Hi All,
Please find attached my assignment 4.
Hi Kadia,
We are in agreement for almost everything! However, one disagreement was about the primary outcome for the Amanyire study. The primary outcome was the number of participants who had begun ART by 14 days after initiating care at the clinic. The Precis-2 article says that reasons to lower points include "Measuring an outcome that is important but at a time that is earlier than would be normal in usual care."
Personally, I don't find ART initiation at 14 days as relevant to patients as the outcome of viral suppression at 10 months that was used in the other study. Even more relevant to patients would be to have fewer infections or better quality of life. While it is possible that beginning ARTs within 14 days instead of 28 days or 60 days might decrease patient anxiety or improve outcomes, the link isn't guaranteed in my mind. Happy to discuss!
Kevin
Kevin, I just posted to Christine's post about how we all disagreed on the primary outcome for the Amanyire study, and it degree of patient-centeredness. However, the rationale you make in this post almost convinces me! I guess I need to think about this a bit more, and re-read the PRECIS-2 breakdown.