Search

Your search keyword '"Hussein, Humaira"' showing total 13 results
Start Over Author "Hussein, Humaira" Search Limiters Available in Library Collection
13 results on '"Hussein, Humaira"'

1. Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in type 2 diabetes : randomised and real-world evidence

Author

Hussein, Humaira

Subjects
Sodium-glucose co-transporter 2 inhibitors, SGLT-2i, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), blood-glucose, Type 2 diabetes, thesis
Abstract

Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) are two of the most recently developed treatment classes in the management of blood-glucose levels in individuals with Type 2 diabetes. While individual treatments have been analysed in randomised controlled trials (RCTs) and observational studies, comparisons of treatments within and between treatment classes are not as well established. In this thesis, using a number of methodological techniques, SGLT-2is and GLP-1RAs were compared for their cardiovascular, cardiometabolic and safety risks in both randomised and observational settings. Throughout this thesis, network meta-analyses (NMA) techniques were used to assess the eficacy and effectiveness of SGLT-2is and GLP-1RAs in RCTs and observational data, separately. Using the real-world database, the Clinical Practice Research Datalink, the effectiveness of treatments within these classes were considered in a UK healthcare setting. In order to provide a comprehensive overview of treatments, RCT data and observational data were synthesised using an extension of NMA models with a power-prior transformation, which allowed for adjustments to be made for the various sources of information. Results from this thesis showed both classes of medications improved health outcomes in individuals with Type 2 diabetes in both RCTs and observational studies. Comparisons between treatment groups highlighted the bene?ts of individual treatments for cardiovascular risk, such as hospital admissions due to heart failure, as well as cardiometabolic risk, such as glycated haemoglobin (HbA1c), body weight and blood pressure levels. Assessment of adverse events showed increased risk of genito-mycotic infection with SGLT-2is and increased risk gastro-intestinal side e?ects in GLP-1RAs, in line with their pharmacological mechanisms. These analyses and results can contribute to the growing body of evidence in Type 2 diabetes management, as well as inform clinicians in the most appropriate treatment plan for individualised care in Type 2 diabetes.

Published
2023
Full Text
View/download PDF

3. Methods for the inclusion of real world evidence in network meta-analysis

Author

Jenkins, David, Hussein, Humaira, Martina, Reynaldo, Dequen-O'Byrne, Pascale, Abrams, Keith R, and Bujkiewicz, Sylwia

Subjects
Statistics - Applications
Abstract

Background: Network Meta-Analysis (NMA) is a key component of submissions to reimbursement agencies world-wide, especially when there is limited direct head-to-head evidence for multiple technologies from randomised controlled trials (RCTs). Many NMAs include only data from RCTs. However, real-world evidence (RWE) is also becoming widely recognised as a valuable source of clinical data. We investigate methods for the inclusion of RWE in NMA and its impact on the uncertainty around the effectiveness estimates. Methods: A range of methods for inclusion of RWE in evidence synthesis, including Bayesian hierarchical and power prior models, were investigated by applying them to an example in relapsing remitting multiple sclerosis. The effect of the inclusion of RWE was investigated by varying the degree of down weighting of this part of evidence by the use of a power prior. Results: Whilst the inclusion of the RWE led to an increase in the level of uncertainty surrounding effect estimates in this example, this depended on the method of inclusion adopted for the RWE. Power prior NMA model resulted in stable effect estimates for fingolimod yet increasing the width of the credible intervals with increasing weight given to RWE data. The hierarchical NMA models were effective in allowing for heterogeneity between study designs; however, this also increased the level of uncertainty. Conclusion: The power prior approach for the inclusion of RWE in NMAs indicates that the degree to which RWE is taken into account can have a significant impact on the overall level of uncertainty. The hierarchical modelling approach further allowed for accommodating differences between study types. Consequently, further work investigating both empirical evidence for biases associated with individual RWE studies and methods of elicitation from experts on the extent of such biases is warranted., Comment: 24 pages, 3 figures

Published
2018
Full Text
View/download PDF

6. Additional file 1 of Hierarchical network meta-analysis models for synthesis of evidence from randomised and non-randomised studies

Author

Hussein, Humaira, Abrams, Keith R., Gray, Laura J., Anwer, Sumayya, Dias, Sofia, and Bujkiewicz, Sylwia

Abstract

Additional file 1: Appendix 1. PRISMA flow chart of included randomised controlled trials and observational studies in the network meta-analysis. Appendix 2. List of references of the studies included in the network meta-analysis. Appendix 3. Table of data extracted from studies included in the network meta-analysis.

Published
2023
Full Text
View/download PDF

10. Additional file 3 of Methods for the inclusion of real-world evidence in network meta-analysis

Author

Jenkins, David A., Hussein, Humaira, Martina, Reynaldo, Dequen-O’Byrne, Pascale, Abrams, Keith R., and Bujkiewicz, Sylwia

Abstract

Additional file 3. Number of subjects, number of relapses and exposure time (person-years) extracted and analysed from randomised controlled trials and real-world studies assessing the impact of treatments in relapse remitting multiple sclerosis.

Published
2021
Full Text
View/download PDF

11. Additional file 5 of Methods for the inclusion of real-world evidence in network meta-analysis

Author

Jenkins, David A., Hussein, Humaira, Martina, Reynaldo, Dequen-O’Byrne, Pascale, Abrams, Keith R., and Bujkiewicz, Sylwia

Abstract

Additional file 5. Annualised relapse rate ratios (95% credible intervals) of each active treatment compared to placebo for values of the down-weighting factor (alpha) between zero (total down-weighting, i.e. RWE not included) and one (RWE considered at ‘face-value’) using the hierarchical power prior model.

Published
2021
Full Text
View/download PDF

12. Additional file 4 of Methods for the inclusion of real-world evidence in network meta-analysis

Author

Jenkins, David A., Hussein, Humaira, Martina, Reynaldo, Dequen-O’Byrne, Pascale, Abrams, Keith R., and Bujkiewicz, Sylwia

Abstract

Additional file 4. Annualised relapse rate ratios (95% credible intervals) of each active treatment compared to placebo for values alpha using the power prior model with between study heterogeneity standard deviation estimates.

Published
2021
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results