Farid Foroutan

McMaster University | McMaster · Department of Clinical Epidemiology and Biostatistics

Background: Computer-aided diagnosis (CADx) allows prediction of polyp histology during colonoscopy, which may reduce unnecessary removal of nonneoplastic polyps. However, the potential benefits and harms of CADx are still unclear. Purpose: To quantify the benefit and harm of using CADx in colonoscopy for the optical diagnosis of small (≤5-mm) r...

Introduction Induction therapy (IT) utility in heart transplantation (HT) remains contested. Commissioned by a clinical‐practice guidelines panel to evaluate the effectiveness and safety of IT in adult HT patients, we conducted this systematic review and network meta‐analysis (NMA). Methods We searched for studies from January 2000 to October 2022...

Prognostic models provide an avenue to predict the risk of individual patients and support shared-decision making. Many prognostic models are published annually, and systematic reviews provide an avenue to collate the existing evidence behind prognostic models to determine whether a model demonstrates adequate predictive performance and is ready fo...

Introduction Because adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare, rapidly progressive, debilitating, and ultimately fatal neurodegenerative disease, a rapid and accurate diagnosis is critical. This analysis examined the frequency of initial misdiagnosis of ALSP via comprehensive review of peer-reviewed...

Background The use of induction therapy (IT) agents in the early post‐heart transplant period remains controversial. The following recommendations aim to provide guidance on the use of IT agents, including Basiliximab and Thymoglobulin, as part of routine care in heart transplantation (HTx). Methods We recruited an international, multidisciplinary...

Background Early identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dy...

Background Recent reports on sex differences in long-term outcomes after surgery for acute type A aortic dissection (ATAAD) are conflicting. We aimed to aggregate updated data on long-term survival and reoperation stratified by sex. Methods A literature search was conducted using Medline, Embase, and Cochrane Central. Studies reporting sex-stratif...

Importance Modulation of intestinal microbiome by administering probiotics, prebiotics, or both may prevent morbidity and mortality in premature infants. Objective To assess the comparative effectiveness of alternative prophylactic strategies through a network meta-analysis (NMA) of randomized clinical trials. Data Sources MEDLINE, EMBASE, Scienc...

Background: Artificial intelligence computer-aided detection (CADe) of colorectal neoplasia during colonoscopy may increase adenoma detection rates (ADRs) and reduce adenoma miss rates, but it may increase overdiagnosis and overtreatment of nonneoplastic polyps. Purpose: To quantify the benefits and harms of CADe in randomized trials. Design:...

Background: Total predicted heart mass (PHM) is the recommended metric to assess donor-recipient size matching in patients undergoing heart transplantation. Separately measuring right ventricular (RV) and left ventricular (LV) PHM may improve risk prediction of 1-year graft failure. Methods: Adult heart transplant recipients from the UNOS databa...

Main statements All endoscopic procedures are invasive and carry risk. Accordingly, all endoscopists should involve the patient in the decision-making process about the most appropriate endoscopic procedure for that individual, in keeping with a patient’s right to self-determination and autonomy. Recognition of this has led to detailed guidelines o...

Background: Heart failure (HF) readmission rates are low in some jurisdictions. However, international comparisons are lacking and could serve as a foundation for identifying regional patient management strategies that could be shared to improve outcomes. Objectives: This study sought to summarize 30-day and 1-year all-cause readmission and mort...

Background context: Cervical spine surgery is rapidly increasing, and our knowledge of the natural history of Degenerative Cervical Myelopathy (DCM) is limited. Purpose: To synthesize accurate time-based estimates of meaningful neurologic decline in patients with DCM managed conservatively and to provide formulae to help communicate survivorship...

The benefit associated with the incorporation of vincristine-corticosteroid pulses in maintenance therapy for pediatric acute lymphoblastic leukemia (ALL) is unclear, particularly in the context of modern intensive therapy. This systematic review and meta-analysis examined the impact of reducing the frequency of vincristine-steroid pulses during ma...

Background Since December 2019, the world has struggled with the COVID‐19 pandemic. Even after the introduction of various vaccines, this disease still takes a considerable toll. In order to improve the optimal allocation of resources and communication of prognosis, healthcare providers and patients need an accurate understanding of factors (such a...

Reagent‐free electronic biosensors capable of analyzing disease markers directly in unprocessed body fluids will enable the development of simple & affordable devices for personalized healthcare monitoring. Here we report a powerful and versatile nucleic acid‐based reagent‐free electronic sensing system. The signal transduction is based on the kine...

Reagent‐free electronic biosensors capable of analyzing disease markers directly in unprocessed body fluids will enable the development of simple & affordable devices for personalized healthcare monitoring. Here we report a powerful and versatile nucleic acid‐based reagent‐free electronic sensing system. The signal transduction is based on the kine...

Objectives: To update previous GRADE guidance addressing inconsistency and interpreting subgroup analyses. Study design and setting: Using an iterative process, we consulted with members of the GRADE working group through multiple rounds of written feedback and discussions at GRADE working group meetings. Results: The guidance complements prev...

Aim: To evaluate the association between frailty and post-cardiac arrest survival, functional decline, and cognitive decline, among patients receiving home care METHODS: Frailty was measured using the Clinical Frailty Scale (CFS) and a valid frailty index. We used multivariable logistic regression to measure the association between frailty and pos...

Background and objective: The prognostic value of age and other non-hematological factors in predicting outcomes in older patients with newly diagnosed acute myeloid leukemia (AML) undergoing antileukemic therapy is not well understood. We performed a systematic review to determine the association between these factors and mortality and health-rel...

Background The non-causal and causal associations, possible age and sex differences between living alone and all-cause mortality among adults were unclear. We aimed to assess the association and causal relation between living alone and all-cause mortality among community-dwelling adults, addressing the certainty of evidence, possible age and sex di...

Aim To evaluate the prognosis of 30-day survival post-cardiac arrest among patients receiving home care and nursing home residents. Methods We conducted a population-level retrospective cohort study of community-dwelling adults (≥18 years) who received cardiac arrest care at a hospital in Ontario, Canada, between 2006 to 2018. We linked population...

Introduction Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a prevailing option for the management of severe early graft dysfunction (EGD). This systematic review and individual patient data (IPD) meta-analysis aims to evaluate: 1) mortality, 2) rates of major complications, 3) prognostic factors and 4) the effect of different VA-EC...

Background: Screening for latent tuberculosis infection (LTBI) in patients with hematological malignancy is recommended because of their increased risk of tuberculosis (TB). We assessed the utility of tuberculin skin test (TST) screening in patients with acute leukemia and subsequent outcomes of LTBI treatment. Methods: We retrospectively evalua...

Background Vincristine (VCR)-steroid pulses have been a component of the maintenance phase of therapy for pediatric acute lymphoblastic leukemia (ALL) since the 1970s. However, major cooperative groups differ in how these are incorporated, if at all. Two previous systematic reviews (Richards 1996, Yetgin 2010) examining this question supported the...

To determine the effectiveness and safety of amino acids in preventing the mortality and morbidity among preterm infants. We conducted a systematic review and network meta-analysis. We searched MEDLINE, EMBASE, Web of Science, CINAHL, Scopus, Cochrane, and Google Scholar, and grey literature, from databases inception to January 2021. We included ra...

Fulminant myocarditis (FM) may lead to cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Results of effectiveness studies of VA-ECMO have been contradictory. We evaluated the aggregate short-term mortality after VA-ECMO and predictive factors in patients with FM. We systematically searched in electronic databa...

Background Renal dysfunction is a common complication after heart transplantation (HT). Renal replacement therapy (RRT) after HT has been associated with increased risk of death. Long-term renal dysfunction is associated mainly to immunosuppressive therapy but is also strongly related to post-transplant renal failure. Predictors of early renal dysf...

Study Design Systematic Review Objectives To conduct a meta-analysis on the survivorship of commonly performed cervical spine procedures to develop survival function curves for (i) second surgery at any cervical level, and (ii) adjacent level surgery. Methods A systematic review of was conducted following PRISMA guidelines. Articles with cohorts...

Background: Immune thrombocytopenia (ITP) is a diagnosis of exclusion and can resemble other thrombocytopenic disorders. Objectives: To develop a clinical prediction model (CPM) for the diagnosis of ITP to aid specialists in investigating patients presenting with undifferentiated thrombocytopenia. Methods: We designed a CPM for ITP diagnosis a...

Description: Coronavirus disease 2019 convalescent plasma (CCP) has emerged as a potential treatment of COVID-19. However, meta-analysis data and recommendations are limited. The Association for the Advancement of Blood and Biotherapies (AABB) developed clinical practice guidelines for the appropriate use of CCP. Methods: These guidelines are ba...

Background Statins are competitive inhibitors of 3-hydroxy-3methylglutaryl coenzyme A reductase (HMG-CoA reductase) that catalyses HMG-CoA conversion to mevalonate, a process involved in synthesizing cholesterol in humans and ergosterol in fungi. The effect of statin use on the risk of development of invasive aspergillosis (IA) in lung transplant r...

Background: Anticoagulation requires urgent reversal in cases of life-threatening bleeding or invasive procedures. Study design and methods: Network meta-analysis for comparing the safety and efficacy of warfarin reversal strategies including plasma and prothrombin complex concentrates (PCCs). Results: Seven studies including 594 subjects usin...

Network meta-analysis (NMA) is an increasingly popular statistical method of synthesising evidence to assess the comparative benefits and harms of multiple treatments in a single analysis. Several automated software packages facilitate conducting NMA using either of two alternative approaches, Bayesian or frequentist frameworks. Researchers must ch...

Objective: To evaluate reporting of minimal important difference (MID) estimates using anchor-based methods for patient-reported outcome measures (PROMs), and the association with reporting deficiencies on their credibility. Study design and setting: Systematic survey of primary studies empirically estimating MIDs. We searched Medline, EMBASE, P...

Introduction: Predicted heart mass (PHM) was neither derived nor evaluated in an obese population. Our objective was to evaluate size mismatch using actual body weight or IBW-adjusted PHM on mortality and risk assessment. Methods: We conducted a retrospective cohort study of adult recipients with BMI ≥30 kg/m2 or recipients of donors with BMI≥30...

[This corrects the article DOI: 10.1371/journal.pone.0241955.].

Background Mortality for patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains high. This meta-analysis aims to identify factors that predict higher risk of mortality after VA-ECMO for AMI.Methods We meta-analyzed mortality after VA-ECMO for CS compl...

Extracorporeal cardiopulmonary resuscitation (eCPR) can improve survival in selected patients with cardiac arrest (CA). In this meta-analysis, we evaluated factors associated with short-term survival and favorable neurologic outcome (FNO) post-eCPR. In June 2019, we systematically searched electronic databases for studies reporting on survival and...

The impact of right ventricular (RV) dysfunction on long‐term post‐HTx outcomes remains uncertain. We assessed the impact of serial measurements of Tricuspid Annular Plane Systolic Excursion (TAPSE) on post‐HTx mortality and morbidity. This two‐center retrospective cohort study included consecutive adult HTx recipients (2000‐2017). We used multivar...

Background: Invasive fungal infections (IFI), particularly invasive aspergillosis (IA), cause significant morbidity and mortality in lung transplant (LTx) recipients. The optimum strategy and antifungal agents for prevention are unclear. Methods: We performed a comprehensive literature search, systematic review, and network meta-analysis using a...

Purpose The International Consortium on Primary Graft Dysfunction is a multicenter, prospective observational study that has collected data on over 2700 HT recipients to identify clinical risk factors for PGD in the contemporary era. The objective of this study was to determine whether BTT with LVAD is associated with PGD and, if so, to identify th...

Purpose Induction therapy provides, when the risk of allograft rejection is the highest, early intense immunosuppression. Whether to use induction therapy, and the choice of optimal regimen remains controversial. Our goal is to develop a clinical practice guideline for the use of induction therapy (IT) in the heart transplant (HT) setting. Methods...

Purpose The utility of immunosuppressive induction therapy (IT) following heart transplantation remains contested. In order to evaluate the effectiveness and safety of IT, we conducted a systematic review and network meta-analysis (NMA), evaluating outcomes at 1 year post-heart transplantation. Methods We searched bibliographic databases for studi...

Purpose Current clinical guidelines related to the identification and management of heart transplant (HT) outcomes are based on small studies or expert consensus. With a growing interest in artificial intelligence (AI) to optimize prognostication and management of patients post-HT, our scoping review aims to summarize the current state of AI in the...

Purpose Primary Graft Dysfunction (PGD) is a leading cause of death early after heart transplantation (HT). Available PGD risk scores are limited to single centres and fail to capture contemporary risk factors. The International Consortium on PGD is an innovative multicenter collaboration comprising of data from 14 centres in the United States, Can...

Introduction Early identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ...

Previous primary studies have explored the association between blood pressure (BP) and mortality in ambulatory heart failure (HF) patients reporting varying and contrasting associations. The aim is to determine the pooled BP prognostic value and explore potential reasons for between-study inconsistency. We searched Medline, Cochrane, EMBASE and CIN...

Risk models, informing optimal long-term medical management, seldom use natriuretic peptides (NP) in ascertaining the absolute risk of outcomes for HF patients. Individual studies evaluating the prognostic value of NPs in HF patients have reported varying effects, arriving at best estimates requires a systematic review. We systematically summarized...

Background Prognostic factors in lung transplantation are those variables that are associated with transplant outcomes. Knowledge of donor and recipient prognostic variables can aid in the optimal allocation of donor lungs to transplant recipients and can also inform post-operative discussions with patients about prognosis. Current research finding...

Invasive fungal infections (IFIs) remain one of the most common infectious complications after organ transplantation, and liver transplant recipients (LTRs) have the highest mortality rate. However, risk factors associated with IFIs have only been evaluated in small single-center studies. We performed a meta-analysis by conducting a comprehensive s...

This updated systematic review provides a critical appraisal of all models using universally accessible clinical and demographic variables, that have been derived and/or validated to predict the success of labour induction. Ten new models were derived in the past four years, but only one model has been externally validated in other settings. Prospe...

Alcohol use is a major risk factor for death and disease worldwide and alcohol-related harms appear to be more prevalent in rural and remote, relative to urban, communities. This Review synthesised international research on rural–urban disparities in hazardous and harmful alcohol use and risk factors for these outcomes within rural and remote commu...

Prognostic models combine several prognostic factors to provide an estimate of the likelihood (or risk) of future events in individual patients, conditional on their prognostic factor values. A fundamental part of evaluating prognostic models is undertaking studies to determine whether their predictive performance, such as calibration and discrimin...

Background : Invasive fungal infection (IFI) remains a common complication after lung transplantation, causing significant morbidity and mortality. We have attempted to quantify systematically risk factors of IFI in lung transplant recipients. Methods : Studies were retrieved from Ovid MEDLINE, Ovid Embase, Cochrane database of systematic reviews...

BACKGROUND In patients with advanced heart failure, a left ventricular assist device (LVAD) offers improved survival and quality of life. NTproBNP is commonly measured during routine follow-up in patients with a LVAD. While NTproBNP has been extensively studied in ambulatory heart failure patients, and proven a useful prognostic marker, there is sc...

Objective To evaluate the efficacy and safety of antiviral antibody therapies and blood products for the treatment of novel coronavirus disease 2019 (covid-19). Design Living systematic review and network meta-analysis, with pairwise meta-analysis for outcomes with insufficient data. Data sources WHO covid-19 database, a comprehensive multilingua...

The coronavirus 2019 (COVID-19) pandemic has disrupted health systems worldwide, including solid organ donation and transplantation programs. Guidance on how best to screen patients who are potential organ donors to minimize the risks of COVID-19 as well as how best to manage immunosuppression and reduce the risk of COVID-19 and manage infection in...

Objective To describe the characteristics of Covid-19 randomized clinical trials (RCTs) and examine the association between trial characteristics and the likelihood of finding a significant effect. Study design We conducted a systematic review to identify RCTs (up to October 21, 2020) evaluating drugs or blood products to treat or prevent Covid-19...

Objective To synthesize the current evidence examining the association between frailty and a series of post-arrest outcomes following the provision of cardiopulmonary resuscitation (CPR). Data sources We searched MEDLINE, PubMed (exclusive of MEDLINE), EMBASE, CINAHL, and Web of Science from inception to August 2020 for observational studies that...

Clinical question What are the benefits and harms of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists when added to usual care (lifestyle interventions and/or other diabetes drugs) in adults with type 2 diabetes at different risk for cardiovascular and kidney outcomes? Current practice Clinic...

Introduction: The benefit of exercise training in cardiac resynchronization therapy (CRT) recipients is not well established. We conducted a systematic review and meta-analysis to determine the effect of exercise training on clinical outcomes in CRT recipients. Methods: A comprehensive search until 2019 was conducted of MEDLINE, Epub, Embase, CINAH...

Donation after circulatory death determination (DCDD) frequently involves antemortem heparin administration to mitigate peri-arrest microvascular thrombosis. We systematically reviewed the literature to: (1) describe heparin administration practices, and (2) explore the effects on transplant outcomes. We searched MEDLINE and EMBASE for studies repo...

Objective To inform a clinical practice guideline (BMJ Rapid Recommendations) considering sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists for treatment of adults with type 2 diabetes, we summarised the available evidence regarding the performance of validated risk models on cardiovascular and kidney outcomes...

Purpose Early graft dysfunction (EGD) is a major cause of morbidity and mortality following heart transplantation (HT). Severe EGD often includes the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Studies evaluating its effectiveness are mostly single centre observations with variable outcomes. This systematic review and meta-a...

Purpose Primary Graft Dysfunction (PGD) is a leading cause of short-term mortality after heart transplantation (HT). Available registries lack data to identify PGD based on post-HT hemodynamics and mechanical circulatory support (MCS). Herein, we describe the development of a multicenter International Consortium on PGD: a registry designed to quant...

Purpose Heart transplantation (HT) improves functional capacity and extends survival. The ISHLT reports that approximately 70% of HT patients can perform their daily activities with no limitation, however, overall employment rates are less than 40% up to 5-years post-HT. Factors related to post-HT unemployment can inform interventions. We describe...

Purpose Cardiac arrest portends a poor prognosis with survival rates of 10% for out-of hospital cardiac arrest (OHCA) and 25% for in-hospital cardiac arrest (IHCA). Despite resuscitation efforts, only a small proportion of patients survive. Extracorporeal cardiopulmonary resuscitation (eCPR) has the potential to restore circulation in an attempt to...

Purpose Adult heart transplant (HTx) recipients receive steroids early post-transplant to minimize the risk of rejection and mortality. There are however no specific, evidence-based recommendations for the optimal steroid regimen (i.e. treatment dose, and duration of therapy) post-HTx. This study aims to determine if the steroid dose used post-HTx...

Purpose Predicted heart mass (PHM) was neither derived nor validated in an obese population. Our objectives were to determine survival according to size mismatch defined by actual PHM and recalculated PHM using ideal body weight (IBW) in obese recipients or recipients of obese donors, and to evaluate whether size mismatch using IBW-adjusted PHM imp...

Objective To date, long-term graft dysfunction, an important cause of death after heart transplantation, has been defined as a left ventricular ejection fraction (LVEF) of ≤40% or right atrial pressure (RAP) of ≥15 mm Hg. Empirical associations between measures of cardiac function and mortality post-transplant remain, however, unestablished. Metho...

Background To review the performance of machine learning (ML) methods compared to conventional statistical models (CSM) for predicting readmission and mortality in patients with myocardial infarction (MI). Methods Following PRISMA guidelines, we systematically reviewed the literature search using MEDLINE, EPUB, Cochrane CENTRAL, EMBASE, INSPEC, AC...

Purpose: Primary graft dysfunction (PGD) is a leading cause of early mortality after heart transplant (HTx). To identify PGD incidence and impact on mortality, and to elucidate risk factors for PGD, we systematically reviewed studies using the ISHLT 2014 Consensus Report definition and reporting the incidence of PGD in adult HTx recipients. Metho...