We conducted a rapid review examining the effectiveness of organisational interventions intended to improve job-related wellbeing of adult employees working from home. A systematic search was conducted on MEDLINE, PsycINFO, and Social Sciences Citation Index in June 2021. Studies were included of adult employees working from home, with wellbeing interventions implemented by organisations for all (or groups of) employees and study designs with any (or no) comparator group. Outcomes were quantitative/qualitative data related to employee psychological and subjective well-being. A total of 1906 unique records were retrieved, of which five studies with a total of 332 participants were included. All five studies included an online intervention, and each had a different type of intervention: well-being and performance coaching; positive psychology coaching; employee empowering sessions; corporate wellbeing programme; and yoga. Interventions showed a pattern of reducing stress levels and enhancing wellbeing. Review results should be interpreted with caution due to study small sample sizes, occurring during the pandemic and having inactive control or no control group, which may mean fluctuating levels of stress unrelated to interventions. The nature of the rapid review meant grey literature may have yielded more studies. This review was registered on Prospero (CRD42021262655).

IntroductionExtending fecal immunochemical tests for hemoglobin (FITs) to primary care patients with high-risk symptoms suggestive of colorectal cancer (CRC) could reduce colonoscopy waiting lists, enabling earlier treatment. Higher FIT thresholds could decrease referrals but increase missed disease compared with lower thresholds. We aimed to systematically review and synthesize test accuracy data across thresholds for use in a cost-effectiveness analysis.MethodsSearches across ten sources were conducted (December 2022). Included were diagnostic accuracy studies of HM-JACKarc, OC-Sensor, FOB Gold, QuikRead go, NS-Prime, and four Immunodiagnostik (IDK) tests in patients presenting to, or referred from, primary care with symptoms suggestive of CRC using any reference standard. Risk of bias was assessed with QUADAS-2. Syntheses of sensitivity and specificity at all reported thresholds were planned for each test to provide summary estimates at all possible thresholds within the observed range. Sensitivity analyses investigating population type and reference standard, and subgroup analyses by patient characteristics (e.g., anemia, age, sex, ethnicity) were conducted.ResultsHM-JACKarc (n=16 studies) sensitivity ranged from 95.9 percent (95 percent credible interval [95% CrI]: 92.7, 97.9) to 46.3 percent (95% CrI: 37.4, 54.9) and specificity from 65.1 percent (95% CrI: 55.6, 74.8) to 97.7 percent (95% CrI: 94.7, 99.2) (thresholds 2 and 400 μg hemoglobin/g feces [μg/g], respectively). OC-Sensor (n=11) sensitivity ranged from 94.2 percent (95% CrI: 91.2, 96.7) to 54.2 percent (95% CrI: 48.4, 60.2) and specificity from 62.7 percent (95% CrI: 47.4, 77.2) to 97.3 percent (95% CrI: 92.9, 99.3) (thresholds 4 and 200 μg/g, respectively). FOB Gold (n=3) sensitivity ranged from 91.4 percent (95% CrI: 71.6, 99.6) to 73.9 percent (95% CrI: 53.8, 91.2) and specificity from 78.1 percent (95% CrI: 70.0, 86.0) to 96.4 percent (95% CrI: 92.6, 98.9) (thresholds 2 and 150 μg/g, respectively). There were limited or no data on the other tests.ConclusionsSensitivity and specificity were synthesized for three tests only, since data for the remaining tests were extremely limited or absent. Even at the lowest threshold, none of the tests had perfect sensitivity. Future studies should further investigate comparative accuracy and the impact of patient characteristics, patient recruitment criteria, and the reference standard on estimates of diagnostic test accuracy.

AIM:Extending faecal immunochemical tests for haemoglobin (FIT) to all primary care patients with symptoms suggestive of colorectal cancer (CRC) could identify people who are likely to benefit from colonoscopy and facilitate earlier treatment. The aim of this work was to investigate the diagnostic accuracy of FIT across different analysers at different thresholds, as a single test or in duplicate (dual FIT). METHOD:This systematic review and meta-analysis searched 10 sources (December 2022). Diagnostic accuracy studies of HM-JACKarc, OC-Sensor, FOB Gold, QuikRead go, NS-Prime and four Immunodiagnostik (IDK) tests in primary care patients were included. Risk of bias was assessed (QUADAS-2). Statistical syntheses produced summary estimates of sensitivity and specificity at any chosen threshold for CRC, inflammatory bowel disease and advanced adenomas separately. Sensitivity analyses investigated reference standard and population type (high, low or all-risk). Subgroup analyses investigated patient characteristics (e.g. anaemia, age, sex, ethnicity). RESULTS:Thirty-seven studies were included. At a threshold of 10 μg/g, pooled results for sensitivity and specificity (95% credible intervals) for CRC, respectively, were: HM-JACKarc (n = 16 studies) 89.5% (84.6%-93.4%) and 82.8% (75.2%-89.6%); OC-Sensor (n = 11 studies) 89.8% (85.9%-93.3%) and 77.6% (64.3%-88.6%); FOB Gold (n = 3 studies), 87.0% (67.3%-98.3%) and 88.4% (81.7%-94.2%). There were limited or no data on the other tests, dual FIT and relating to patient characteristics. CONCLUSION:Test sensitivity at a threshold of 10 μg/g highlights a requirement for adequate safeguards in test-negative patients with ongoing symptoms. Further research is needed into the impact of patient characteristics and dual FIT.

IntroductionApproximately 42,000 new cases of colorectal cancer (CRC) are diagnosed annually in the United Kingdom with 16,800 deaths. Evidence suggests that quantitative fecal immunochemical tests (FIT) are a good predictor of CRC risk in symptomatic patients presenting to primary care. We aimed to assess the cost-effectiveness of FIT in this setting, considering capacity constraints and waiting times for subsequent colonoscopy.MethodsWe compared two diagnostic FIT strategies, at various thresholds, in the model: (i) FIT for all patients and (ii) current practice where only low-risk patients received FIT. Patients with positive FIT scores and high-risk patients in current practice received colonoscopy. Diagnostic accuracy evidence from published literature, standard UK cost sources, and other sources were used to estimate health outcomes and costs. Waiting times before colonoscopy were assumed proportional to the numbers referred, with the impact of delayed colonoscopy taken from published models. Savings per quality-adjusted life years (QALYs) lost and incremental net monetary benefit (INMB) were used. Uncertainty was evaluated.ResultsModel results suggested that, compared to current practice, FIT generated a positive INMB for the majority of thresholds assessed (GBP200 [USD254] to GBP350 [USD445] per patient at a willingness to pay of GBP20,000 [USD25,474] per QALY gained). A reduction in the number of patients sent to colonoscopy led to cost savings. However, these thresholds were associated with slight QALY losses due to a small proportion of false negative results associated with significantly delayed diagnosis, which outweighed the benefits associated with quicker times to colonoscopy for those with positive FIT results. Savings of over GBP100,000 (USD127,374) per QALY lost were generated. Conclusions were robust to the sensitivity analyses undertaken.ConclusionsWith capacity constraints explicitly represented in the economic modeling, offering FIT to all patients presenting to primary care with symptoms suggestive of CRC was cost effective when compared to current practice. However, the optimal threshold could not be robustly determined due to limited diagnostic accuracy data, parameter uncertainty, and limitations in the model structure; additional primary research could reduce uncertainty.

Background:The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data.Methods:This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task.Results:The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data.Conclusions:We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future.

An emerging risk results “… from a newly identified hazard to which a significant exposure may occur, or from an unexpected new or increased significant exposure and/or susceptibility to a known hazard”. In the field of emerging food and feed risks, expert knowledge elicitation methodologies represent important tools for identifying and addressing data gaps associated with emerging risk identification, particularly under conditions of risk uncertainty and/or ambiguity. A systematic review was conducted to identify expert knowledge elicitation methods which have been used in the context of emerging food and feed risks. The primary research questions were which existing expert knowledge elicitation methodologies have been used to study emerging food and feed risks? and what contexts or situations have been studied using expert knowledge elicitation methodologies in relation to emerging food and feed-related risks? Three databases were searched: Web of Science Core Collection, Scopus, and Google Scholar. Searches covered all studies published from 1998 onwards. A total of 59 studies were included in the review following the application of the inclusion and exclusion criteria. Given the heterogeneity of the included studies, a thematic analysis was applied to assess these papers in relation to the research questions. There was no one expert knowledge elicitation method consistently adopted for the identification of a specific type of emerging food and feed risk. Method triangulation was observed in 23 studies and was reported to improve the validity of results in 15 of these. Most published research considered emerging risks associated with societal controversy (“ambiguous risks”). Although the use of methodological triangulation appears to be helpful in relation to understanding emerging food and feed risks, future research into the development of a harmonised framework will enable the identification, processing, and evaluation of emerging food risks in a systemic way which can facilitate comparative analysis and harmonise mitigation strategies to address emerging risks and their drivers.

Background Treat to target (TTT) is a broad concept for treating patients with rheumatoid arthritis (RA). It involves setting a treatment target, usually remission or low disease activity (LDA). This is often combined with frequent patient assessment and intensive and rapidly adjusted drug treatment, sometimes based on a formal protocol. Objective To investigate the clinical effectiveness and cost-effectiveness of TTT compared with routine care. Data sources Databases including EMBASE and MEDLINE were searched from 2008 to August 2016. Review methods A systematic review of clinical effectiveness was conducted. Studies were grouped according to comparisons made: (1) TTT compared with usual care, (2) different targets and (3) different treatment protocols. Trials were subgrouped by early or established disease populations. Study heterogeneity precluded meta-analyses. Narrative synthesis was undertaken for the first two comparisons, but was not feasible for the third. A systematic review of cost-effectiveness was also undertaken. No model was constructed as a result of the heterogeneity among studies identified in the clinical effectiveness review. Instead, conclusions were drawn on the cost-effectiveness of TTT from papers relating to these studies. Results Sixteen clinical effectiveness studies were included. They differed in terms of treatment target, treatment protocol (where one existed) and patient visit frequency. For several outcomes, mixed results or evidence of no difference between TTT and conventional care was found. In early disease, two studies found that TTT resulted in favourable remission rates, although the findings of one study were not statistically significant. In established disease, two studies showed that TTT may be beneficial in terms of LDA at 6 months, although, again, in one case the finding was not statistically significant. The TICORA (TIght COntrol for RA) trial found evidence of lower remission rates for TTT in a mixed population. Two studies reported cost-effectiveness: in one, TTT dominated usual care; in the other, step-up combination treatments were shown to be cost-effective. In 5 of the 16 studies included the clinical effectiveness review, no cost-effectiveness conclusion could be reached, and in one study no conclusion could be drawn in the case of patients denoted low risk. In the remaining 10 studies, and among patients denoted high risk in one study, cost-effectiveness was inferred. In most cases TTT is likely to be cost-effective, except where biological treatment in early disease is used initially. No conclusions could be drawn for established disease. Limitations TTT refers not to a single concept, but to a range of broad approaches. Evidence reflects this. Studies exhibit substantial heterogeneity, which hinders evidence synthesis. Many included studies are at risk of bias. Future work Future studies comparing TTT with usual care must link to existing evidence. A consistent definition of remission in studies is required. There may be value in studies to establish the importance of different elements of TTT (the setting of a target, the intensive use of drug treatments and protocols pertaining to those drugs and the frequent assessment of patients). Conclusion In early RA and studies of mixed early and established RA populations, evidence suggests that TTT improves remission rates. In established disease, TTT may lead to improved rates of LDA. It remains unclear which element(s) of TTT (the target, treatment protocols or increased frequency of patient visits) drive these outcomes. Future trials comparing TTT with usual care and/or different TTT targets should use outcomes comparable with existing literature. Remission, defined in a consistent manner, should be the target of choice of future studies. Study registration This study is registered as PROSPERO CRD42015017336. Funding The National Institute for Health Research Health Technology Assessment programme.

Using digital technology to share patient-generated health data has the potential to improve the self-management of multiple long-term health conditions. Sharing these data can allow patients to receive additional support from healthcare professionals and peer communities, as well as enhance their understanding of their own health. A deeper understanding of the concerns raised by those living with long-term health conditions when considering whether to share health data via digital technology may help to facilitate effective data sharing practices in the future. The aim of this review is to identify whether trust, identity, privacy and security concerns present barriers to the successful sharing of patient-generated data using digital technology by those living with long-term health conditions. We also address the impact of stigma on concerns surrounding sharing health data with others. Searches of CINAHL, PsychInfo and Web of Knowledge were conducted in December 2019 and again in October 2020 producing 2,581 results. An iterative review process resulted in a final dataset of 23 peer-reviewed articles. A thorough analysis of the selected articles found that issues surrounding trust, identity, privacy and security clearly present barriers to the sharing of patient-generated data across multiple sharing contexts. The presence of enacted stigma also acts as a barrier to sharing across multiple settings. We found that the majority of literature focuses on clinical settings with relatively little attention being given to sharing with third parties. Finally, we suggest the need for more solution-based research to overcome the discussed barriers to sharing.

Peer support through social media has been shown to have significant potential to improve health care outcomes. Despite this, very little is understood about how to design a social media-based peer support system. We use the model of unplatformed design to structure a multi-phase design process of a WhatsApp-based peer support system, with and for participants undergoing extreme weight loss as part of a health care intervention into diabetes management. From a mixed-methods evaluation of a three-month deployment of the system and reflections upon the design process we explore the value of the model in facilitating the expression of authentic peer support, and identify how the unique characteristics of unplatformed design allowed for the creation of a peer support system that was responsive to participants’ existing everyday use of social media technologies.

Background: Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. Objectives: The objectives were to evaluate the clinical effectiveness, safety and cost-effectiveness of non-bisphosphonates {denosumab [Prolia®; Amgen Inc., Thousand Oaks, CA, USA], raloxifene [Evista®; Daiichi Sankyo Company, Ltd, Tokyo, Japan], romosozumab [Evenity®; Union Chimique Belge (UCB) S.A. (Brussels, Belgium) and Amgen Inc.] and teriparatide [Forsteo®; Eli Lilly and Company, Indianapolis, IN, USA]}, compared with each other, bisphosphonates or no treatment, for the prevention of fragility fracture. Data sources: For the clinical effectiveness review, nine electronic databases (including MEDLINE, EMBASE and the World Health Organization International Clinical Trials Registry Platform) were searched up to July 2018. Review methods: A systematic review and network meta-analysis of fracture and femoral neck bone mineral density were conducted. A review of published economic analyses was undertaken and a model previously used to evaluate bisphosphonates was adapted. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years for a simulated cohort of patients with heterogeneous characteristics. This was done for each non-bisphosphonate treatment, a strategy of no treatment, and the five bisphosphonate treatments previously evaluated. The model was populated with effectiveness evidence from the systematic review and network meta-analysis. All other parameters were estimated from published sources. An NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net monetary benefit was estimated using non-parametric regression. A probabilistic sensitivity analysis and scenario analyses were used to assess uncertainty. Results: Fifty-two randomised controlled trials of non-bisphosphonates were included in the clinical effectiveness systematic review and an additional 51 randomised controlled trials of bisphosphonates were included in the network meta-analysis. All treatments had beneficial effects compared with placebo for vertebral, non-vertebral and hip fractures, with hazard ratios varying from 0.23 to 0.94, depending on treatment and fracture type. The effects on vertebral fractures and the percentage change in bone mineral density were statistically significant for all treatments. The rate of serious adverse events varied across trials (0–33%), with most between-group differences not being statistically significant for comparisons with placebo/no active treatment, non-bisphosphonates or bisphosphonates. The incremental cost-effectiveness ratios were > £20,000 per quality-adjusted life-year for all non-bisphosphonate interventions compared with no treatment across the range of QFracture and FRAX scores expected in the population eligible for fracture risk assessment. The incremental cost-effectiveness ratio for denosumab may fall below £30,000 per quality-adjusted life-year at very high levels of risk or for high-risk patients with specific characteristics. Raloxifene was dominated by no treatment (resulted in fewer quality-adjusted life-years) in most risk categories. Limitations: The incremental cost-effectiveness ratios are uncertain for very high-risk patients. Conclusions: Non-bisphosphonates are effective in preventing fragility fractures, but the incremental cost-effectiveness ratios are generally greater than the commonly applied threshold of £20,000–30,000 per quality-adjusted life-year. Study registration: This study is registered as PROSPERO CRD42018107651. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 29. See the NIHR Journals Library website for further project information.

Identification of emerging risks in the food chain is essential if EFSA is to anticipate future needs in risk assessment, in relation to both data and methodology. The objectives and research proposed in the DEMETER project were specifically designed to support current (and future) EFSA procedures for emerging issue and risks identification by providing community resourcesto allow EFSA and EU Member State authorities to share data, knowledge and methods on emerging risks identification in a rapid and effective manner through a digital platform. To this end, an “Emerging Risk Knowledge Exchange Platform (ERKEP)” was developed as a prototype technical solution. Its design is based on a consultation on end-users needs and the analysis of existing knowledge sharing solutions. ERKEP consists of three main components: 1) A content management system (CMS) providing the end-user's “entry point” and Graphical User Interface (GUI) to ERKEP; 2) A web-based data analytics platform (DAP) for sharing and executing data analytics workflows (DAWs), based on the KNIME Server infrastructure; 3) External web-based services hosted by 3rd party service providers. Different DAWs were developed and added to the platform, these are: 1) Emerging risk identification system for the milk supply chain based on automated data retrieval; 2) NewsRadar; 3)Trending topics in news based on text mining and network analysis, and;4) Patent network analysis. Methodologies were identified to integrate social science information and data, into the emerging risk identification framework. Systematic reviews of the literature wereconducted in the areas of expert elicitation, citizen science, and behavioural science and a framework to incorporate data from Citizen Science into the EKREP platform was proposed. Finally, sustainability and maintenance of the project's outputs were conceptualized to enable use thereof beyond project DEMETER.

Today, new mothers are experiencing parenthood differently. Digital resources can provide a wealth of information, present opportunities for socialising, and even assist in tracking a baby's development. However, women are often juggling the role of motherhood with other commitments, such as work. The aim of this workshop is to understand the digital support needs and practices during parenthood from the perspective of employed mothers. We are interested in exploring the ways that women utilise the technologies which have been designed to support mothers, and specifically, the importance of work-life balance and the various roles that mothers play. There is a need to better understand and identify which technologies are being used to support working women through their motherhood journey, and ensure a healthy transition to support women's changing identities.

The Abbott FreeStyle Libre flash glucose monitoring system is a novel sensor-based, factory-calibrated device that allows individuals with diabetes to monitor their interstitial glucose levels, capture up to 8 hours of interstitial glucose data, and predict future changes in interstitial glucose by scanning a temporary implantable glucose sensor with a reader device or compatible mobile phone. The study aim was to determine whether use of a flash glucose monitoring system had an impact on quality of life and to explore why this was the case. Raw data were collected as part of a brief semi-structured interview supported by the ABCD FreeStyle Libre Follow-Up Visit Data Collection form. Data were collected pragmatically at outpatient clinic follow-up visits, and the first 40 patients to complete six months of continuous use were included in the study. Feedback on use of the device was overwhelmingly (although not unanimously) positive. A number of basic themes were identified independently by the investigators, which were then grouped into four organising themes: Contrast with capillary blood glucose monitoring; Impact on hypoglycaemia experience; Glycaemic control and complications; and Improved wellbeing and quality of life. These themes are analysed and illustrated in the article. Copyright (C) 2019 John Wiley & Sons.

[This corrects the article DOI: 10.1017/jns.2019.20.].

OBJECTIVES:The aim of this study was to estimate the effectiveness of first-line biologic disease modifying drugs(boDMARDs), and their approved biosimilars (bsDMARDs), compared with conventional (csDMARD) treatment, in terms of ACR (American College of Rheumatology) and EULAR (European League against Rheumatism) responses. METHODS:Systematic literature search, on eight databases to January 2017, sought ACR and EULAR data from randomized controlled trials (RCTs) of boDMARDs / bsDMARDs (in combination with csDMARDs, or monotherapy). Two adult populations: methotrexate (MTX)-naïve patients with severe active RA; and csDMARD-experienced patients with moderate-to-severe active RA. Network meta-analyses (NMA) were conducted using a Bayesian Markov chain Monte Carlo simulation using a random effects model with a probit link function for ordered categorical. RESULTS:Forty-six RCTs met the eligibility criteria. In the MTX-naïve severe active RA population, no biosimilar trials meeting the inclusion criteria were identified. MTX plus methylprednisolone (MP) was most likely to achieve the best ACR response. There was insufficient evidence that combination boDMARDs was superior to intensive (two or more) csDMARDs. In the csDMARD-experienced, moderate-to-severe RA population, the greatest effects for ACR responses were associated with tocilizumab (TCZ) monotherapy, and combination therapy (plus MTX) with bsDMARD etanercept (ETN) SB4, boDMARD ETN and TCZ. These treatments also had the greatest effects on EULAR responses. No clear differences were found between the boDMARDs and their bsDMARDs. CONCLUSIONS:In MTX-naïve patients, there was insufficient evidence that combination boDMARDs was superior to two or more csDMARDs. In csDMARD-experienced patients, boDMARDs and bsDMARDs were comparable and all combination boDMARDs / bsDMARDs were superior to single csDMARD.

The proliferation of digital technologies has facilitated the adoption of innovative approaches to addressing global maternal health challenges. Worldwide, HCI researchers - from both resource-constrained and resource-rich countries are actively engaged in developing novel responses to an ever-evolving maternal health landscape. However, opportunities for these researchers to interact and engage in sustained dialogue and collaboration are limited. The purpose of this Special Interest Group (SIG) is to bring these professionals together to support an active global network of maternal health researchers and facilitate collaboration across borders.

As part of its Single Technology Appraisal process, the UK National Institute for Health and Care Excellence (NICE) invited the manufacturer of ibrutinib (Janssen) to submit evidence on the clinical effectiveness and cost effectiveness of ibrutinib for the treatment of relapsed or refractory (R/R) mantle cell lymphoma (MCL). The School of Health and Related Research Technology Assessment Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence contained within the company’s submission to NICE. The clinical effectiveness evidence for ibrutinib included one randomised controlled trial comparing ibrutinib and temsirolimus and two single-arm studies. The company’s indirect comparison of ibrutinib versus rituximab plus chemotherapy (R-chemo) produced a hazard ratio (HR) for progression-free survival (PFS) of 0.28. The ERG’s random effects network meta-analysis (NMA) indicated that the treatment effect on PFS was highly uncertain (HR 0.27; 95% credible interval (CrI) 0.06–1.26). The company’s Markov model assessed the cost effectiveness of ibrutinib versus R-chemo for the treatment of R/R MCL from the perspective of the National Health Service (NHS) and Personal Social Services over a lifetime horizon. Based on a re-run of the company’s model by the ERG, the incremental cost-effectiveness ratio (ICER) for ibrutinib versus R-chemo [including the company’s original patient access scheme (PAS)] was expected to be £76,014 per quality-adjusted life-year (QALY) gained. The ERG had several concerns regarding the company’s model structure and the evidence used to inform its parameters. The ERG’s preferred analysis, which used the ERG’s NMA and the observed Kaplan–Meier curve for time to ibrutinib discontinuation and excluded long-term disutilities for R-chemo, produced ICERs of £63,340 per QALY gained for the overall R/R MCL population and of £44,711 per QALY gained for patients with one prior treatment. Following an updated PAS and consideration of evidence from a later data-cut of the RAY trial, the appraisal committee concluded that the most plausible ICER for the one prior treatment subgroup was likely to be lower than the company’s estimate of £49,848 per QALY gained. The company’s ICER for the overall R/R MCL population was higher, at £62,650 per QALY gained. The committee recommended ibrutinib as an option for treating R/R MCL in adults only if they have received only one previous line of therapy and the company provides ibrutinib with the discount agreed in the commercial access agreement with NHS England.

Online self-reported 24-h dietary recall systems promise increased feasibility of dietary assessment. Comparison against interviewer-led recalls established their convergent validity; however, reliability and criterion-validity information is lacking. The validity of energy intakes (EI) reported using Intake24, an online 24-h recall system, was assessed against concurrent measurement of total energy expenditure (TEE) using doubly labelled water in ninety-eight UK adults (40-65 years). Accuracy and precision of EI were assessed using correlation and Bland-Altman analysis. Test-retest reliability of energy and nutrient intakes was assessed using data from three further UK studies where participants (11-88 years) completed Intake24 at least four times; reliability was assessed using intra-class correlations (ICC). Compared with TEE, participants under-reported EI by 25 % (95 % limits of agreement -73 % to +68 %) in the first recall, 22 % (-61 % to +41 %) for average of first two, and 25 % (-60 % to +28 %) for first three recalls. Correlations between EI and TEE were 0·31 (first), 0·47 (first two) and 0·39 (first three recalls), respectively. ICC for a single recall was 0·35 for EI and ranged from 0·31 for Fe to 0·43 for non-milk extrinsic sugars (NMES). Considering pairs of recalls (first two v. third and fourth recalls), ICC was 0·52 for EI and ranged from 0·37 for fat to 0·63 for NMES. EI reported with Intake24 was moderately correlated with objectively measured TEE and underestimated on average to the same extent as seen with interviewer-led 24-h recalls and estimated weight food diaries. Online 24-h recall systems may offer low-cost, low-burden alternatives for collecting dietary information.

With technologies that afford much larger-scale data collection than previously imagined, new ways of processing and interpreting qualitative textual data are required. HCI researchers use a range of methods for interpreting the 'full range of human experience' from qualitative data, however, such approaches are not always scalable. Feminist geography seeks to explore how diverse and varied accounts of place can be understood and represented, whilst avoiding reductive classification systems. In this paper, we assess the extent to which unsupervised topic models can support such a research agenda. Drawing on literature from Feminist and Critical GIS, we present a case study analysis of a Volunteered Geographic Information dataset of reviews about breastfeeding in public spaces. We demonstrate that topic modelling can offer novel insights and nuanced interpretations of complex concepts such as privacy and be integrated into a critically reflexive feminist data analysis approach that captures and represents diverse experiences of place.

In both developing and developed countries, policies implemented by governments are affecting the health of already marginalized communities. Within the HCI community there are examples of implicit and explicit forms of health activism as well as sub-communities adopting an activist approach to address issues of social justice that ultimately influence the social determinants of health. This SIG aims to bring together these groups of HCI scholars to outline an agenda for health activism and research-identifying and highlighting characteristics of this burgeoning domain.