Conectar
by Vikram Arora, Alex Thabane, Jude Hynes, Adam Sutoski, Mohit Bhandari
IntroductionStroke is a leading cause of long-term disability and mortality worldwide. Survivors can experience a range of physical and emotional challenges, often leading to depression, anxiety, and a poorer quality of life. Creative arts therapies (CATs), an umbrella term encompassing music, art, dance/movement, drama, and creative writing therapies, have increasingly been explored in stroke survivor populations as interventions to improve psychological outcomes. Qualitative analysis suggests these therapies can be helpful, but the exact efficacy of CATs in stroke rehabilitation, as well as the optimal intervention types and treatment protocols, has yet to be established. This systematic review and meta-analysis plans to evaluate the effect of CATs on depression, anxiety, and quality of life among adults recovering from stroke.
MethodsThis protocol has been prospectively registered with PROSPERO (CRD420251237926). Eligible studies will include primary quantitative research involving creative arts interventions. Searches will be conducted in Medline, Embase, and PsycInfo from inception to December 2025. Two reviewers will independently screen records, extract data, and assess study quality and the certainty of the evidence using the RoB 2, ROBINS-I, and GRADE tools. Restricted maximum likelihood random-effects meta-analyses of Cohen’s d effect sizes and risk ratios will be performed to calculate pooled effect sizes for each outcome. Subgroup analyses will explore moderators such as the effect of study design, intervention type, session frequency, and patient setting.
Dissemination of resultsResults will be disseminated through a peer-reviewed publication, conference presentations, and clinical networks to inform evidence-based guidelines on the use of CATs in multidisciplinary stroke care.
The predictive value of carotid-femoral pulse wave velocity (cfPWV) for cardiovascular (CV) events in individuals with blood pressure (BP) 120–159/80–99 mm Hg, where more accurate risk stratification has the greatest clinical effect, is unknown. This study aims to determine whether cfPWV improves the prediction of CV events beyond traditional risk factors in individuals with moderate BP.
A systematic review and meta-analysis.
PubMed and EMBASE were searched through April 2023.
We included prospective, population-based cohort studies with ≥1 year follow-up that directly measured cfPWV as an index of arterial stiffness and reported incident CV disease (CVD), atherosclerotic CVD (ASCVD), coronary heart disease, stroke or all-cause mortality outcomes.
Individual participant data from 11 cohorts (n=15 987) were harmonised and analysed using two-stage random-effects meta-analysis. Incremental predictive and clinical utility analyses compared 10-year risk models with and without cfPWV.
There were 1279 first atherosclerotic CV events over a median follow-up of 9.9 years. A 1-SD increase in loge(cfPWV) was associated with a 1.21-fold (95% CI 1.08 to 1.36) increase in risk of ASCVD. Adding cfPWV to traditional risk factors improved ASCVD prediction: change in discrimination (C-index): 0.0048 (95% CI 0.0002 to 0.0094), p=0.041. In hypothetical populations of 100 000 individuals with moderate BP, cfPWV-guided treatment could reduce event rates by 2.7% and 3.1% under European and US guidelines, respectively.
Adding cfPWV to traditional CV risk factors may improve the prediction and classification of first CV events in individuals with moderate BP. Additional screening with cfPWV could enhance risk stratification for antihypertensive treatment initiations.
Due to the growing use of high-dimensional data and methodological advances in medical research, reproducibility of research is increasingly dependent on the availability of reproducible code. However, code is rarely made available and too often only partly reproducible. Here, we aim to provide practical and easily implementable recommendations for medical researchers to improve the reproducibility of their code. We reviewed current coding practices in the population-based Rotterdam Study cohort. Based on this review, we formulated the following five recommendations to improve the reproducibility of code used in data analysis: (1) make reproducibility a priority and allocate time and resources; (2) implement systematic code review by peers, as it further strengthens reproducibility. We provide a code review checklist, which serves as a practical tool to facilitate structured code review; (3) write comprehensible code that is well-structured; (4) report decisions transparently, for instance by providing the annotated workflow code for data cleaning, formatting and sample selection; and (5) focus on accessibility of code and data and share both, when possible, via an open repository to foster accessibility. Ideally, this repository should be managed by the institution and should be accessible to everyone. Based on these five recommendations, medical researchers can take actionable steps to improve the reproducibility of their research. Importantly, these recommendations are thought to provide a practical starting point for enhancing reproducibility rather than mandatory guidelines.
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