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Liv, Per
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Publications (10 of 48) Show all publications
Mickelsson, M., Ekblom, K., Stefansson, K., Liv, P., Nyman, E., Själander, A., . . . Hultdin, J. (2024). ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography. Journal of Clinical Medicine, 13(5), Article ID 1333.
Open this publication in new window or tab >>ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography
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2024 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, no 5, article id 1333Article in journal (Refereed) Published
Abstract [en]

Background: The ABO blood group system has previously been associated with cardiovascular disease (CVD), where non-O blood group individuals have shown an increased risk. Studies assessing early atherosclerotic disease while also including RhD are few. We aimed to determine whether the ABO and RhD blood groups are associated with subclinical atherosclerosis in a healthy population.

Methods: We included 3532 participants from the VIPVIZA trial with available carotid ultrasonography results to assess subclinical disease. Information about blood groups was obtained from the SCANDAT-3 database, where 85% of VIPVIZA participants were registered.

Results: RhD− individuals aged 40 years showed increased carotid intima–media thickness (B 1.09 CI 95% 1.03; 1.14) compared to RhD+ individuals. For ABO, there were no differences in ultrasonography results when assessing the whole study population. However, 60-year-old individuals with heredity for CVD and a non-O blood group had decreased odds for carotid plaques (OR 0.54 CI 95% 0.33; 0.88).

Conclusions: RhD blood group is associated with subclinical atherosclerosis in younger individuals, indicating a role as a mediator in the atherosclerotic process. In addition, a non-O blood group was associated with decreased subclinical atherosclerosis in individuals aged 60 and with heredity (corresponding to the group with the highest atherosclerotic burden).

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
ABO blood group system, atherosclerosis, cardiovascular prevention, carotid intima–media thickness, carotid plaques, RhD factor
National Category
Cardiac and Cardiovascular Systems Hematology
Identifiers
urn:nbn:se:umu:diva-222584 (URN)10.3390/jcm13051333 (DOI)001182882700001 ()2-s2.0-85187443119 (Scopus ID)
Funder
Visare Norr, Dnr 981146Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-08Bibliographically approved
Andersson, E. M., Liv, P., Nordin, S., Näslund, U. & Lindvall, K. (2024). Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?. Social Science and Medicine, 341, Article ID 116530.
Open this publication in new window or tab >>Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?
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2024 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 341, article id 116530Article in journal (Refereed) Published
Abstract [en]

Background: Pictorial communication about subclinical atherosclerosis can improve cardiovascular disease (CVD) risk, but whether it leads to long-term shifts in self-rated CVD risk (risk perception) and beliefs about possibility to influence personal risk (efficacy beliefs) is unknown.

Purpose: To study the impact of personalized color-coded and age-related risk communication about atherosclerosis and motivational conversation, compared to traditional risk factor-based communication, on risk perception and efficacy beliefs. Also, whether risk perception increases with message severity.

Method: The effect of the pragmatic RCT Visualization of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention (VIPVIZA) was analyzed using a linear mixed effects model with risk perception and efficacy believes at 1-year and 3-year follow up as dependent variables. Participants’ (n = 3532) CVD risk perception and efficacy beliefs were assessed with visual analog scales (0–10). Fixed effects were group (intervention vs control), time point (1 year or 3 years) and interaction between group and time point. Further, the models were adjusted for corresponding baseline measurement of the dependent variable and a baseline × time point interaction. Effect of pictorial color-coded risk in the intervention group was investigated using a corresponding mixed effects model, but with pictorial risk group (message severity) as exposure instead of intervention group.

Results: After one year, the intervention group rated their CVD risk as higher (m = 0.46, 95% CI 0.32–0.59), with an effect also after 3 years (m = 0.57, 95% CI 0.43–0.70). The effect was consistent in stratified analyses by sex and education. Overall, no effect on efficacy beliefs was observed. In the intervention group, differences in CVD risk perception were found between participants with different color-coded risk messages on atherosclerosis status.

Conclusion: Personalized, color-coded and age-related risk communication about atherosclerosis had an effect on risk perception with an effect also after 3 years, whereas overall, no effect on efficacy beliefs was observed.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Atherosclerosis, Cardiovascular disease, Pictorial communication, Prevention, Response efficacy, Risk perception, Self efficacy, Vascular age
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-218586 (URN)10.1016/j.socscimed.2023.116530 (DOI)001166046000001 ()38169179 (PubMedID)2-s2.0-85181833982 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL- 643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016–01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineThe Swedish Stroke AssociationSwedish Insurance SocietyVisare NorrThe Swedish Heart and Lung Association
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-04-26Bibliographically approved
Jännebring, J., Liv, P., Knuts, M. & Idahl, A. (2024). Impact of patient-reported salpingitis on the outcome of hysterectomy and adnexal surgery: a national register-based cohort study in Sweden. Acta Obstetricia et Gynecologica Scandinavica
Open this publication in new window or tab >>Impact of patient-reported salpingitis on the outcome of hysterectomy and adnexal surgery: a national register-based cohort study in Sweden
2024 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: Salpingitis is caused by ascending microbes from the lower reproductive tract and contributes to tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The aim of this study was to analyze if the risk for complications and dissatisfaction after hysterectomy and adnexal surgery was increased in women reporting previous salpingitis.

Material and methods: This is an observational cohort study including women undergoing gynecologic surgery from 1997 to 2020, registered in the Swedish National Quality Register of Gynecologic Surgery (GynOp). Patient-reported previous salpingitis was the exposure. Complications up to 8 weeks and satisfaction at 1 year postoperatively were the outcomes. Multivariable logistic regression and ordinal regression were performed. Results were adjusted for potential confounders including age, body mass index, smoking and year of procedure as well as endometriosis and previous abdominal surgery. Multiple imputation was used to handle missing data.

Results: In this study, 61 222 women were included, of whom 5636 (9.2%) women reported a previous salpingitis. There was an increased risk for women reporting previous salpingitis in both the unadjusted and fully adjusted models to have complications within 8 weeks of surgery (adjusted odds ratio [aOR] 1.22, 95% confidence interval [CI] 1.14–1.32). The highest odds ratios were found for bowel injury (aOR 1.62, 95% CI 1.29–2.03), bladder injury (aOR 1.52, 95% CI 1.23–1.58), and postoperative pain (aOR 1.37, 95% CI 1.22–1.54). Women exposed to salpingitis were also more likely to report a lower level of satisfaction 1 year after surgery compared with unexposed women (aOR 0.87, 95% CI 0.81–0.92).

Conclusions: Self-reported salpingitis appears to be a risk factor for complications and dissatisfaction after gynecologic surgery. This implies that known previous salpingitis should be included in the risk assessment before gynecologic procedures.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
hysterectomy, intraoperative complications, patient reported outcome, patient satisfaction, pelvic inflammatory disease, postoperative complications, salpingectomy, salpingitis, salpingo-oophorectomy
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-221819 (URN)10.1111/aogs.14797 (DOI)001162569300001 ()38358021 (PubMedID)2-s2.0-85185684553 (Scopus ID)
Available from: 2024-03-12 Created: 2024-03-12 Last updated: 2024-03-12
Law, L., Lindqvist, P., Liv, P., Hellman, U., Lejon, K., Geijer, M., . . . Forsblad-d'Elia, H. (2024). Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation. Clinical Rheumatology, 43(5), 1559-1570
Open this publication in new window or tab >>Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation
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2024 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 43, no 5, p. 1559-1570Article in journal (Refereed) Published
Abstract [en]

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA.

Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations.

Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 109/L) and monocytes (0.6 ± 0.2 109/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R2 = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R2 = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP.

Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. 

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Cardiovascular disease (CVD), Carotid intima-media thickness (cIMT), Radiographic axial spondyloarthritis (r-axSpA), Ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-221778 (URN)10.1007/s10067-024-06913-8 (DOI)001176391500001 ()38443604 (PubMedID)2-s2.0-85186622797 (Scopus ID)
Funder
Swedish Research CouncilRegion VästerbottenStiftelsen Konung Gustaf V:s 80-årsfond
Available from: 2024-03-06 Created: 2024-03-06 Last updated: 2024-04-18Bibliographically approved
Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., . . . Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychology and Health
Open this publication in new window or tab >>Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
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2023 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.

Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.

Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.

Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.

Place, publisher, year, edition, pages
Routledge, 2023
Keywords
Cardiovascular disease, cardiovascular risk score, carotid artery plaque, carotid vascular ultrasound, social support
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-217344 (URN)10.1080/08870446.2023.2286296 (DOI)37994844 (PubMedID)2-s2.0-85177567916 (Scopus ID)
Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2023-12-01
Lövgren, A., Ilgunas, A., Häggman-Henrikson, B., Elias, B., Roudini, O. A., Visscher, C., . . . Liv, P. (2023). Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors. Journal of Evidence-Based Dental Practice, 23(3), Article ID 101888.
Open this publication in new window or tab >>Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors
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2023 (English)In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 23, no 3, article id 101888Article in journal (Refereed) Published
Abstract [en]

Objectives: Temporomandibular disorders (TMDs) is a collective term for pain and functional disturbances related to the jaw muscles and the temporomandibular joint. In contrast to screening for orofacial pain, knowledge is limited on the association between patient-reported outcomes and screening for joint-related functional jaw disturbances. Therefore, our aim was to evaluate the association between a screening question for functional jaw disturbances, and disease-specific outcome measures for functional jaw limitations and oral behaviors.

Methods: This study included 299 individuals (201 women; 20-69 years, median 37.0) in a general population sample from Västerbotten, Northern Sweden in 2014. A single screening question for functional jaw disturbances “Does your jaw lock or become stuck once a week or more?” was used to categorize individuals as cases or controls. Patient-reported outcomes on functional jaw disturbances were assessed with the 20-item jaw functional limitation scale (JFLS-20) and oral behaviors with the 21-item Oral Behaviors Checklist (OBC-21).

Results: The strongest predictive probability to have a positive screening outcome was functional jaw limitations related to mobility (AUCboot=0.78, 95 CI:0.71-0.86, P <.001), followed by limitations related to communication (AUCboot = 0.74, 95 CI:0.63-0.80, P <.001) and mastication (AUCboot = 0.73, 95 CI:0.66-0.81, P <.001). The frequency of oral behaviors was not significantly associated with a positive screening outcome (AUCboot = 0.65, 95 CI:0.55-0.72, P =.223).

Conclusions: Self-reported functional limitations, but not oral behaviors, are strongly associated with a single screening question for frequent functional jaw disturbances. This finding provides support for incorporating a question on jaw catching/locking once a week or more in screening instruments for TMDs.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Clinical decision-making, Dental, General practice, Screening, Temporomandibular joint disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-212835 (URN)10.1016/j.jebdp.2023.101888 (DOI)2-s2.0-85166922410 (Scopus ID)
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2023-09-28Bibliographically approved
Nyman, E., Liv, P., Wester, P., Näslund, U. & Grönlund, C. (2023). Carotid wall echogenicity at baseline associates with accelerated vascular aging in a middle-aged population. The International Journal of Cardiovascular Imaging, 39(3), 575-583
Open this publication in new window or tab >>Carotid wall echogenicity at baseline associates with accelerated vascular aging in a middle-aged population
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2023 (English)In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 39, no 3, p. 575-583Article in journal (Refereed) Published
Abstract [en]

Ultrasonic echolucent carotid intima-media (IM) complex and accelerated progression of carotid intima mediathickness (cIMT) have both separately been shown to predict future cardiovascular events. The aim of this studywas to evaluate if the echogenicity of the IM-complex is associated with the 3-year progression of cIMT. B-modeultrasound images captured at baseline and 3-year follow-up in the ‘Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention’ (VIPVIZA) trial were included (n: 3154). The bilateral mean cIMT and IM-echogenicity by greyscale median (GSM) were measured in the common carotid artery. Associations between IM-GSM at baseline and the 3-year cIMT progression were investigated using linear regression models for the whole population and stratified by sex, age and VIPVIZA study group (intervention versus control). In addition, adjusted analyses for confounding factors were performed. Unadjusted analysis showed that decreased IM-GSM at baseline was associated with increased progression of cIMT (p < 0.001). Stratified by age, the association was significant among 40 (p < 0.001) and 60 years old (p < 0.001). The association was statistically significant in both sexes and on comparison of VIPVIZA study subgroups. Adjustments for confounding factors did not alter the estimated relationship between IM-GSM and cIMT progression. Echolucent carotid intima media at baseline associates with increased 3-year cIMT progression among an asymptomatic, middle-aged population. Echogenicity of the intima media may identify individuals at risk for accelerated vascular aging.

Place, publisher, year, edition, pages
Springer Science+Business Media B.V., 2023
Keywords
Asymptomatic, Atherosclerosis, Carotid intima media, Echogenicity, Ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-204476 (URN)10.1007/s10554-022-02760-3 (DOI)000919023200002 ()36680684 (PubMedID)2-s2.0-85146659539 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016−01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineVisare Norr
Available from: 2023-02-17 Created: 2023-02-17 Last updated: 2023-09-05Bibliographically approved
Salvador, D., Liv, P., Norberg, M., Pahud de Mortanges, A., Saner, H., Glisic, M., . . . Näslund, U. (2023). Changes in fasting plasma glucose and subclinical atherosclerosis: a cohort study from VIPVIZA trial. Atherosclerosis, Article ID 117326.
Open this publication in new window or tab >>Changes in fasting plasma glucose and subclinical atherosclerosis: a cohort study from VIPVIZA trial
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2023 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, article id 117326Article in journal (Refereed) In press
Abstract [en]

Background and aims: Studies on the influence of fasting plasma glucose (FPG) on the development of carotid plaque (CP) and intima media thickness (CIMT) mainly focused on single FPG measures. We investigated whether changes in FPG (ΔFPG) are associated with incident CP and CIMT change (ΔCIMT) over time.

Methods: Analyses were based on information from 1896 participants from the VIPVIZA trial (Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention), with baseline and 3-year follow-up data on FPG, ultrasonographic CP (none or ≥1 lesion/s) and CIMT assessments. We studied the association between baseline FPG (prior to intervention) or 3-year ΔFPG (mmol/L) and incident CP (logistic regression) or ΔCIMT (linear regression). Analyses were adjusted for multiple potential confounders.

Results: 1896 and 873 individuals, respectively, were included in the analysis on incident CP and ΔCIMT. Participants were 60 years old at baseline and 61% and 54% were females, in the CP and CIMT analyses, respectively. Every mmol/L increase in FPG was associated with an increased odds of incident CP (odds ratio: 1.42, 95% confidence interval [CI]: 1.17, 1.73), but there was no association with ΔCIMT (mean difference: 0.002 mm, 95% CI: −0.003, 0.008) after 3 years. Baseline FPG was not associated with incident CP nor ΔCIMT progression.

Conclusions: In middle-aged individuals with low to moderate risk for cardiovascular diseases, 3-year ΔFPG was positively associated with the risk of incident CP, but not with ΔCIMT. Single measures of FPG may not be sufficient in estimating cardiovascular risk among individuals with low to moderate risk.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Carotid intima media thickness, Carotid plaque, Fasting plasma glucose, Prevention, Subclinical atherosclerosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-216637 (URN)10.1016/j.atherosclerosis.2023.117326 (DOI)37932189 (PubMedID)2-s2.0-85175522942 (Scopus ID)
Funder
EU, Horizon 2020, 801076
Available from: 2023-11-16 Created: 2023-11-16 Last updated: 2024-04-26
Dahlgren, G., Liv, P., Öhberg, F., Slunga-Järvholm, L., Forsman, M. & Rehn, B. (2023). Correlations between Ratings and Technical Measurements in Hand-Intensive Work. Bioengineering, 10(7), Article ID 867.
Open this publication in new window or tab >>Correlations between Ratings and Technical Measurements in Hand-Intensive Work
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2023 (English)In: Bioengineering, E-ISSN 2306-5354, Vol. 10, no 7, article id 867Article in journal (Refereed) Published
Abstract [en]

An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall’s tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% −0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
electromyography, ergonomics, exposure, hand, hand intensity, humans, inertial measurement units, musculoskeletal disorders, occupational health, psychophysics, rating, risk, upper extremity, wrist
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-212749 (URN)10.3390/bioengineering10070867 (DOI)001034881300001 ()37508893 (PubMedID)2-s2.0-85166303077 (Scopus ID)
Funder
AFA Insurance, 210031Umeå University
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2023-08-11Bibliographically approved
Idahl, A., Liv, P., Darelius, A., Collins, E., Sundfeldt, K., Pålsson, M. & Strandell, A. (2023). HOPPSA update: changes in the study protocol of Hysterectomy and OPPortunistic SAlpingectomy, a registry-based randomized controlled trial. Trials, 24(1), Article ID 222.
Open this publication in new window or tab >>HOPPSA update: changes in the study protocol of Hysterectomy and OPPortunistic SAlpingectomy, a registry-based randomized controlled trial
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2023 (English)In: Trials, E-ISSN 1745-6215, Vol. 24, no 1, article id 222Article in journal (Refereed) Published
Abstract [en]

Background: The HOPPSA trial is a multi-center national registry-based randomized controlled trial to test the safety and effectiveness of performing opportunistic salpingectomy at hysterectomy to reduce the risk of epithelial ovarian cancer (EOC). The study protocol was first published in January 2019 and is available at https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-3083-8. Here, we report amendments made to the study protocol since commencement of the trial.

Changes in methods and analysis: The primary outcomes analyses have been changed. (1) Complications will be analyzed using binomial generalized estimating equation (GEE) with log link function, while the unadjusted analyses according to Miettinen and Nurminen will be performed as a sensitivity analysis. (2) Absolute change in Menopause Rating Scale (MRS) will primarily be analyzed using a mixed effects model, adjusted for baseline MRS and center as a random effect. (3) Time to EOC will be analyzed using the mixed effects Cox regression model with center as random effect, while the unadjusted log-rank test will be performed as a sensitivity analysis. The primary outcome Complications will be based solely on the specific assessment in the GynOp quality registry. The Clavien-Dindo classification will be evaluated as a secondary outcome. Furthermore, MRS is also measured three years postoperatively to better pinpoint the onset of menopausal symptoms.

Discussion: The changes to the protocol mainly concern the analyses of data. No changes to recruitment, randomization, intervention, or follow-up of primary outcomes have been made. An interim analysis during 2021 concluded that the study should continue until the target sample size is reached.

Trial registration: ClinicalTrials.gov, NCT03045965. Registered 8 February 2017.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Complications, HOPPSA, Hysterectomy, Menopausal symptoms, Opportunistic salpingectomy, Ovarian cancer
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-206351 (URN)10.1186/s13063-023-07244-w (DOI)000959463600002 ()36959664 (PubMedID)2-s2.0-85150909736 (Scopus ID)
Funder
Swedish Cancer Society, CAN 2017/464Swedish Cancer Society, CAN 21 1408 PjJane and Dan Olsson Foundation, 2016–49Cancerforskningsfonden i Norrland, AMP 17–859Cancerforskningsfonden i Norrland, LP 17–2169Cancerforskningsfonden i Norrland, LP 22–2314
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2024-01-17Bibliographically approved
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