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BackgroundThe National Institute for Health and Care Excellence (NICE) 2020 guidelines recommends aspirin for colorectal cancer prevention for people with Lynch syndrome. Strategies to change practice should be informed by understanding the factors influencing prescribing.AimTo investigate the optimal type and level of information to communicate with GPs to increase willingness to prescribe aspirin.Design and settingGPs in England and Wales (n= 672) were recruited to participate in an online survey with a 23factorial design. GPs were randomised to one of eight vignettes describing a hypothetical patient with Lynch syndrome recommended to take aspirin by a clinical geneticist.MethodAcross the vignettes, the presence or absence of three types of information was manipulated: 1) existence of NICE guidance; 2) results from the CAPP2 trial; 3) information comparing risks/benefits of aspirin. The main effects and all interactions on the primary (willingness to prescribe) and secondary outcomes (comfort discussing aspirin) were estimated.ResultsThere were no statistically significant main effects or interactions of the three information components on willingness to prescribe aspirin or comfort discussing harms and benefits. In total, 80.4% (540/672) of GPs were willing to prescribe, with 19.7% (132/672) unwilling. GPs with prior awareness of aspirin for preventive therapy were more comfortable discussing the medication than those unaware (P= 0.031).ConclusionIt is unlikely that providing information on clinical guidance, trial results, and information comparing benefits and harms will increase aspirin prescribing for Lynch syndrome in primary care. Alternative multilevel strategies to support informed prescribing may be warranted.

La science ouverte vise à améliorer la rigueur, la robustesse et la reproductibilité de la recherche en psychologie. Malgré la résistance de certain·es universitaires, le mouvement de la science ouverte a été soutenu par certain·es chercheur·euses en début de carrière (ECR), qui ont proposé de nouveaux outils et des méthodes innovantes pour promouvoir et utiliser les principes de la recherche ouverte. Les ECR féministes ont beaucoup à apporter à cette nouvelle façon de faire de la recherche. Cependant, elles et ils sont confronté·es à des obstacles spécifiques, qui peuvent les empêcher de s'engager pleinement dans le mouvement de la science ouverte. Nous, dix ECR féministes spécialisées en psychologie, issues de divers parcours universitaires et personnels, explorons la science ouverte à travers un regard féministe afin de considérer comment les ECR peuvent utiliser leur voix et leur pouvoir de manière unique. En adoptant une approche critique et intersectionnelle, nous discutons de la manière dont la recherche féministe en début de carrière peut être complétée ou remise en question par les changements en faveur de la science ouverte. Nous présentons également comment les ECR peuvent agir en tant qu’acteur·rices pour le changement dans un contexte de précarité universitaire. Nous identifions les moyens par lesquels la science ouverte peut bénéficier de l'épistémologie féministe et nous concluons en envisageant un avenir pour les ECR féministes qui souhaitent s'engager dans les pratiques de la science ouverte dans leur propre recherche.

[Note that this paper is now published at Psychology of Women Quarterly in the Special Issue on Feminist Psychology and Open Science https://doi.org/10.1177/03616843211029255] Open science aims to improve the rigor, robustness, and reproducibility of psychological research. Despite resistance from some academics, the open science movement has been championed by some early career researchers, who have proposed innovative new tools and methods to promote and employ open research principles. Feminist early career researchers have much to contribute to this emerging way of doing research. However, they face unique barriers, which may prohibit their full engagement with the open science movement. We, ten feminist early career researchers in psychology, from a diverse range of academic and personal backgrounds, explore open science through a feminist lens, to consider how voice and power may be negotiated in unique ways for early career researchers. Taking a critical and intersectional approach, we discuss how feminist early career research may be complemented or challenged by shifts towards open science. We also propose how early career researchers can act as grassroots changemakers within the context of academic precarity. We identify ways in which open science can benefit from feminist epistemology and end with envisaging a future for feminist early career researchers who wish to engage with open science practices in their own research.

© 2020, The Royal Society of Medicine. In recent years there has been increasing awareness of problems that have undermined trust in medical research. This review outlines some of the most important issues including research culture, reporting biases, and statistical and methodological issues. It examines measures that have been instituted to address these problems and explores the success and limitations of these measures. The paper concludes by proposing three achievable actions which could be implemented to deliver significantly improved transparency and mitigation of bias. These measures are as follows: (1) mandatory registration of interests by those involved in research; (2) that journals support the ‘registered reports’ publication format; and (3) that comprehensive study documentation for all publicly funded research be made available on a World Health Organization research repository. We suggest that achieving such measures requires a broad-based campaign which mobilises public opinion. We invite readers to feedback on the proposed actions and to join us in calling for their implementation.

Purpose Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects. Methods We searched for systematic reviews and clinical guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation’s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate. PROSPERO: 2019CRD4201914001. Results We identified 33 systematic reviews and 18 clinical guidelines. 21% of reviews were high quality, and the average quality score for guidelines was 44%. Evidence for most strategies was absent or weak. There was consensus from a low-quality review and multiple guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events. Conclusions Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies. Implications for Cancer Survivors Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.

We undertook a systematic review to synthesise the data on attitudes and behaviour towards the use of aspirin for cancer prevention, and healthcare providers' attitudes towards implementing aspirin in practice. Searches were carried out across 12 databases (e.g. MEDLINE, EMBASE). We used the Mixed Methods Appraisal Tool to evaluate study quality, and conducted a narrative synthesis of the data. The review was pre-registered (PROSPERO: CRD42018093453). Thirty-eight studies were identified. Uptake and adherence data were all from trials. Trials recruited healthy participants, those at higher risk of cancer, and those with cancer. Four studies reported moderate to high (40.9–77.7%) uptake to an aspirin trial among people who were eligible. Most trials (18/22) reported high day-to-day adherence (≥80%). Three trials observed no association between gender and adherence. One trial found no association between adherence and colorectal cancer risk. Three studies reported moderate to high (43.6–76.0%) hypothetical willingness to use aspirin. Two studies found that a high proportion of healthcare providers (72.0–76.0%) perceived aspirin to be a suitable cancer prevention option. No qualitative studies were identified. The likelihood that eligible users of aspirin would participate in a trial evaluating the use of aspirin for preventive therapy was moderate to high. Among participants in a trial, day-to-day adherence was high. Further research is needed to identify uptake and adherence rates in routine care, the factors affecting aspirin use, and the barriers to implementing aspirin into clinical care., Highlights • Most eligible people offered participation in an aspirin trial accepted. • Among participants, most reported high (≥80%) adherence on a day-to-day basis. • No studies examined uptake and adherence in routine care. • Further research is needed to identify the barriers to using aspirin in practice.

Tamoxifen reduces breast cancer incidence in women at increased risk, but may cause side effects. We examined women's knowledge of tamoxifen's potential harms and benefits, and the extent to which knowledge reflects subjective judgments of awareness and decision quality. After a hospital appointment, 408 (55.7%) women at increased risk of breast cancer completed a survey assessing objective knowledge about the potential benefit (risk reduction) and harms (endometrial cancer, thromboembolic events, and menopausal side effects) of tamoxifen, and subjective tamoxifen knowledge and decisional quality. Two hundred fifty-eight (63.2%) completed a 3-month follow-up survey. Sixteen percent (15.7%) of participants recognized the potential benefit and three major harms of using tamoxifen. These women were more likely to have degree-level education [vs. below degree level; OR, 2.24; 95% confidence interval (CI), 1.11–4.55] and good numeracy (vs. poor numeracy; OR, 5.91; 95% CI, 1.33–26.19). Tamoxifen uptake was higher in women who recognized all harms and benefits (vs. not recognizing; OR, 2.47; 95% CI, 0.94–6.54). Sixty-six percent (65.8%) of tamoxifen users were unaware of its potential benefit and harms. Most (87.1%) women reported feeling informed about tamoxifen, and subjective decisional quality was high [Mean (SD), 17.03 (1.87), out of 18]. Knowledge regarding the potential harms and benefit of tamoxifen is low in women considering prevention therapy, and they may need additional support to make informed decisions about tamoxifen preventive therapy.