral to mental health services and psychotropic medication prescribing. We examined differences by gender, age group and Index of Multiple Deprivation quintile.ResultsLikelihood of having at least one GP/practice nurse consultation was broadly similar (83.2% vs 80.3% in the COVID-19 cohort). The proportion of patients referred to mental health services in the COVID-19 cohort (4.2%) was around two-thirds of that in the prepandemic cohort (6.1%). Similar proportions were prescribed psychotropic medication within 3 months in the prepandemic (54.0%) and COVID-19 first-wave (54.9%) cohorts.ConclusionsDespite the challenges experienced by primary healthcare teams during the initial COVID-19 wave, prescribing and consultation patterns following self-harm were broadly similar to prepandemic levels. We found no evidence of widening of digital exclusion in terms of access to remote consultations. However, the reduced likelihood of referral to mental health services warrants attention. Accessible outpatient and community services for people who have self-harmed are required as the COVID-19 crisis recedes and the population faces new challenges to mental health.
| S-EPMC8844953 | biostudies-literature
Project description:PurposeConflicting information on potential benefits of drugs as well as reports on hypothetical harm of commonly used drugs in COVID-19 treatment have challenged clinicians and healthcare systems. We analyzed the change in ambulatory drug utilization before, during, and after the first wave of the pandemic in 2020.MethodsWe explored dispensing data of nearly 19 000 pharmacies at the expense of the statutory health insurance funds covering 88% of Germany's population. We analyzed utilization of publicly discussed drugs with conflicting information. Drug utilization as number of packages dispensed per week from January to June 2020, reflecting 314 million claims, was compared with 2019.ResultsUtilization of hydroxychloroquine increased +110% during March 2020 and then slightly decreased until week April 13-19. Renin-angiotensin-aldosterone system inhibitors and simvastatin/atorvastatin increased, +78% and +74%, respectively, and subsequently decreased below 2019 levels. Utilization of azithromycin and all systemic antibiotics decreased continuously from March 2-8 until June to levels considerably lower compared to 2019 (June 22-28: azithromycin: -55%, all systemic antibiotics: -27%). Pneumococcal vaccines utilization initially increased +373%, followed by supply shortages. Paracetamol utilization showed an initial increase of +111%, mainly caused by an increase of over-the-counter dispensings.ConclusionsApart from the pandemic itself, the data suggest that dissemination of misinformation and unsound speculations as well as supply shortages influenced drug prescribing, utilization, and purchasing behavior. The findings can inform post-pandemic policy to prevent unfounded over- and underprescribing and off-label use as well as drug shortages during a public health crisis.
| S-EPMC8441787 | biostudies-literature
Project description: Not available
| S-EPMC10506509 | biostudies-literature
Project description:Stay-at-home-orders, online learning, and work from home policies are some of the responses governments, universities, and other institutions adopted to slow the spread of COVID-19. However, research shows these measures have increased pre-existing gender disparities in the workplace. The working conditions for women during the pandemic worsened due to increased family care responsibilities and unequal distribution of domestic labor. In the academy, working from home has resulted in reduced research time and increased teaching and family care responsibilities, with a larger proportion of that burden falling to women. We investigate the persistence of gender inequity among academic scientists resulting from university COVID-19 responses over time. We draw on two surveys administered in May 2020 and May 2021 to university-based biologists, biochemists, and civil and environmental engineers, to analyze how the pandemic response has disproportionately impacted women in academia and the endurance of those inequities. Results show significantly greater negative impacts from the pandemic on women's research activities and work-life balance, compared to men. We conclude by discussing the implications of our results, and the need for the academy to better predict and adjust to the gender disparities its policies create.
| S-EPMC9269954 | biostudies-literature