Guideline panel social dynamics influence the development of clinical practice recommendations: a mixed-methods systematic review.

OBJECTIVES: To synthesize empirical studies that investigate the cognitive and social processes involved in the deliberation process of guideline development meetings and determine the distribution of deliberated topics. STUDY DESIGN AND SETTING: We conducted a mixed-method systematic review using a convergent segregated approach. We searched for empirical studies that investigate the intragroup dynamics of guideline development meetings indexed in bibliographic databases. RESULTS: Of the 5,899 citations screened, 12 studies from six countries proved eligible. Chairs, cochairs, and methodologists contributed to at least one-third of the discussion time in guideline development meetings; patient partners contributed the least. In interdisciplinary groups, male gender and occupation as a physician were positively associated with the amount of contribution. Compared to groups that used the Grading of Recommendations Assessment, Development and Evaluation approach, for groups that did not, when faced with insufficient or low-quality evidence, relied more on their clinical experience. The presence of a cognitive "yes" bias was apparent in meetings: panelists tended to acquiesce with positive statements that required less cognitive effort than negative statements. CONCLUSION: The social dynamics of the discussions were linked to each panelist's activity role, professional background, and gender, all of which influenced the level of contributions they made in guideline development meetings.

Facilitating Access to Healthcare for Performing Artists Using Subsidized Health Services in Canada: An Interpretive Descriptive Study.

BACKGROUND: Performing artists are often confronted with job insecurity and insufficient health coverage. As a result, artists may not have access to non-publicly funded health services that are essential to their well-being. A health centre in Canada that specializes in providing healthcare to artists offers eligible artists subsidized health services, with the aim to treat acute health issues that impact an artists' ability to engage in their artistic practice. PURPOSE: We evaluated the use of the subsidized health services and explored the subsidy recipients' and the selection committee's perspectives on the impact of these services on the health of performing artists. METHODS: We applied an interpretive descriptive approach to our qualitative inquiry. We conducted individual, semi-structured interviews with recipients of the subsidy and a focus group with the selection committee that selected recipients of the subsidy. Data were analyzed using thematic analysis. RESULTS: A total of 14 artists and all members of the selection committee (n=3) participated. Recipients and selection committee perceived that subsidized health services were critical in enabling consistent and timely diagnosis and treatment. Several themes emerged from the data: 1) need for universal health benefits to restore equity and offset healthcare insecurity, 2) the critical role of subsidies in accessing health services, 3) risks of abruptly ending health services when subsidy runs out, 4) barriers in applying for and accessing subsidies, 5) mental health challenges, and 6) importance of the subsidy in the context of the COVID-19 pandemic. All recipients saw noticeable improvement in health outcomes that they believed would have been otherwise unattainable if they did not have timely access to care. CONCLUSIONS: Subsidized health services play an important role in ensuring that performing artists have access to care for injuries and health conditions that are related to their profession. Future research can examine the long-term impact of subsidized services on the recipients' health and employment outcomes.

Completeness of reporting for COVID-19 case reports, January to April 2020: a meta-epidemiologic study.

BACKGROUND: The quality of case reports, which are often the first reported evidence for a disease, may be negatively affected by a rush to publication early in a pandemic. We aimed to determine the completeness of reporting (COR) for case reports published on coronavirus disease 2019 (COVID-19). METHODS: We conducted a systematic search of the PubMed database for all single-patient case reports of confirmed COVID-19 published from Jan. 1 to Apr. 24, 2020. All included case reports were assessed for adherence to the CARE (Case Report) 31-item checklist, which was used to create a composite COR score. The primary outcome was the mean COR score assessed by 2 independent raters. Secondary outcomes included whether there was a change in overall COR score with certain publication factors (e.g., publication date) and whether there was a linear relation between COR and citation count and between COR scores and social media attention. RESULTS: Our search identified 196 studies that were published in 114 unique journals. We found that the overall mean COR score was 54.4%. No one case report included all of the 31 CARE checklist items. There was no significant correlation between COR with either citation count or social media attention. INTERPRETATION: We found that the overall COR for case reports on COVID-19 was poor. We suggest that journals adopt common case-reporting standards to improve reporting quality.