More Frequent Clinic Visits Are Associated with Improved Outcomes for Children with NAFLD

Lam, Carol K.L.; Bandsma, Robert; Ling, Simon C.; Mouzaki, Marialena

doi:10.1155/2016/8205494

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…Furthermore, SiVET participants had four more clinic visits to complete trial procedures and adherence counselling. Regular study clinic visits have been associated with improved study outcomes and completion [30]. More clinic visits resulted in more HIV risk reduction counselling and other free Health care services in the SiVET cohort than non-SIVET cohort and a lower HIV incidence observed in this group [8].…”

Section: Discussionmentioning

confidence: 99%

Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda

Abaasa

Todd

Nash

et al. 2020

BMC Med Res Methodol

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Background: Outcomes in observational studies may not best estimate those expected in the HIV vaccine efficacy trials. We compared retention in Simulated HIV Vaccine Efficacy Trials (SiVETs) and observational cohorts drawn from two key populations in Uganda. Methods: Two SiVETs were nested within two observational cohorts, one in Fisherfolk (FF) and another one in Female Sex Workers (FSW). Adult participants in each observational cohort were screened for enrolment into SiVETs. Those screened-out or not screened continued participation in the observational (non-SiVET) cohorts. SiVET participants were administered a licensed hepatitis B vaccine in a schedule that mimicked an actual HIV vaccine efficacy trial. Both cohorts were followed for 12 months and retention was assessed through dropout, defined as lost to follow up, being uncontactable, refusal to continue or missing the last study clinic visit. Dropout rates were compared using Poisson models giving rate ratios and 95% confidence intervals (95%CI). Results: Out of 1525 participants (565 FF and 960 FSW), 572 (38%) were enrolled into SiVETs (282-FF and 290-FSW), and 953 (62%) remained in the non-SiVET cohorts. Overall, 326 (101 SiVET, 225 non-SiVET) dropped out in 1260 Person Years of Observation (PYO), a dropout rate of 25.9 /100 PYO (95%CI: 23.2-28.8); fewer dropped out in the SiVET cohorts (18.4, 95% CI: 15.1-22.4) than in the non-SiVET cohorts (31.6, 95% CI: 27.8-36.1), rate ratio (RR) =0.58, 95% CI: 0.46-0.73. In all cohorts, the dropout was more marked in FSW than in FF population. Duration lived in community was associated with dropout in both SiVETs and religion in both non-SiVET cohorts. Conclusion: The rate of dropout was lower in SiVET compared to non-SiVET cohort. Though the difference in dropout between SiVET and non-SiVET was generally similar, the actual dropout rates were higher in the FSW population. Conduct of SiVETs in these key populations could mean that designing HIV Vaccine Efficacy Trials will benefit from lower dropout rate shown in SiVET than non-SiVET observational cohort.

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Section: Discussionmentioning

confidence: 99%

Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda

Abaasa

Todd

Nash

et al. 2020

BMC Med Res Methodol

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show abstract

“…Classifications of weight were as follows: overweight, class I obesity, class II severe obesity, or class III severe obesity, using recommended BMI percentile cutoffs (85th‐95th, 95th to 1.19 × 95th, 1.2‐1.4 × 95th, greater than 1.4 × 95th, respectively) . T2DM was defined as HbA1c ≥ 6.5% and/or a positive oral glucose tolerance test (serum glucose level at 2 h ≥ 200 mg/dL) and/or a diagnosis of T2DM by an endocrinologist.…”

Section: Methodsmentioning

confidence: 99%

“…Given the close association of NAFLD with these risk factors, we hypothesized that severe paediatric obesity, as defined by current thresholds, is associated with severity of NAFLD. Understanding if severe obesity is an independent risk factor for more severe NAFLD could facilitate management decisions, such as whether to proceed with a liver biopsy, or guide treatment recommendations and frequency of follow‐up …”

Section: Introductionmentioning

confidence: 99%

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

et al. 2019

Self Cite

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Background: Paediatric non-alcoholic fatty liver disease (NAFLD) is highly prevalent among children with obesity. The primary objective of this study was determining whether obesity severity is associated with NAFLD severity. By using paediatric classifications for severe obesity, clinicians may be able to better risk stratify patients, which in turn would guide more effective management and treatment.Methods: Retrospective cohort study including patients followed at Cincinnati Children's Medical Center for NAFLD. Patients were categorized as overweight or class I, II, III obese based on established body mass index (BMI) cut-offs. Liver disease severity was determined using biochemical, imaging (magnetic resonance elastography [MRE]), and histologic evidence of liver injury.Results: Three cohorts were studied individually based on the method used to assess disease severity (biochemical n = 767, imaging n = 366, and histology n = 249). Between the three cohorts, there were significant differences in age, proportion of patients with class II and class III obesity, and serum alanine transaminase (ALT) levels. In the biochemistry cohort, the odds of having ALT > 80 U/L were highest in patients with class III obesity (P = .026). In the imaging cohort, liver stiffness was significantly different between BMI groups of patients (P = .001). In the histology cohort, those with class III obesity had significantly higher odds of NAFLD activity score (NAS) ≥ 5 (P = .012). Discussion:Obesity severity is associated with liver disease severity. Patients with more severe obesity are more likely to have more advanced liver disease, a finding that can assist in risk stratification, as well as monitoring and treatment approaches.

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Section: Discussionmentioning

confidence: 99%

Comparison of retention in observational cohorts and nested Simulated HIV Vaccine Efficacy Trials in the Key populations in Uganda

Abaasa

Todd

Nash

et al. 2020

Preprint

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Background: Outcomes in observational studies may not best estimate those expected in the HIV vaccine efficacy trials. We compared retention in Simulated HIV Vaccine Efficacy Trials (SiVETs) and observational cohorts drawn from two key populations in Uganda.Methods: Two SiVETs were nested within two observational cohorts, one in Fisherfolk (FF) and another one in Female Sex Workers (FSW). Adult participants in each observational cohort were screened for enrolment into SiVETs. Those screened-out or not screened continued participation in the observational (non-SiVET) cohorts. SiVET participants were administered a licensed hepatitis B vaccine in a schedule that mimicked an actual HIV vaccine efficacy trial. Both cohorts were followed for 12 months and retention was assessed through dropout, defined as lost to follow up, being uncontactable, refusal to continue or missing the last study clinic visit. Dropout rates were compared using Poisson models giving rate ratios and 95% confidence intervals (95%CI). Results: Out of 1,525 participants (565 FF and 960 FSW), 572 (38 %) were enrolled into SiVETs (282-FF and 290-FSW), and 953 (62%) remained in the non-SiVET cohorts. Overall, 326 (101 SiVET, 225 non-SiVET) dropped out in 1,260 Person Years of Observation (PYO), a dropout rate of 25.9 /100 PYO (95%CI: 23.2-28.8); fewer dropped out in the SiVET cohorts (18.4, 95% CI: 15.1-22.4) than in the non-SiVET cohorts (31.6, 95% CI: 27.8-36.1), rate ratio (RR) =0.58, 95% CI: 0.46-0.73. In all cohorts, the dropout was more marked in FSW than in FF population. Duration lived in community was associated with dropout in both SiVETs and religion in both non-SiVET cohorts.Conclusion: The rate of dropout was lower in SiVET compared to non-SiVET cohort. Though the difference in dropout between SiVET and non-SiVET was generally similar, the actual dropout rates were higher in the FSW population. Conduct of SiVETs in these key populations could mean that designing HIV Vaccine Efficacy Trials will benefit from lower dropout rate shown in SiVET than non-SiVET observational cohort.

show abstract

More Frequent Clinic Visits Are Associated with Improved Outcomes for Children with NAFLD

Cited by 10 publications

References 17 publications

Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda

Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

Comparison of retention in observational cohorts and nested Simulated HIV Vaccine Efficacy Trials in the Key populations in Uganda

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