ABSTRACT Background Itch in systemic sclerosis (SSc) is thought to be most significant in early disease, but no longitudinal studies have examined itch course. We estimated itch presence and severity from SSc disease onset, accounting for participant age and time since onset at each assessment. Methods People with SSc from the multinational Scleroderma Patient-centred Intervention Network Cohort completed past-week itch severity assessments (0 to 10 numerical rating scale) at enrolment and longitudinally at 3-month intervals. To estimate itch probability (score > 0) and, if present, itch severity, we used two-stage mixed effects models with basis splines to address non-linearity. The primary predictor was age at each assessment, partitioned into age at non-Raynaud phenomenon symptom onset and time since onset. We estimated prevalence and severity for onset ages of 20, 30, 40, 50 and 60 years and, for each onset age, at 2 years, 3 years, 4 years, 5 years, 7 years, and 5-year intervals 10 years to 35 years post-onset. Findings We included 2173 participants with 19 733 itch assessments (mean [standard deviation] 9·1 [6·9] assessments). 1896 of 2173 (87·3%) participants were women. Mean age at enrolment was 54·7 (SD 12·7) years. 873 (40·2%) participants had diffuse cutaneous SSc. Predicted itch probability was between 35·0% (95% CI 31·8% to 38·5%) and 36·8% (95% CI 33·3% to 40·4%) at all onset age and disease duration combinations. Mean itch severity, when present, was moderate, between 4·1 (95% CI 4·1 to 4·1) and 4·4 (95% CI 4·3 to 4·4), for all age and duration combinations. Interpretation Itch prevalence and mean severity were stable across onset ages and over time within onset ages. Findings suggest that itch is common in SSc and not as closely related to disease duration as previously thought. Research is needed to elucidate itch pathophysiology and identify effective management strategies. Funding Funding for the study was provided by a Skin Investigation Network of Canada Team Development Award. Funding for the Scleroderma Patient-centred Intervention Network Cohort has been received from the Canadian Institutes of Health Research (TR3-119192; PJT-149073; PJT-148504; PJT-195879; PJT-203755); the Arthritis Society; the Lady Davis Institute for Medical Research of the Jewish General Hospital, Montréal, Québec, Canada; the Jewish General Hospital Foundation, Montréal, Québec, Canada; McGill University, Montréal, Québec, Canada Scleroderma Society of Ontario; Scleroderma Canada; Sclérodermie Québec; Scleroderma Manitoba; Scleroderma Atlantic; the Scleroderma Association of BC; Scleroderma SASK; Scleroderma Australia; Scleroderma New South Wales; Scleroderma Victoria; and the Scleroderma Foundation of California. RESEARCH IN CONTEXT Evidence before this study We searched PubMed using the terms “itch” or “pruritus” with “systemic sclerosis” or “scleroderma” on March 26, 2025, to identify previous studies that have evaluated the trajectory of itch prevalence or severity in systemic sclerosis (SSc) from the time of disease onset. We did not find any longitudinal studies. We identified 4 cross-sectional studies, and none found statistically significant associations between disease duration and itch. Three of the studies included between 56 and 126 participants. The fourth study included 959 participants and found that itch was experienced on most days in the last month based on a single dichotomous item among 46% of participants between 1 and 4·9 years since non-Raynaud phenomenon (non-RP) symptom onset and 41% for those 5 or more years since onset (not statistically significant). Added value of this study This was the first longitudinal study of itch prevalence and severity in SSc. We evaluated 2173 Scleroderma Patient-Centred Intervention Network participants from 7 countries who reported itch severity in the past week (0 to 10 numerical rating scale) at cohort enrolment and subsequently at 3-month intervals (19 733 total itch assessments). We simultaneously modelled probability of having any itch and, if present, itch severity. We accounted for both normal aging and SSc disease duration by including age of onset of non-RP symptoms and time since onset in our models. We found that itch prevalence and mean severity were stable across the course of the disease. Between 35% and 37% of participants reported itch (numerical rating scale score > 0) across all ages of onset and time since onset combinations. Mean itch severity, among participants with itch, was between 4·1 and 4·4 points, a moderate level, at all onset age and disease duration combinations. Findings were consistent for subgroups defined by participant country, sex, and diffuse versus limited cutaneous SSc. Implications of all the available evidence Itch is rarely researched in SSc, and itch assessment and management are typically not part of routine SSc care. It is commonly assumed that itch is most prominent, if present, in early disease. Our study showed that, contrary to this assumption, itch is present for many people with SSc across the course of the disease; itch prevalence and mean severity were stable across time regardless of age of SSc onset. Findings from our study underline the need for research on the pathogenesis of itch in SSc and the development and testing of treatments. Itch assessment and management should be part of routine SSc care.

BACKGROUND:Latent factor scoring may provide more precise score estimates than sum scores, but this has not been evaluated for the Hospital Anxiety and Depression Scale (HADS). We investigated whether latent factor scores could improve HADS depression screening accuracy. METHODS:We used a HADS screening accuracy individual participant data meta-analysis (IPDMA) database. We included 42 studies (7982 participants; 12 to 1143 per study) with a semi-structured interview reference standard. We randomly split the database into calibration and validation datasets. In calibration, we estimated latent scores using one-factor models (14-item HADS total scale [HADS-T], 7-item depression subscale [HADS-D]) plus HADS-T two-factor and bi-factor (general factor and two specific factors) models. We estimated cut-offs that maximized combined sensitivity and specificity for each method. In validation, we compared screening accuracy between latent variable approaches and the HADS-D sum score. The process was repeated 1000 times to estimate 95% confidence intervals for parameters. RESULTS:After removing iterations with failed models in confirmatory factor analysis (N = 304) or IPDMA (N = 31), aggregated results showed that confidence intervals for sensitivity, specificity, and combined sensitivity and specificity included 0 for all comparisons between factor scores and sum scores. Statistically significant but minimal advantages appeared in the receiver operating characteristic curve for the two-factor and bi-factor models (0.01, 95% CI [0.01, 0.02]; 0.02, 95% CI [0.01, 0.02]). Sensitivity analysis confirmed findings. CONCLUSIONS:Latent factor scoring did not meaningfully improve HADS screening accuracy compared with sum scores. Sum scores may be preferred in applied settings for their simplicity and feasibility.

Participants who continue across the full duration of longitudinal studies often differ from those lost to attrition, defined as discontinuing participation for any reason, and some participants may sporadically miss assessments. Complex participation patterns, such as in multicenter chronic disease cohorts, have not been studied. We aimed to implement an approach to identify participation subgroups and factors associated with theses. We applied our approach in the SPIN Cohort, a multicenter, longitudinal systemic sclerosis (SSc) cohort, because it is an example of an open-ended cohort with no planned end date and complex participation patterns. We used group-based trajectory modeling to identify participation subgroups and multinomial logistic regression to identify predictors of subgroup membership. Data were obtained for 2883 participants from 54 sites in 7 countries. We identified 5 participation subgroups: Ongoing Participation (29%), Immediate Attrition (29%), Mid-Term Attrition (19%), Long-Term Attrition (12%), and Ongoing Sporadic (11%) participation. Older age and sites outside the United States were associated with lower odds of belonging to all subgroups other than Ongoing Participation. Compared to Ongoing Participation, several sociodemographic variables were associated with higher odds of being in the Immediate Attrition group. Our method can be applied to other cohorts with complex participation patterns.

Introduction: Research results are often not effectively communicated to study participants or others with relevant lived experience. Effective communication of research results would help study participants understand their contribution to research and could improve trust in research and likelihood of research participation. We aim to conduct a living (i.e., regularly updated) systematic review to assess the comparative effectiveness of communication tools for disseminating research results to study participants or others with relevant lived experience. Our primary objectives are to evaluate (1) overall satisfaction with the communication of study results, defined as how well the tool met participants' expectations and needs; (2) understanding of the study results, assessed through self-reported (e.g., perceived understanding) or objective measures (e.g., multiple-choice questions about study findings); and (3) ease of use, including clarity of language and navigability of the tool. Secondary objectives, including subgroup analyses will also be undertaken. Methods: Eligible studies will be randomized controlled trials (RCTs) that compare 2 or more communication tools for disseminating research results to people who participate in health research studies or others with relevant lived experience. Eligible tools will include, but will not be limited to, plain-language or lay summaries, infographics, visual abstracts, news articles or newsletters, comics, podcasts, study-specific websites, brochures, summary sheets, videos, leaflets, cartoons, and reports. Eligible comparators will include tools not specifically designed for study participants or others with relevant lived experience (e.g., scientific article, abstract) or another eligible tool. We will search MEDLINE, EMBASE, PsycInfo, CINAHL, and Cochrane Central. Automated searches will be set for monthly updates. Two independent reviewers screen, extract, and assess risk in identified studies. Meta-analyses will be considered if ≥ 2 eligible RCTs assess the effectiveness of similar tools and report comparable outcomes in similar populations. Discussion: Findings will inform decisions on how to most effectively share research results with study participants and others with relevant lived experience. Registration: PROSPERO (CRD42024463844).

OBJECTIVE:Somatic items used in depression assessments can potentially overlap with symptoms related to physical illness, including systemic sclerosis (SSc). No studies have looked at whether somatic depression items may be influenced by diffuse versus limited SSc disease subtypes, which are associated with varying degrees of symptom presentation. The objective of this study was to evaluate differential item functioning (DIF) in items of the 8-item Patient Health Questionnaire (PHQ-8) across SSc subtypes. We also assessed the PHQ-8 for DIF across language (English and French), sex, and age. METHODS:Participants enrolled in the Scleroderma Patient-Centered Intervention Network Cohort who completed the PHQ-8 at enrollment between April 2014 and October 2020 were included. Confirmatory factor analysis (CFA) was used to evaluate the unidimensional structure of the PHQ-8, and DIF analyses based on SSc subtype, language, sex, and age were conducted using Multiple Indicators Multiple Causes models. RESULTS:In total, 2,191 participants were included. CFA with several covarying error terms supported a one-factor structure for the PHQ-8 (Tucker-Lewis Index = 0.99, Comparative Fit Index = 0.98, Root Mean Square Error of Approximation = 0.08). We did not identify statistically significant DIF based on SSc subtype. Statistically significant DIF was found in one item for language, one item for sex, and two items for age. However, the effect of DIF on overall PHQ-8 scores was negligeable in all cases. CONCLUSION:We did not find evidence that the PHQ-8 performs differently across SSc subtypes, language of administration, sex, and age groups.

Randomised controlled trials that use cohorts or health-and-care systems data, often known as routinely collected data-such as electronic health records, registries, or administrative claims-are becoming increasingly common. These trials have the potential to streamline recruitment, intervention delivery, follow-up (within trial and long term), and to lower costs. The lack of clear information governance pathways, heterogeneous data quality, delays in data recording and acquisition, and regulatory or ethical complexities undermine reproducibility and bias assessment when routinely collected data are used in trials. We introduce the SPIRIT-ROUTINE extension to the SPIRIT 2025 guideline: a checklist and explanation designed to improve the reporting of trial protocols that rely on cohorts or routinely collected data sources. Investigators, funders, ethics committees, journal editors, and peer reviewers can use the SPIRIT-ROUTINE extension to enhance completeness, transparency, and usability of such protocols to support better research, healthcare decisions, and patient outcomes.

AIMS:Assessing depression symptoms in people with a chronic illness is challenging due to possible bias from overlapping somatic symptoms associated with both depression and chronic illnesses. Previous studies, however, have found that people with a chronic illness do not report more somatic symptoms on depression measures than people without a chronic illness with similar levels of mood and cognitive symptoms. The reason for this surprising finding is unknown. Our primary objective was to evaluate differences in mean sum scores of Patient Health Questionnaire-8 (PHQ-8) somatic symptom items (sleep disturbances, fatigue, appetite changes) in people with a chronic illness when the items were administered outside the context of a depression questionnaire versus as part of the PHQ-8. Secondary objectives were to evaluate individual somatic item scores. We hypothesised that people who completed somatic items outside of a depression assessment would have significantly higher scores than those who completed items as part of a depression assessment. METHODS:We conducted a randomised controlled experiment within the Scleroderma Patient-centred Intervention Network (SPIN) Cohort, a multinational cohort of people with systemic sclerosis. SPIN Cohort participants were randomly allocated to complete the PHQ-8 with somatic items (sleep disturbances, fatigue, appetite changes) presented separately from psychological items and without any indication that they were part of a depression questionnaire (Reordered Items arm) or in standard format (Standard PHQ-8 arm). Participants were automatically randomised when they logged into the SPIN Cohort platform to complete routine research assessments. The primary outcome was the mean sum score of PHQ-8 somatic items. Secondary outcomes were the mean scores of individual somatic items. Differences were assessed using between-groups t-tests. RESULTS:In total, 851 participants were included (N = 428 in Reordered Items arm, N = 423 in Standard PHQ-8 arm). Mean (SD) PHQ-8 score was 6.0 (5.3) for all participants. We found no statistically significant differences in PHQ-8 somatic item sum scores (0.05 points; 95% confidence interval [CI]: -0.29 to 0.38) or in mean scores for item 3 (sleep disturbances; 0.04 points; 95% CI: -0.09 to 0.19), item 4 (fatigue; 0.03 points; 95% CI: -0.11 to 0.16) and item 5 (appetite changes; -0.03 points; 95% CI: -0.15 to 0.10). CONCLUSIONS:We did not find evidence that responses to PHQ-8 somatic items were influenced by whether participants were aware they were responding to items about depression. This finding supports the validity of self-reported questionnaires for depression symptom assessment in people with chronic medical conditions.

Objectives: We previously synthesized evidence on mental health changes from pre-COVID-19 to during COVID-19 among 134 cohorts published up to April 2022. Our objective was to update our synthesis to provide comprehensive evidence of changes in general mental health, depression symptoms, and anxiety symptoms from prior to the pandemic to during the pandemic. Design : Systematic review. Data Sources: MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, Open Science Framework Preprints. Eligibility criteria for selecting studies: We included studies that compared general mental health, anxiety symptoms, or depression symptoms, assessed January 1, 2020 or later, to outcomes collected January 1, 2018 to December 31, 2019 in any population. We required ≥ 90% of participants pre-COVID-19 and during COVID-19 be the same or that statistical methods were used to address missing data. We conducted restricted maximum-likelihood random-effects meta-analyses (worse COVID-19 outcomes representing positive change) for the general population and subgroups with at least two studies in an outcome domain. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies. Results: We searched up to April 3, 2023, reviewed 149,026 unique citations, and included 178 studies with non-overlapping data from 186 cohorts. Most studies reported COVID-19 outcomes collected in 2020 (158 studies, 89%) and were from high-income (135 studies, 76%) or upper-middle income (36 studies [30 from China], 20%) countries. Among general population studies, we did not find changes in anxiety symptoms (standardized mean difference [SMD change ] = 0.07, 95% CI -0.29 to 0.42), but general mental health (SMD change = 0.11, 95% CI 0.01 to 0.20) and depression symptoms (SMD change = 0.07, 95% CI 0.00 to 0.14) worsened minimally. Among women or females, general mental health (SMD change = 0.14, 95% CI 0.00 to 0.28), anxiety symptoms (SMD change = 0.18, 95% CI 0.09 to 0.27), and depression symptoms (SMD change = 0.15, 95% CI 0.05 to 0.26) all worsened by minimal amounts. Among children and adolescents, both general mental health (SMD change = 0.10, 95% CI 0.03 to 0.17), and depression symptoms (SMD change = 0.09, 95% CI 0.03 to 0.16) worsened minimally. In 24 other analyses across outcome domains among subgroups, 4 analyses suggested minimal to small symptom worsening, and 1 suggested minimal improvement, and no other subgroup had significant change for more than 1 outcome domain. There were only 5 studies from lower-middle-income countries, and none from low-income countries. Among potentially marginalized groups, we identified one eligible study on prisoners, 3 on sexual or gender minorities, but no studies on other groups, such as racial and ethnic minority groups or those experiencing housing insecurity or homelessness. Substantial heterogeneity and risk of bias were present across analyses. Conclusions: High risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. There were small negative changes for women or females in all domains. Funding: Canadian Institutes of Health Research (PJT-195921; CMS-171703; MS1-173070; GA4-177758; WI2-179944); McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund (R2-42). Registration: PROSPERO (CRD42020179703); registered on April 17, 2020.

Objective Our objective was to develop a brief Support Group Leader Self‐efficacy Scale (Brief‐SGLSS) that maintains the core content and measurement properties of the full 32‐item SGLSS among systemic sclerosis (SSc) support group leaders. Methods Development and validation involved four steps conducted by researchers and a Support Group Advisory Team of people with SSc: (1) item content assessment and prioritization, including a Delphi process; (2) item analysis and preliminary selection, including analysis of SGLSS measurement properties using Scleroderma Patient‐centered Intervention Network–Scleroderma‐Support group Leader Education (SPIN‐SSLED) trial data and a data‐driven item resampling process; (3) advisory team input to select final Brief‐SGLSS items; and (4) comparison of convergent validity and trial change data of the Brief‐SGLSS and full SGLSS. Results Items were categorized into six content themes. Two Delphi rounds resulted in one item excluded from consideration. A 6‐item Brief‐SGLSS was selected at the consensus advisory panel meeting based on the resampling process and content and statistical considerations. The Pearson correlation of the Brief‐SGLSS and full SGLSS was 0.96. The standardized mean difference between intervention (n = 74) and waitlist (n = 72) groups in the SPIN‐SSLED trial immediately post intervention was 0.93 (95% confidence interval [CI] 0.59–1.27) for the full 32‐item SGLSS and 0.93 (95% CI 0.58–1.27) for the Brief‐SGLSS. Convergent validity of the Brief‐SGLSS and full SGLSS with other measures was similar. Conclusion The 6‐item SGLSS is shorter and more feasibly implemented than the full SGLSS and maintains similar measurement properties.

Importance:A previous systematic review reported that general mental health and anxiety symptoms, but not depression or stress, worsened more for females or women than for males or men from before to during the COVID-19 pandemic based on 12 studies published up to August 2021. Objective:To update a systematic review on sex or gender differences in mental health symptom changes from before to during the COVID-19 pandemic. Data Sources:Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints were searched from December 31, 2019, to August 31, 2023. Study Selection:Eligible studies included data to calculate changes in general mental health, anxiety symptoms, depression symptoms, or stress from before to during the COVID-19 pandemic by sex or gender. Data Extraction and Synthesis:Standardized mean differences (SMDs) for continuous changes and proportions for dichotomous changes were used. Two independent reviewers extracted data and evaluated risk of bias. Data were pooled via random-effects models on March 21, 2024. Main Outcomes and Measures:The main outcome was the differences in SMD changes and proportions between women or females and men or males of mental health symptoms from before the COVID-19 pandemic to during the COVID-19 pandemic. Results:The study included 27 unique cohorts from 14 countries (n = 102-18 127; 31 155 women or females and 30 737 men or males). Differences in SMD change between men and women were minimal and not statistically significant for continuous outcomes of general mental health (0.01 [95% CI, -0.07 to 0.10 and 95% prediction interval (PI), -0.23 to 0.25]; 8 cohorts; 21 762 participants; heterogeneity [I2] = 81.4%), anxiety (0.09 [95% CI, -0.04 to 0.22 and 95% PI, -0.27 to 0.45]; 7 cohorts; 6039 participants; I2 = 68.7%), depression (0.10 [95% CI, -0.00 to 0.20 and 95% PI, -0.23 to 0.43]; 12 cohorts; 9750 participants; I2 = 65.4%), and stress (-0.08 [95% CI, -0.16 to 0.01 and 95% PI, -0.18 to 0.02]; 8 cohorts; 2994 participants; I2 = 0%). Substantial heterogeneity, high risk of bias, or both were present across analyses. No studies reported changes for gender minority groups (eg, transgender, nonbinary). Conclusion and Relevance:In this systematic review and meta-analysis of sex or gender differences in mental health changes from before to during the COVID-19 pandemic, no significant differences were found. However, findings should be interpreted cautiously and may not apply in all settings due to heterogeneity and methodological limitations of included studies.

Importance:Risk and protective factors for suicide mortality in youths remain poorly synthesized, as prior reviews have focused on all ages or nonfatal outcomes. Objective:To systematically assess factors associated with risk of suicide mortality in youths. Data Sources:MEDLINE, PsycINFO, Embase, and CINAHL from inception to March 7, 2025. Study Selection:Case-control and cohort studies of youths (aged ≤24 years) examining risk and/or protective factors associated with suicide mortality vs living general-population controls were included. Two independent reviewers screened 9497 records. Data Extraction and Synthesis:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 2 reviewers independently screened reports; 1 extracted data, verified by a second. Evidence was synthesized using vote counting and random-effects meta-analysis in April 2026. Main Outcomes and Measures:The primary outcome was suicide mortality at age 24 years or younger. Results:Ninety reports from 68 studies, mostly from high-income countries, identified distinct risk and/or protective factors; 54 reports contributed to 30 meta-analyses. The factors associated with the highest odds of suicide risk included schizophrenia (odds ratio [OR], 22.23; 95% CI, 12.05-41.03; I2 = 85.4%; 7 reports), mood disorders (OR, 11.32; 95% CI, 6.11-20.97; I2 = 64.6%; 7 reports), and self-harm (OR, 14.06; 95% CI, 5.58-35.39; I2 = 90.1%; 10 reports). Clinical indicators of health care use were also associated with higher risk, including mental health services use in preceding year (OR, 7.39; 95% CI, 6.45-8.47; I2 = 0.0%; 5 reports) and psychiatric admission (OR, 31.96; 95% CI, 13.83-73.86; I2 = 94.8%; 6 reports). At the socioecological level, several indicators were associated with higher risk, including maltreatment (OR, 4.03; 95% CI, 1.41-11.50; I2 = 67.1%; 5 reports), out-of-home placement (OR, 4.47; 95% CI, 2.15-9.28; I2 = 42.1%; 5 reports), youth justice system involvement (OR, 2.70; 95% CI, 1.94-3.75; I2 = 64.2%; 7 reports), and low educational attainment (OR, 2.95; 95% CI, 1.66-5.24; I2 = 76.0%; 5 reports). In contrast, indicators of family stability were associated with lower risk, including living with both parents (OR, 0.55; 95% CI, 0.48-0.62; I2 = 12.1%; 11 reports). Heterogeneity was substantial across analyses, while Newcastle-Ottawa ratings indicated moderate-to-high study quality. Conclusions and Relevance:In this systematic review and meta-analysis, suicide mortality in youths was associated with mental disorders, health care contact, and adversity, supporting both clinical care and population-level prevention, with future research needed in underrepresented populations.

OBJECTIVES:To develop and validate the Fatigue Coping Strategies Questionnaire (FCSQ), a self-report measure to assess coping with fatigue in systemic sclerosis (SSc). METHODS:We generated an initial pool of items by combining content from existing coping questionnaires and fatigue management programs. Items were added, removed, or modified according to Nominal Group Technique (NGT) sessions conducted with individuals with SSc. Candidate items were administered to SPIN Cohort participants. Exploratory factor analysis (EFA) was used to determine factor structure, with item reduction based on factor loadings, cross-loadings, and conceptual overlap. Measurement properties were assessed using confirmatory factor analysis, differential item functioning (DIF) by language and disease subtype, and Cronbach's alpha. RESULTS:73 items were reviewed during the 5 NGT sessions (2 English-language, 3 French language) with 19 participants. 36 items were retained and administered to 645 SPIN Cohort participants. EFA identified a 7-factor structure, resulting in a 21-item questionnaire across 7 domains: Rest and Energy Conservation (2 items), Focus on Fatigue (3), Time and Activity Management (6), Ignoring Fatigue (4), Faith-Based Coping (2), Stress Management (2), and Physical Activity (2). Internal consistency was close to or above acceptable across domains (α=0.66 to 0.83). Five items showed significant DIF by language, but none meaningfully influenced scores (r>0.99 between DIF-adjusted and unadjusted models). No DIF was observed by disease subtype. CONCLUSIONS:The FCSQ is a valid and reliable measure of fatigue-related coping in SSc. Future research should evaluate the measure's responsiveness to change and potential adaptation for other chronic conditions.

BACKGROUND:We evaluated reporting of diagnostic test accuracy (DTA) systematic reviews using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-DTA and PRISMA-DTA for abstracts. METHODS:We searched MEDLINE for recent DTA systematic reviews (September 2023-Mar 2024) to achieve a sample size of 100. Analyses evaluated adherence to PRISMA-DTA (and abstracts), on a per-item basis. Association of reporting with journal, country, impact factor (IF), index-test type, subspecialty area, use of supplemental material, PRISMA citation, word count, and PRISMA adoption was evaluated. Comparison to the baseline evaluation from 2019 was done. Protocol: https://doi.org/10.17605/OSF.IO/P25TE. RESULTS:Overall adherence (n = 100) was 78% (20.3/26.0 items, SD = 2.0) for PRISMA-DTA and 52% (5.7/11.0 items, SD = 1.6) for abstracts. Infrequently reported items (<33% of studies): eligibility criteria, definitions for data extraction, synthesis of results, and characteristics of the included studies. Infrequently reported items in abstracts were characteristics of the included studies, strengths and limitations, and funding. Reporting completeness for full text was minimally higher in studies in higher IF journals [20.7 vs 19.8 items; 95% confidence interval (95%CI) (0.09; 1.77)], as well as studies that cited PRISMA [21.1 vs 20.1 items; 95%CI (0.04; 1.95)], or used supplemental material (20.7 vs 19.2 items; 95%CI (0.63; 2.35)]. Variability in reporting was not associated with author country, journal, abstract word count limitations, PRISMA adoption, structured abstracts, study design, subspecialty, open-access status, or index test. No association with word counts was observed among full text or abstracts. Compared to the baseline evaluation, reporting was improved for full texts [71% to 78%; 95%CI (1.18; 2.26)] but not for abstracts [50% to 52%; 95%CI (-0.20; 0.60)]. CONCLUSIONS:Compared to the baseline evaluation published in 2019, we observed modest improved adherence to PRISMA-DTA and no improvement in PRISMA-DTA for abstracts reporting.

Concerns have been raised about an increase in children’s mental health symptoms over the past 30 years, including after COVID-19 lockdowns. Yet, few studies have investigated variations over generations, while considering sex and socioeconomic status. We aimed to address this gap by comparing mental health symptoms (emotional distress, impulsivity/hyperactivity/inattention, disruptive behaviours) reported by classroom teachers of 11-year-olds in three population-based, prospective, representative cohorts in Quebec, Canada. Analyses included 1665 (83

Objective To adapt and evaluate the Coping Strategies Questionnaire-Revised (CSQ-R), designed to assess pain coping, for assessing coping with fatigue in systemic sclerosis (SSc). Methods We adapted CSQ-R items for fatigue, and a panel of people with SSc verified content validity. Scleroderma Patient-centred Intervention Network Cohort participants completed the CSQ-R-Fatigue. We evaluated factor structure with confirmatory factor analysis (CFA), assessed differential item functioning (DIF) by English and French language and disease subtype, and evaluated internal consistency and test-retest reliability. Results 863 participants were included. Most were female (n=756; 88%), and 36% (n=308) had diffuse SSc. We replicated the 6-factor CSQ-R structure (Tucker-Lewis Index =0.95, Comparative Fit Index =0.97, Root Mean Square Error of Approximation =0.05). We found substantive DIF across multiple factors, however, for language and disease subtype (11 items on 6 factors for language, 10 items on 5 factors for subtype). Factor-score differences due to DIF by language and subtype were >= 0.20 standardised mean differences for 4 factors each. Test-retest reliability for factors based on intraclass correlation was between 0.68 [95% CI 0.58, 0.76] and 0.91 [95% CI 0.88, 0.93]; n=183. Conclusion The CSQ-R-Fatigue may not be appropriate to assess coping with fatigue in SSc due to possible biases related to language and disease severity. An additional concern is that the CSQ-R-Fatigue focuses on psychological coping and does not assess active coping strategies. Research is needed to identify or develop tools to evaluate coping strategies for managing fatigue in SSc.

Introduction/Objective:Visible differences from medical conditions and injuries are associated with body image concerns, particularly among females and young adults. We compared dissatisfaction with appearance and social discomfort between people with systemic sclerosis and burn injury, since the extent and implications of appearance changes are well-established in burn injury. Methods:We searched PubMed, PsycInfo, EMBASE, and CINAHL to 8 December 2024 for studies that used the Satisfaction with Appearance Scale among adults with burn injury or systemic sclerosis. We emailed study authors and requested Satisfaction with Appearance Scale Dissatisfaction with Appearance and Social Discomfort subscale means and standard deviations for subgroups defined by sex (female, male) and age (18-44 years, 45-64 years, ⩾ 65 years). For each subgroup, we conducted a random-effects meta-analysis to estimate the difference between mean scores for people with burn injury and systemic sclerosis. Results:We identified 17 eligible studies from nine unique cohorts. We obtained subgroup results from two of three eligible burn cohorts (2658 participants, 98% of total eligible) and five of six eligible systemic sclerosis cohorts (3402 participants, 99% of total eligible participants). Dissatisfaction with Appearance subscale scores were higher among people with systemic sclerosis compared to burn injury by 2.2 to 5.7 points (standardized mean difference = 0.20 to 0.53) for females and males across all age groups (p < 0.05 for males aged 18-44 and 45-64 years). For social discomfort, differences were close to zero (standardized mean difference < 0.10) for females aged 18-44 and 45-64 years. For females aged ⩾ 65 years and all male age groups, scores were higher in systemic sclerosis than burn injury (standardized mean difference = 0.22 to 0.45), although none were statistically significant. Conclusion:Dissatisfaction with appearance and social discomfort appear to be similar or greater among people with systemic sclerosis compared to people who have been hospitalized with a burn injury.