Ashley (Ley) Muller

Trondheim Municipality

Background The COVID-19 pandemic has become a source of fear across the world. Measuring the level or significance of fear in different populations may help identify populations and areas in need of public health and education campaigns. We were interested in diagnostic tests developed to assess or diagnose COVID-19-related fear or phobia. Methods...

Evidence-based responses to covid-19 must be based on high-quality research. Low-quality research is particularly dangerous when it feeds into stigmatizing narratives, including blaming immigrants for spreading infection.

The covid-19 pandemic has heavily burdened healthcare systems throughout the world. We performed a rapid systematic review to identify, assess and summarize research on the mental health impact of the covid-19 pandemic on HCWs (healthcare workers). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence on 11 May and in...

In Norway, Opioid Maintenance Treatment (OMT) is provided to people with opioid dependence. Understanding the experiences of patients and health personnel dealing with OMT can provide valuable information to improve quality of OMT services as well as to increase acceptability and accessibility to use OMT services. We summarized 24 qualitative stu...

Background Anabolic-androgenic steroid (AAS) use is associated with health problems and substance use. Substance use is common among inmates. This study aims to estimate lifetime and prison use of AAS and other substances, compare characteristics of groups of inmates, and describe factors associated with AAS use in a national prison population. M...

Objectives To investigate medical students’ ability to interpret evidence, as well as their self-assessed understandability, perceived usefulness and preferences for design alternatives in an interactive decision support tool, displaying GRADE evidence summaries for multiple treatment options (Making Alternative Treatment CHoices Intuitive and Trus...

Sammendrag Bakgrunn: Helsedirektoratet ønsker å vurdere muligheten for å etablere et nasjonalt overdosevarslingssystem (OVS) for å kunne varsle brukere om økt overdosefare. OVS som system forstås her som et sett med sammenhengende elementer som fungerer som en helhet, der hensikten er tidlig oppdagelse av økt overdoserisiko kombinert med rask varsl...

Background Risk of bias (RoB) assessment is an essential part of systematic reviews of treatment effect. RoB assessment requires reviewers to read and understand each eligible trial and depends on a sound understanding of trial methods and RoB tools. RoB assessment is a highly skilled task, subject to human error, and can be time-consuming and expe...

Open Access-Publication. https://doi.org/10.1080/00918369.2023.2170757 Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclu- sion, chemsex had to be the main fo...

Machine learning (ML) is a focus area for the Cluster for Reviews and Health Technology Assessments (HTV), Division for Health Services, NIPH. In autumn 2021, ML 2.0 continued the work after ML 1.0. This report describes the ML 2.0 team's work, results and experiences. ML team 2.0's key achievements include: • implementation of an intense machine l...

Since 2020 the Cluster for Reviews and Health Technology Assessments (HTV) has implemented machine learning (ML) in the production of evidence syntheses and health technology assessments. This was due to a need and desire to streamline such research processes, as the gold standard methods are resource-intensive, making current practices unsustainab...

Background Opioid Maintenance Treatment (OMT) is the gold standard for people with opioid dependence but drop- out can be high. Understanding both patients and health personnel’s experiences with the treatment can provide valuable information to improve the quality of OMT and to increase acceptability and accessibility of services. The aim of this...

Background Machine learning (ML) tools exist that can reduce or replace human activities in repetitive or complex tasks. Yet, ML is underutilized within evidence synthesis, despite the steadily growing rate of primary study publication and the need to periodically update reviews to reflect new evidence. Underutilization may be partially explained b...

Introduction: Opioid maintenance treatment (OMT) is increasingly approached as a long-term treatment. As opioid use patterns change over time, patients may be entering treatment with different goals, such as harm reduction or recovery. The evidence base is also increasing as to the importance of self-reported satisfaction with treatment. This study...

Introduction: Opioid maintenance treatment (OMT) is increasingly approached as a long-term treatment. As opioid use patterns change over time, patients may be entering treatment with different goals, such as harm reduction or recovery. The evidence base is also increasing as to the importance of self-reported satisfaction with treatment. This study...

https://eppi.ioe.ac.uk/eppi-vis/login/open?webdbid=205 In 2021, the Norwegian Institute of Public Health published an evidence and gap map (EGM) on interventions to reduce sick leave among employees. The Norwegian Labour and Welfare Administration requested an updated EGM, now with broader inclusion criteria, to gain a greater overview of availab...

The Norwegian Directorate of Health is currently considering the possibility of establishing a national warning system for overdoses. Such a system would connect data collection and risk analysis with planned methods to communicate warnings of particularly potent or dangerous drugs to users. We conducted a single health technology assessment. Our f...

In the production of a systematic review or HTA, reivew authors have categorized included studies according to user-defined PICO (or SPICE, SPIDER, etc) ontologies, categorized excluded studies according to exclusion criteria, extracted data from a small amount of studies, and critically appraised these same studies. All of this “assessment data” c...

Keynote 1: Digital transformation and automation - reports on collaboration between information specialists and IT developers. I suggest that we should think about machine learning as a disruptive innovation within the field of evidence synthesis. I will argue for why a disruptive innovation framework is helpful, what it requires of us, and then –...

During this workshop, the Norwegian Institute of Public Health’s (NIPH) machine learning (ML) implementation team within the Cluster for Reviews and Health Technology Assessments will present our implementation and evaluation activities. Participants will get the chance to dive into key activities that they think might be particularly useful to the...

Aim: We conducted a study aimed to assess the feasibility of RobotReviewer in two real world cases of systematic reviews at the Norwegian Institute of Public Health. Feasibility is operationalized to be measured by a combination of accuracy, resource use, and acceptance. We wish to present the results regarding the participants’ acceptability for t...

Background Machine learning and automation are increasingly used to make the evidence synthesis process faster and more responsive to policymakers’ needs. In systematic reviews of randomized controlled trials (RCTs), risk of bias assessment is a resource-intensive task that typically requires two trained reviewers. One function of RobotReviewer, an...

Introduction: Screening studies is one of most resource-intensive phases of a systematic review: two reviewers independently assess potentially thousands of studies, though only a small fraction of these studies are relevant. Some review software packages contain a ranking algorithm that pushes the most relevant unscreened studies to the top of a r...

Background: Machine learning (ML) tools exist that can reduce or replace human activities in repetitive or complex tasks. Yet ML is underutilized within evidence synthesis, despite the steadily growing rate of primary study publication and need to periodically update reviews to reflect new evidence. Underutilization may be partially explained by a...

Background Machine learning (ML) tools exist that can reduce or replace human activities in repetitive or complex tasks. Yet ML is underutilized within evidence synthesis, despite the steadily growing rate of primary study publication and need to periodically update reviews to reflect new evidence. Underutilization may be partially explained by a p...

Background Opioid use has increased globally in the recent decade. Although pain remains a significant problem among older adults, susceptibility to opioid-related harms highlights the importance of careful opioid therapy monitoring on individual and societal levels. We aimed to describe the trends of prescription opioid utilisation among residents...

Background: The evidence base is steadily increasing regarding the time savings of using machine learning (ML) within evidence synthesis, particularly supervised methods such as classification. Unsupervised methods such as clustering have been less explored. Yet clustering – a method to uncover groups of similar data, from a large and heterogenous...

Workshop held for Master of Science (MSc) in Global Health students at the Norwegian University of Science and Technology.

Given the concerns raised regarding the effects of prenatal exposure to methadone and buprenorphine on the developmental outcomes of the children, this study assessed mental health and use of services in a national sample of school-aged children (N = 78) born to women enrolled in opioid maintenance treatment during pregnancy, compared with a group...

Background Pregnant people can experience living far away from delivery institutions as unsafe for themselves and their foetus or new-born. This systematic review examined distance to delivery institution and risks of serious complications for the pregnant person or the foetus or new-born. Methods We searched seven databases for studies from high-...

Systematic reviews are resource-intensive. The machine learning tools being developed mostly focus on the study identification process, but tools to assist in analysis and categorization are also needed. One possibility is to use unsupervised automatic text clustering, in which each study is automatically assigned to one or more meaningful clusters...

Children and youth living in child welfare institutions are one of society’s most vulnerable groups, and on average have poorer school outcomes compared with children who are not in institutional care. The purpose of this systematic review is to investigate the effects of and experiences with educational interventions conducted outside of schools f...

Background The Living Evidence Map Project at the Norwegian Institute of Public Health (NIPH) gives an updated overview of research results and publications. As part of NIPH’s mandate to inform evidence-based infection prevention, control and treatment, a large group of experts are continously monitoring, assessing, coding and summarising new COVID...

Background: One lesson from the current COVID-19 pandemic is the need to optimize health care provision outside of traditional settings, and potentially over longer periods of time. An important strategy is remote patient monitoring (RPM), allowing patients to remain at home, while they transmit health data and receive follow-up services. Material...

Page 281 of the EACS 2021 Conference Abstract PDFs: https://onlinelibrary.wiley.com/doi/full/10.1111/hiv.13183

Background: In Norway, Opioid Maintenance Treatment (OMT) is provided to people with opioid dependence. Understanding the experiences of patients and healthcare providers dealing with OMT can provide valuable information to improve quality of OMT services as well as to increase acceptability and accessibility to use OMT services. Objectives: To st...

Purpose of review: To summarize the most recent evidence regarding nonprescribed androgen use among women and trans men. Recent findings: Fourteen heterogeneous studies met inclusion criteria. Three provided lifetime prevalence estimates among particular subgroups (from 0.5 to 8%), whereas one longitudinal study found adverse childhood experiences...

Machine learning (ML) has the potential to increase the efficiency of evidence syntheses. During 2020-2021, a team in the division for Health Services at the Norwegian Institute of Public Health, tested and documented pros and cons of using ML in various phases of the conduct of various evidence syntheses, and built employees’ competence in using M...

In 2020-2021, a team in the Cluster for Reviews and Health Technology Assessments, Division for Health Services at the Norwegian Institute of Public Health (NIPH) ran a project on machine learning (ML) related to the conduct of evidence syntheses. Part of the work involved creating a vision and proposals for expanding ML activities in 2021-2022. T...

These recommendations from the Technical Advisory Group (TAG) on the Mental Health Impacts of COVID-19 in the WHO European Region represent the work of the TAG between February and June 2021. At its second meeting on 23 March 2021, the TAG agreed to frame the recommendations across three key areas of impact: general population and communities; vuln...

Between March 2020 and May 2021, the Divsion of Reviews and Health Technology Assessments went from using no machine learning in evidence synthesis products, to at least one machine learning approach in 33-50% of all products. Here are a few early reflections on building a machine learning team from the ground up, and the scaling up processes that...

Purpose This study aimed to synthesise the available knowledge on how participant engagement in supported employment (SE) interventions is presented, defined, and conceptualised. We also aimed to develop a working definition of participant engagement in SE based on the results of our study. Methods This systematic scoping review was conducted follo...

Pregnant women can experience the distance between their homes and delivery institutions as unsafe for themselves and the foetus or new-born. The objective of this systematic review is to answer the following questions: What is the relationship of distance to delivery institution for unwanted events, risk of complications and illness for the pregna...

Sexual violence in close relationships is a serious social problem and we lack knowledge about the effect of treatment measures for perpetrators. The objective of this systematic review was to examine the effect of treatments for persons who commit sexual violence in close relationships. We searched for randomized and non-randomized controlled tria...

A critical commentary of a short report on covid-19 infection among Oslo's neighborhoods. See an English translation of this commentary here: https://ideas.repec.org/p/osf/socarx/dgq23.html

The Covid-19 pandemic and subsequent infection control measures (e.g. lockdown), unemployment, and general uncertainty impacted the world in 2020. The degree to which the pandemic has had adverse consequences for at-risk children and youth, for instance in terms of maltreatment, is uncertain. We conducted a rapid systematic mapping review, a type o...

Research based knowledge about the effect of antipsychotics largely comes from studies where patients receive medication voluntarily. In a real-life setting, there are also patients who receive antipsychotics involuntarily. The purpose of this systematic review is to summarize research on the effect of involuntary treatment with antipsychotics comp...

Our commision was to map studies examining the effect of the covid-19 pandemic and restrictions on children andyouth. Our research question was: what are the effects of the covid-19 pandemic on the wellbeing of children and youth? We conducted a rapid review, that is, a systematic reviewconducted quicker and with simpler methods than usual. We neit...

Planned machine learning: "priority screening" in EPPI Reviewer, custom classifiers, RobotReviewer to assess risk of bias.

Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is understood as a complex condition, likely triggered and sustained by an interplay of biological, psychological, and social factors. Little oversight exists of the field of causal research. This systematic scoping review explores potential causal factors of CFS/ME as researche...

Objectives To describe and explore somatic disease burdens of ageing long-term patients in opioid maintenance treatment (OMT), a unique population emerging in countries offering OMT as a long-term treatment. Methods We used data from the Norwegian Cohort of Patient in Opioid Maintenance Treatment and Other Drug Treatment Study (NorComt). 156 patie...

Children have the right to be involved in all matters affecting them. The Norwegian Directorate for Children, Youth and Family Affairs (Bufdir) commissioned the Norwegian Institute of Public Health to map out research that has examined children and young people's user involvement within the child welfare services. Methods: We performed a systematic...

We conducted a systematic review (of the format ‘systematic literature search with categorization’). In September 2020, we searched in major databases for empirical research published 2015-2020. One of four reviewers screened all retrieved records and considered relevance relative to the inclusion criteria. The main inclusion criterion was that the...

This set of synopses summarize the findings of six systematic and non-systematic reviews of qualitative and quantitative evidence. All six engage with the effect of prisons and other secure institutions on children and youth. While the methodological quality of five of the six was low, findings point in the same direction: prisons and other secure...

Fagmiljø for velferdstjenesteforskning i område for helsetjenester, Folkehelseinstituttet (FHI), fikk i august 2020 i oppdrag av Barne-, ungdoms- og familiedirektoratet (Bufdir) å gjøre et dypdykk i oversiktene som inngår i den systematiske oversikten til Berg mf. (2020). Oppdraget var å: 1. Beskrive hvor mange barn/unge har bedring i atferdsvanske...

Planned machine learning: "priority screening" in EPPI Reviewer

Background Norway is interested in implementing remote patient monitoring (RPM) within primary health services. This systematic review will first identify the types of RPM that are of interest to Norwegian health authorities, then synthesize the effects of RPM on clinical health and health service utilization outcomes among adults with chronic dise...

Background: In Norway, Opioid Maintenance Treatment (OMT) is provided to people with opioid dependence. Understanding the experiences of patients and healthcare providers dealing with OMT can provide valuable information to improve quality of OMT services as well as to increase acceptability and accessibility to use OMT services. Objectives: To st...

Children and youth in public care, i.e. child welfare institutions or foster homes, have the same rights as other children to privacy, protection, and care. Bufdir commissioned a review of the research that exists on the use of force and setting limits, and the relationship between these two, in welfare institutions and foster homes. Aims included...

Background: The covid-19 pandemic has heavily burdened, and in some cases overwhelmed, healthcare systems throughout the world. Healthcare workers are not only at heightened risk of infection, but also of adverse mental health outcomes. Identification of organizational, collegial and individual risk and resilience factors impacting the mental healt...

By providing care to patients with covid-19, health care workers are at higher risk of infection and death. Knowledge of these risks combined with long hours, fatigue, and occupational burnout, may increase the psychological toll of this pandemic on health care workers. It is important to understand the psychological impact of the covid-19 pandemic...

Background: Remarkably little is known about drug use during imprisonment, including whether it represents a continuation of pre-incarceration drug use, or whether prison is also a setting for drug use initiation. This paper aims to describe drug use among people in prison in Norway and investigate risk factors associated with in-prison drug use....

Remote patient monitoring (RPM) allows for the real-time trans-mission of health data, evaluation of this data, and appropriate follow-up. This allows providers to monitor the health status of chronically ill patients and quickly adjust treatment regimes, without requiring that patients continually visit providers’ offices. We included 11 randomize...

In the field of child welfare in Norway today, different assessment tools are used to map the individual situations of at-risk children and youth. The tools are designed to give a better understanding of the child’s or youth’s need for help, as well as support decisions about further interventions. The Norwegian Directorate for Children, Youth and...

Strength-based theories of rehabilitation emphasize the importance of opportunities for offenders to achieve “good lives” to not re-offend. The extent to which these groups feel enabled to achieve a good life may be measured through subjective, overall quality of life (QoL). The aim is to systematically review the QoL instruments used among detaine...

The Division of Health Services in the Norwegian Institute of Public Health was commissioned by the Norwegian Directorate for Children, Youth and Family Affairs to conduct a systematic literature search with categorization of empirical research about support services and recruitment of foster families, including guidance and supervision of foster h...

What kind of instruments are used to measure the quality of life of detained offenders, whether in prison or forensic treatment? What do these instruments tell us? This systematic review included 41 studies from Europe, North America, the Middle East, and Australasia, that utilized 12 validated quality of life instruments.

A recent meta-analysis identified 11 RCTs of prison-based exercise, with promising results (Sanchez-Lastra et al. 2019). But can inmates begin or maintain exercise without interventions? What about inmates struggling with substance use - who may have the most to gain from exercise? In this nationwide observational study we saw that that inmates wit...

Background: The amount and quality of QoL instruments has improved greatly in the past several decades, and these measures are increasingly integrated into chronic disease management. However, populations that are both marginalized and burdened by complex health needs may not be served by existing tools. We focus on two such populations – substanc...

This systematic review aims to compare the effects of buprenorphine with methadone on outcomes in women who have been in OMT throughout or in parts of their pregnancies, and on outcomes in fetuses and children who have been prenatally exposed to one of these OMT medications.

Staub et al. recently reported on participant involvement in the planning and evaluation of an exercise intervention for patients in heroin-assisted treatment. Very few exercise interventions among people with opioid or other substance use disorders report surveying potential participants about their actual interests and preferences beforehand, and...

The Norwegian Centre for Addiction Research (SERAF) was commissioned by the Norwegian Directorate of Health to summarize existing research on heroin-assisted treatment for opioid-dependent persons, and to develop a proposal for Norway's first pilot project of such treatment. In this document, a two-site pilot project is proposed that enrolls 150-30...

Background Quality of life (QoL) is a patient-reported outcome of increasing importance in the substance use disorder (SUD) treatment field, and impaired QoL may be an important impetus for treatment uptake. Instruments and methodologies abound, precluding comparison, as does a dearth of population norms. The QOL10 is a generic, overall QoL tool co...

Key message: When there is a suspicion of abuse, neglect or psychosocial problems in children, it is often necessary to interview children. But how to assess the credibility (truthfulness) of children’s statements is a difficult question. We aimed to assess the accuracy of using open-ended questions versus other types of questions in structured con...

The Sustainable Development Goals are powerful indicators of a global commitment to social justice. A prerequisite to enjoying fair and equitable treatment is good health, and attaining good health has been enshrined as a universal human right in the World Health Organization´s Constitution since 1946. Sustainable Development Goal 3 aims for good h...

Purpose – Measuring quality of life (QoL) under incarceration can be used to track successful rehabilitation and risk of re-offending. However, few studies have measured QoL among general incarcerated populations, and it is important to use psychometrically strong measures that pose minimal burdens to respondents and administrators. The paper aims...

Background Quality of life (QoL) is an established outcome measure of substance use disorder treatment. The WHOQOL-BREF is the gold standard tool, but its appropriateness for particularly vulnerable patient populations must be further explored. This article examines the scaling qualities of the WHOQOL-BREF in a Norwegian substance use disorder pop...

Background and aims While the Nordic countries have considerably stricter controls on opioid prescribing for chronic non-cancer pain than other countries, previous research has warned that prescription of strong opioids is increasing. This study examines consumption of and developments in dispensed prescribed opioids to individuals receiving ambula...

Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in Norwegian prisons in 2013-2014, co...

Opioid maintenance treatment (OMT) is publicly provided on a long-term basis in Norway and aims to stabilize patients and link them to necessary psychosocial treatment. Norway has an ageing cohort of OMT patients of significant magnitude, and their somatic and mental health needs are not yet fully understood. The role of benzodiazepine use as part...

Why do people with Alcohol Use Disorder [AUD] frequently relapse after completing treatment? This study examines the experience of relapse compared to near-relapse, thereby illustrating the difference between relapsing and staying abstinent when faced with a high-risk situation. Through twelve qualitative interviews and subsequent Interpretive Phen...

Symposium 3 in the Exercise and Disability conference, hosted by the Norwegian Institute of Sports Sciences, focused on the research base of using exercise in mental health and substance use disorder treatment.

Presentasjon av 156 langtids LAR-pasienter i NorComt studien, med fokus på manglende sosiale nettverk og daglige aktiviteter.

Background: Exercise is increasingly understood as an important resource for people with harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. Methods: This study analyzed self-reports from 1468 inmates in Norwegian prisons, compared them accor...

Background: Women who exercise intensively, whether competitive or recreational, devote a lot of time and energy into exercise, which requires high levels of ambition and motivation. The aim of the study is to investigate the self-understanding and bodily identity of different (competitive vs recreational) forms of exercise, and to investigate the...

Background: Women who exercise intensively, whether competitive or recreational, devote a lot of time and energy into exercise, which requires high levels of ambition and motivation. The aim of the study is to investigate the self-understanding and bodily identity of different (competitive vs recreational) forms of exercise, and to investigate the...

INTRODUCTION: Opioid maintenance treatment (OMT) is a long-term intervention aiming at stability and reduced risk for patients. This project aims to estimate the 1-year drop-out rate of from OMT and to investigate factors associated with drop-out from OMT. METHODS: 14 OMT clinics recruited 174 patients entering OMT between 2012-5 in Norway and pro...

https://www.sciencedirect.com/science/article/pii/S0376871618301650 Background: Drop-out is a core problem in opioid maintenance treatment (OMT), but patients’ reactions to and acceptance of the various OMT medications are insufficiently investigated. In Norway, there has been vocal patient resistance to the newest medication, buprenorphine-naloxo...

Substance use disorders are increasingly being recognized as chronic diseases, with important treatment implications: not only should a finite course of treatment not be expected to be curative, but outcomes of interest must be relevant to the patient and not limited to reduced substance use. While quality of life is a standard outcome measure amon...

Purpose: Opioid dependence is a chronic relapsing disorder. Despite increasing research on quality of life (QOL) in people with opioid dependence, little attention has been paid to the instruments used. This systematic review examines the suitability of QOL instruments for use in opioid-dependent populations and the instruments' quality. Methods:...

https://authors.elsevier.com/a/1VqrX1LiD2u1ak Aims: To investigate changes in social network and quality of life of a substance use disorder cohort as they progressed through treatment. Design: Multi-site, prospective, observational study of 338 adults entering substance use disorder treatment. Setting: Patients at 21 facilities across Norway cont...

Background Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participatio...

Background: Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participati...