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  • 1
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    A Multi-component Intervention (NEXpro) Reduces Neck Pain-Related Work Productivity Loss: A Randomized Controlled Trial Among Swiss Office Workers
    Springer Science and Business Media LLC ; 2023
    In:  Journal of Occupational Rehabilitation Vol. 33, No. 2 ( 2023-06), p. 288-300
    Details
    In: Journal of Occupational Rehabilitation, Springer Science and Business Media LLC, Vol. 33, No. 2 ( 2023-06), p. 288-300
    Abstract: Purpose Neck pain is common among office workers and leads to work productivity loss. This study aimed to investigate the effect of a multi-component intervention on neck pain-related work productivity loss among Swiss office workers. Methods Office workers, aged 18–65 years, and without serious neck-related health problems were recruited from two organisations for our stepped-wedge cluster randomized controlled trial. The 12-week multi-component intervention included neck exercises, health-promotion information, and workplace ergonomics. The primary outcome of neck pain-related work productivity loss was measured using the Work Productivity and Activity Impairment Questionnaire and expressed as percentages of working time. In addition, we reported the weekly monetary value of neck pain-related work productivity loss. Data was analysed on an intention-to-treat basis using a generalized linear mixed-effects model. Results Data from 120 participants were analysed with 517 observations. At baseline, the mean age was 43.7 years (SD 9.8 years), 71.7% of participants were female ( N  = 86), about 80% ( N  = 95) reported mild to moderate neck pain, and neck pain-related work productivity loss was 12% of working time (absenteeism: 1.2%, presenteeism: 10.8%). We found an effect of our multi-component intervention on neck pain-related work productivity loss, with a marginal predicted mean reduction of 2.8 percentage points ( b  = −0.27; 95% CI: −0.54 to −0.001, p  = 0.049). Weekly saved costs were Swiss Francs 27.40 per participant. Conclusions: Our study provides evidence for the effectiveness of a multi-component intervention to reduce neck pain-related work productivity loss with implications for employers, employees, and policy makers. Trial Registration ClinicalTrials.gov, NCT04169646. Registered 15 November 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646 .
    Type of Medium: Online Resource
    ISSN: 1053-0487 , 1573-3688
    URL: Article
    DOI: 10.1007/s10926-022-10069-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 2
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    On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial
    Springer Science and Business Media LLC ; 2020
    In:  BMC Musculoskeletal Disorders Vol. 21, No. 1 ( 2020-12)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: Non-specific neck pain and headache are major economic and individual burden in office-workers. The aim of this study is to investigate the effect of a multi-component intervention combining workstation ergonomics, health promotion information group workshops, neck exercises, and an app to enhance intervention adherence to assess possible reductions in the economic and individual burden of prevalent and incident neck pain and headache in office workers. Methods/design This study is a stepped wedge cluster-randomized controlled trial. Eligible participants will be any office-worker aged 18–65 years from two Swiss organisations in the Cantons of Zurich and Aargau, working more than 25 h a week in predominantly sedentary office work and without serious health conditions of the neck. One hundred twenty voluntary participants will be assigned to 15 clusters which, at randomly selected time steps, switch from the control to the intervention group. The intervention will last 12 weeks and comprises workstation ergonomics, health promotion information group workshops, neck exercises and an adherence app. The primary outcome will be health-related productivity losses (presenteeism, absenteeism) using the Work Productivity and Activity Impairment Questionnaire. Secondary outcomes are neck disability and pain (measured by the Neck Disability Index, and muscle strength and endurance measures), headache (measured by the short-form headache impact test), psychosocial outcomes (e.g. job-stress index, Fear-Avoidance Beliefs Questionnaire), workplace outcomes (e.g. workstation ergonomics), adherence to intervention, and additional measures (e.g. care-seeking). Measurements will take place at baseline, 4 months, 8 months, and 12 months after commencement. Data will be analysed on an intention to treat basis and per protocol. Primary and secondary outcomes will be examined using linear mixed-effects models. Discussion To the authors’ knowledge, this study is the first that investigates the impact of a multi-component intervention combining current evidence of effective interventions with an adherence app to assess the potential benefits on productivity, prevalent and incident neck pain, and headache. The outcomes will impact the individual, their workplace, as well as private and public policy by offering evidence for treatment and prevention of neck pain and headache in office-workers. Trial registration ClinicalTrials.gov, NCT04169646 . Registered 15 November 2019 - Retrospectively registered.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-020-03388-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 3
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    Cervical musculoskeletal impairments and pressure pain sensitivity in office workers with headache
    Elsevier BV ; 2023
    In:  Musculoskeletal Science and Practice Vol. 66 ( 2023-08), p. 102816-
    Details
    In: Musculoskeletal Science and Practice, Elsevier BV, Vol. 66 ( 2023-08), p. 102816-
    Type of Medium: Online Resource
    ISSN: 2468-7812
    URL: Article
    DOI: 10.1016/j.msksp.2023.102816
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2879116-2
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  • 4
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    Development and validation of a prognostic model for the early identification of COVID-19 patients at risk of developing common long COVID symptoms
    Springer Science and Business Media LLC ; 2022
    In:  Diagnostic and Prognostic Research Vol. 6, No. 1 ( 2022-11-17)
    Details
    In: Diagnostic and Prognostic Research, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2022-11-17)
    Abstract: The coronavirus disease 2019 (COVID-19) pandemic demands reliable prognostic models for estimating the risk of long COVID. We developed and validated a prediction model to estimate the probability of known common long COVID symptoms at least 60 days after acute COVID-19. Methods The prognostic model was built based on data from a multicentre prospective Swiss cohort study. Included were adult patients diagnosed with COVID-19 between February and December 2020 and treated as outpatients, at ward or intensive/intermediate care unit. Perceived long-term health impairments, including r educed exercise tolerance/reduced r e silience, s hortness of breath and/or t iredness (REST), were assessed after a follow-up time between 60 and 425 days. The data set was split into a derivation and a geographical validation cohort. Predictors were selected out of twelve candidate predictors based on three methods, namely the augmented backward elimination (ABE) method, the adaptive best-subset selection (ABESS) method and model-based recursive partitioning (MBRP) approach. Model performance was assessed with the scaled Brier score, concordance c statistic and calibration plot. The final prognostic model was determined based on best model performance. Results In total, 2799 patients were included in the analysis, of which 1588 patients were in the derivation cohort and 1211 patients in the validation cohort. The REST prevalence was similar between the cohorts with 21.6% ( n  = 343) in the derivation cohort and 22.1% ( n  = 268) in the validation cohort. The same predictors were selected with the ABE and ABESS approach. The final prognostic model was based on the ABE and ABESS selected predictors. The corresponding scaled Brier score in the validation cohort was 18.74%, model discrimination was 0.78 (95% CI: 0.75 to 0.81), calibration slope was 0.92 (95% CI: 0.78 to 1.06) and calibration intercept was −0.06 (95% CI: −0.22 to 0.09). Conclusion The proposed model was validated to identify COVID-19-infected patients at high risk for REST symptoms. Before implementing the prognostic model in daily clinical practice, the conduct of an impact study is recommended.
    Type of Medium: Online Resource
    ISSN: 2397-7523
    URL: Article
    DOI: 10.1186/s41512-022-00135-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2886634-4
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  • 5
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    Supramalleolar Osteotomy for Tibial Component Malposition in Total Ankle Replacement
    SAGE Publications ; 2017
    In:  Foot & Ankle Orthopaedics Vol. 2, No. 3 ( 2017-09-01), p. 2473011417S0000-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 2, No. 3 ( 2017-09-01), p. 2473011417S0000-
    Abstract: Ankle Introduction/Purpose: A key for success in total ankle replacement is a balanced ankle joint. If the tibial component is misaligned, the ligamentous structures, the malleoli and the tendons may be overused, which, may lead to pain and impairment during gait. A misaligned tibial component can be revised using a corrective bone resection and re-insertion of a new component or using a corrective osteotomy of the distal tibia above the stable implant. The aim of this study was to review a series of patients, in whom a corrective supramalleolar osteotomy was performed to realign a misaligned tibial component in total ankle replacement. Methods: Twenty-two patients (nine male; 13 female; mean age, 62.6 years; range, 44.7 – 80.0) were treated with a supramalleolar osteotomy to correct a painful dysbalanced ankle, following a varus implanted tibial component. Following radiological and clinical outcomes were recorded preoperatively and at the follow-up examination within the first 24 months: the tibial anterior surface angle (TAS), the tibial lateral surface angle (TLS), patient’s pain measured with the Visual Analogue Scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score, range of motion (ROM) of the ankle and patient’s satisfaction. Furthermore, postoperative complications were reviewed. Results: The TAS changed on average from 85.2 ± 2.5 degrees preoperatively to 91.4 ± 2.9 degrees postoperatively (p 〈 0.0001), the AOFAS score increased from 46 ± 14 to 66 ± 16 points (p 〈 .0001) and the VAS pain score decreased from 5.8 ± 1.9 to 3.3 ± 2.4 (p 〈 .001). No statistical difference was found in the TLS and the range of motion. The osteotomy healed in 19 patients (86%), re-osteosynthesis was successful in the remaining three patients. In one of these three patients, a chronic infection of the ankle joint led to a below-knee amputation. Fifteen patients (68%) were (very) satisfied, four (18%) moderately satisfied and three (14 %) patients were not satisfied with the obtained postoperative result. Conclusion: The supramalleolar osteotomy was found to be an efficient alternative to correct the misaligned tibial component in total ankle replacement. Pain could be successfully addressed in the majority of the patients. The treatment of a malpositioned, well anchored tibial component with a supramalleolar osteotomy, instead of exchanging the tibial component, allows preservation of the bone stock. However, non-union should be mentioned as a possible complication of this surgery. Nonetheless, this method might be a feasible treatment option, especially for younger patients.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011417S000039
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2874570-X
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  • 6
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    Evaluation of Different Recruitment Methods: Longitudinal, Web-Based, Pan-European Physical Activity Through Sustainable Transport Approaches (PASTA) Project
    JMIR Publications Inc. ; 2019
    In:  Journal of Medical Internet Research Vol. 21, No. 5 ( 2019-05-06), p. e11492-
    Details
    In: Journal of Medical Internet Research, JMIR Publications Inc., Vol. 21, No. 5 ( 2019-05-06), p. e11492-
    Type of Medium: Online Resource
    ISSN: 1438-8871
    URL: Article
    DOI: 10.2196/11492
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
    detail.hit.zdb_id: 2028830-X
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  • 7
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    Towards a comprehensive safety evaluation of cycling infrastructure including objective and subjective measures
    Elsevier BV ; 2018
    In:  Journal of Transport & Health Vol. 8 ( 2018-03), p. 44-54
    Details
    In: Journal of Transport & Health, Elsevier BV, Vol. 8 ( 2018-03), p. 44-54
    Type of Medium: Online Resource
    ISSN: 2214-1405
    URL: Article
    DOI: 10.1016/j.jth.2017.12.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2747533-5
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  • 8
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    Development and internal validation of a prediction model for long-term opioid use—an analysis of insurance claims data
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Pain ( 2023-9-28)
    Details
    In: Pain, Ovid Technologies (Wolters Kluwer Health), ( 2023-9-28)
    Abstract: In the United States, a public-health crisis of opioid overuse has been observed, and in Europe, prescriptions of opioids are strongly increasing over time. The objective was to develop and validate a multivariable prognostic model to be used at the beginning of an opioid prescription episode, aiming to identify individual patients at high risk for long-term opioid use based on routinely collected data. Predictors including demographics, comorbid diseases, comedication, morphine dose at episode initiation, and prescription practice were collected. The primary outcome was long-term opioid use, defined as opioid use of either 〉 90 days duration and ≥10 claims or 〉 120 days, independent of the number of claims. Traditional generalized linear statistical regression models and machine learning approaches were applied. The area under the curve, calibration plots, and the scaled Brier score assessed model performance. More than four hundred thousand opioid episodes were included. The final risk prediction model had an area under the curve of 0.927 (95% confidence interval 0.924-0.931) in the validation set, and this model had a scaled Brier score of 48.5%. Using a threshold of 10% predicted probability to identify patients at high risk, the overall accuracy of this risk prediction model was 81.6% (95% confidence interval 81.2% to 82.0%). Our study demonstrated that long-term opioid use can be predicted at the initiation of an opioid prescription episode, with satisfactory accuracy using data routinely collected at a large health insurance company. Traditional statistical methods resulted in higher discriminative ability and similarly good calibration as compared with machine learning approaches.
    Type of Medium: Online Resource
    ISSN: 0304-3959 , 1872-6623
    URL: Article
    DOI: 10.1097/j.pain.0000000000003023
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1494115-6
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  • 9
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    Imaging of the subtalar joint: A novel approach to an old problem
    Wiley ; 2019
    In:  Journal of Orthopaedic Research Vol. 37, No. 4 ( 2019-04), p. 921-926
    Details
    In: Journal of Orthopaedic Research, Wiley, Vol. 37, No. 4 ( 2019-04), p. 921-926
    Abstract: Evaluation of the subtalar joint using conventional radiographs is difficult. The purpose of this study was to assess how the posterior facet of the subtalar joint is projected on eight standard radiographic views of the foot and ankle. Weightbearing computed tomography (CT) scans of 27 volunteers without ankle pathology were performed. Eight standard views of the foot and ankle (antero‐posterior [AP] view, mortise view, subtalar view, four different Broden views) were reconstructed using digitally reconstructed radiographs (DRRs). The appearance of the posterior facet of the subtalar joint was assessed for each view. In addition, the position of the joint line was projected onto three‐dimensional (3‐D) models of the calcaneus. We found (i) on the AP view of the ankle joint, the posterior part of the posterior facet is visualized and appears convex (calcaneal side); (ii) on the mortise view of the ankle joint, a slightly more anterior part (compared to the AP view) is visualized and appears either convex or flat; (iii) on the subtalar view, the anterior part of the posterior facet is visualized and appears either convex, flat or concave; and (iv) using the Broden views, the posterior and anterior part of the posterior facet can be visualized. This study clarifies which parts of the posterior facet of the subtalar joint are visualized on eight standard views of the foot and ankle. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
    Type of Medium: Online Resource
    ISSN: 0736-0266 , 1554-527X
    URL: Issue
    URL: Article
    DOI: 10.1002/jorr.v37.4
    DOI: 10.1002/jor.24220
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2050452-4
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  • 10
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    Combining evidence from clinical trials in conditional or accelerated approval
    Wiley ; 2023
    In:  Pharmaceutical Statistics Vol. 22, No. 4 ( 2023-07), p. 707-720
    Details
    In: Pharmaceutical Statistics, Wiley, Vol. 22, No. 4 ( 2023-07), p. 707-720
    Abstract: Conditional (European Medicines Agency) or accelerated (U.S. Food and Drug Administration) approval of drugs allows earlier access to promising new treatments that address unmet medical needs. Certain post‐marketing requirements must typically be met in order to obtain full approval, such as conducting a new post‐market clinical trial. We study the applicability of the recently developed harmonic mean ‐test to this conditional or accelerated approval framework. The proposed approach can be used both to support the design of the post‐market trial and the analysis of the combined evidence provided by both trials. Other methods considered are the two‐trials rule, Fisher's criterion and Stouffer's method. In contrast to some of the traditional methods, the harmonic mean ‐test always requires a post‐market clinical trial. If the ‐value from the pre‐market clinical trial is , a smaller sample size for the post‐market clinical trial is needed than with the two‐trials rule. For illustration, we apply the harmonic mean ‐test to a drug which received conditional (and later full) market licensing by the EMA. A simulation study is conducted to study the operating characteristics of the harmonic mean ‐test and two‐trials rule in more detail. We finally investigate the applicability of these two methods to compute the power at interim of an ongoing post‐market trial. These results are expected to aid in the design and assessment of the required post‐market studies in terms of the level of evidence required for full approval.
    Type of Medium: Online Resource
    ISSN: 1539-1604 , 1539-1612
    URL: Issue
    URL: Article
    DOI: 10.1002/pst.v22.4
    DOI: 10.1002/pst.2302
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2083706-9
    detail.hit.zdb_id: 2163550-X
    SSG: 15,3
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