Morten Wang Fagerland

• Salte, Odd Bjørn; Olbers, Torsten; Risstad, Hilde; Fagerland, Morten; Søvik, Torgeir Thorson & Høgestøl, Ingvild Kristine [Show all 9 contributors for this article] (2024). Ten-Year Outcomes Following Roux-en-Y Gastric Bypass vs Duodenal Switch for High Body Mass Index: A Randomized Clinical Trial. JAMA Network Open. ISSN 2574-3805. doi: 10.1001/jamanetworkopen.2024.14340.
• Rolfsen, Mads Peder; Gammelsrud, Karianne Wiger; Espeland, Ansgar; Bråten, Lars Christian Haugli; Mjønes, Sverre Bugge & Austevoll, Ivar Magne [Show all 15 contributors for this article] (2024). Bacterial growth in patients with low back pain and Modic changes: protocol of a multicentre, case–control biopsy study. BMJ Open. ISSN 2044-6055. doi: 10.1136/bmjopen-2023-082244.
• Rolfsen, Mads Peder; Gammelsrud, Karianne Wiger; Espeland, Ansgar; Bråten, Lars Christian Haugli; Mjønes, Sverre Bugge & Austevoll, Ivar Magne [Show all 15 contributors for this article] (2024). Bacterial growth in patients with low back pain and Modic changes: protocol of a multicentre, case–control biopsy study. BMJ Open. ISSN 2044-6055. 14(5). doi: 10.1136/bmjopen-2023-082244.
• Bache-Mathiesen, Lena Kristin; Bahr, Roald; Sattler, Tine; Fagerland, Morten Wang; Whiteley, Rod & Skazalski, Christopher M. (2024). Causal inference did not detect any effect of jump load on knee complaints in elite men's volleyball. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 34(5). doi: 10.1111/sms.14635.
• Pivoriunas, Jonas; Vethe, Nils Tore; Husebye, Einar; Fagerland, Morten; Bergan, Stein & Kristiansen, Oscar [Show all 8 contributors for this article] (2024). Validation of a novel direct method to determine reduced adherence to atorvastatin therapy. European Heart Journal (EHJ) - Cardiovascular Pharmacotherapy. ISSN 2055-6837. doi: 10.1093/ehjcvp/pvae001. Show summary

  Aims Objective methods to determine statin adherence are requested to improve lipid management. We have recently established a method to detect reduced adherence to atorvastatin therapy with cut‐off values based on the sum of atorvastatin and its major metabolites in blood. We aimed to validate this method in patients with and without cardiovascular disease, and optimize previous cut-off values. Methods and results The pharmacokinetic study included 60 participants treated with atorvastatin 20 mg (N=20), 40 mg (N=20), and 80 mg (N=20). Atorvastatin was then stopped and blood samples collected from day zero to day four. Quantification of the parent drug and its metabolites in blood plasma was performed with a liquid chromatography-tandem mass spectrometry assay. The cut-off values for reduced adherence were validated and optimized by calculating diagnostic sensitivity and specificity. Our candidate cut-off value of dose-normalized six-component sum of atorvastatin plus metabolites <0.10 nM/mg provided a sensitivity of 97% and a specificity of 93% for detecting ≥2 omitted doses. An optimized cut-off <0.062 nM/mg provided a sensitivity of 90% and a specificity of 100%. An alternative simplified two-component metabolite sum with cut-off value <0.05 nM/mg provided a sensitivity of 98% and a specificity of 76%. An optimized cut-off <0.02 nM/mg provided a sensitivity of 97% and a specificity of 98%. Conclusion This validation study confirms that our direct method discriminates reduced adherence from adherence to atorvastatin therapy with high diagnostic accuracy. The method may improve lipid management in clinical practice and serve as a useful tool in future studies.

• Kristensen, Anna Meta Dyrvig; Munkhaugen, John; Halvorsen, Sigrun; Olsen, Michael Hecht; Bakken, Arnhild & Sehested, Thomas Steen Gyldenstierne [Show all 12 contributors for this article] (2023). The Danish-Norwegian randomized trial on beta-blocker therapy after myocardial infarction: Design, rationale, and baseline characteristics. European Heart Journal (EHJ) - Cardiovascular Pharmacotherapy. ISSN 2055-6837. 10(3), p. 175–183. doi: 10.1093/ehjcvp/pvad093.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Dalen-Lorentsen, Torstein; Tabben, Montassar; Chamari, Karim & Clarsen, Benjamin Matthew [Show all 7 contributors for this article] (2023). A new statistical approach to training load and injury risk: separating the acute from the chronic load. Biology of Sport. ISSN 0860-021X. 41(1), p. 119–134. doi: 10.5114/biolsport.2024.127388. Full text in Research Archive Show summary

  The relationship between recent (acute) training load relative to long-term (chronic) training load may be associated with sports injury risk. We explored the potential for modelling acute and chronic loads separately to address current statistical methodology limitations. We also determined whether there was any evidence of an interaction in the association between acute and chronic training loads and injury risk in football. A men’s Qatar Stars League football cohort (1 465 players, 1 977 injuries), where training load was defined as the number of minutes of activity, and a Norwegian elite U-19 football cohort (81 players, 60 injuries), where training load was defined as the session rating of perceived exertion (sRPE). Mixed logistic regression was run with training load on the current day (acute load) and cumulative past training load estimated by distributed lag non-linear models (chronic load) as independent variables. Injury was the outcome. An interaction between acute and chronic training load was modelled. In both football populations, we observed that the risk of injury on the current day for different values of acute training load was highest for players with low chronic load, followed by high and then medium chronic load. The slopes varied substantially between different levels of chronic training load, indicating an interaction. Modelling acute and chronic loads separately in regression models is a suitable statistical approach for analysing the association between relative training load and injury risk in injury prevention research. Sports scientists should also consider the potential for interactions between acute and chronic load.

• Ofstad, Anne Pernille; Brunborg, Cathrine; Johansen, Odd Erik; Mørkedal, Bjørn; Fagerland, Morten & Laugsand, Lars Erik [Show all 8 contributors for this article] (2023). Development of a tool to predict the risk of incident heart failure in a general population: the HUNT for HF risk score. ESC Heart Failure. ISSN 2055-5822. 10(5), p. 2807–2815. doi: 10.1002/ehf2.14390. Full text in Research Archive Show summary

  Aims Currently, no incident heart failure (HF) risk score that is in regular use in a general population is available. We aimed to develop this and compare with existing HF risk scores. Methods and results Participants in the third wave (2006–08) of the population-based Trøndelag Health Study 3 (HUNT3) were included if they reported no previous HF. Any hospital diagnoses captured during follow-up (until the end of 2018) of HF, cardiomyopathy, or hypertensive heart disease were assessed by an experienced cardiologist. Valid HF events were defined as symptoms/signs of HF and objective evidence of structural/functional abnormality of the heart at rest. The model was compared with slightly modified HF risk scores (the Health Aging and Body Composition HF risk score, the Framingham HF risk score, the Pooled Cohort equations to Prevent HF risk score, and NORRISK 2). Among 36 511 participants (mean ± SD age of 57.9 ± 13.3 years, 55.4% female), with a mean follow-up of 10.2 ± 1.3 years, 1366 developed HF (incidence rate of 3.66 per 1000 participant years). Out of the 38 relevant clinical variables assessed, we identified 12 (atrial fibrillation being the strongest) that independently predicted an HF event. The final model demonstrated good discrimination (C statistics = 0.904) and calibration, was stable in internal validation, and performed well compared with existing risk scores. The model identified that, at enrolment, 31 391 (86%), 2386 (7%), 1246 (3%), and 1488 (4%) had low, low-intermediate, high-intermediate, and high 10-year HF risk, respectively. Conclusions Twelve clinical variables independently predicted 10-year HF risk. The model may serve well as the foundation of a practical, online risk score for HF in general practice.

• Lundstam, Karolina; Pretorius, Mikkel; Bollerslev, Jens; Godang, Kristin; Fagerland, Morten & Mollerup, Charlotte [Show all 15 contributors for this article] (2023). Positive Effect of Parathyroidectomy Compared to Observation on BMD in a Randomized Controlled Trial of Mild Primary Hyperparathyroidism. Journal of Bone and Mineral Research. ISSN 0884-0431. 38(3), p. 372–380. doi: 10.1002/jbmr.4763. Full text in Research Archive
• Moseid, Nils Fredrik Holm; Lemyre, Nicolas; Roberts, Glyn; Fagerland, Morten; Moseid, Christine Holm & Bahr, Roald (2023). Associations between health problems and athlete burnout: a cohort study in 210 adolescent elite athletes. BMJ Open sport & exercise medicine. ISSN 2055-7647. 9(1), p. 1–11. doi: 10.1136/bmjsem-2022-001514. Full text in Research Archive Show summary

  Objectives: We studied associations between the burden of health problems and athlete burnout in a population of athletes from Norwegian Sport Academy High Schools. Methods: This is a mixed prospective/retrospective cohort study. We included 210 athletes, 135 boys and 75 girls, from endurance, technical and team sports. We used the Oslo Sports Trauma Centres Questionnaire for Health Problems to collect 124 weeks of health data. During the first 26 weeks, athletes reported the health data prospectively using a smartphone app. For the following 98 weeks, we collected health data by interviewing athletes at the end of their third year in Sport Academy High School. At the time of the interview, the athletes also completed a web-based questionnaire, including the Athlete Burnout Questionnaire and covering social relations in sports and school, coach relations and living conditions. Results: A greater burden of health problems was associated with a higher score for athlete burnout (B: 0.16, 95% CI 0.09 to 0.22, p<0.001). In a multivariable model, this was true for both illnesses (B: 0.21, 95% CI 0.10 to 0.32, p<0.001), acute injuries (B: 0.16, 95% CI 0.04 to 0.27, p=0.007) and overuse injuries (B: 0.10, 95% CI 0.002 to 0.18, p=0.011). This was also true in gender and sports category subgroups. The coach having a high influence on training week was associated with a lower score for athlete burnout. Conclusion: A greater burden of health problems was associated with greater symptoms of athlete burnout in athletes attending Sport Academy High Schools.

• Nguyen, Thao; Fagerland, Morten; Hollan, Ivana; Whist, Jon Elling; Feinberg, Mark W. & Agewall, Stefan (2023). High-sensitivity cardiac troponin T is associated with disease activity in patients with inflammatory arthritis. PLOS ONE. ISSN 1932-6203. 18:e0281155.(2), p. 1–10. doi: 10.1371/journal.pone.0281155. Full text in Research Archive Show summary

  Objective: To investigate whether high-sensitivity cardiac troponin T (hsTnT) correlates to markers of disease activity in inflammatory arthritis (IA), and whether antirheumatic treatment influences hsTnT levels. Methods: We assessed 115 patients with active IA (64 rheumatoid arthritis (RA), 31 psoriatic arthritis and 20 ankylosing spondylitis) before and after using methotrexate (MTX) alone or tumor necrosis factor inhibitor (TNFi) with or without MTX co-medication (TNFi±MTX). All patients starting with TNFi had been previously unsuccessfully treated with MTX monotherapy. HsTnT (measured in serum by electro-chemiluminescence immunoassay (Roche Elecsys® Troponin T- high-sensitivity)), and other clinical and laboratory parameters were evaluated at baseline, and after 6 weeks and 6 months of treatment. Results: Of markers of disease activity, baseline levels of hsTnT positively correlated with Physicians' Global Assessment Score of disease activity in the total patient cohort (p = 0.039). In RA group, hsTnT positively correlated with swollen joints, Disease Activity Score for 28 joints with ESR and serum tumor necrosis factor levels (p = 0.025, p = 0.008, p = 0.01, respectively). Median hsTnT at baseline was 5.0 ng/L, and did not change significantly at 6-week visit (6.0 ng/L, p = 0.37) and 6-month visit (6.0 ng/L, p = 0.18) with either antirheumatic therapy. Conclusions: HsTnT levels were associated with inflammatory markers for IA disease activity. However, while inflammatory markers significantly improved after antirheumatic treatment, hsTnT did not change during the 6-month follow-up period. Copyright: © 2023 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

• Leblanc, Marissa Erin; Rueegg, Corina Silvia; Bekiroğlu, Nural; Esterhuizen, Tonya M.; Fagerland, Morten Wang & Falk, Ragnhild Sørum [Show all 20 contributors for this article] (2022). Statistical advising: Professional development opportunities for the biostatistician. Statistics in Medicine. ISSN 0277-6715. 41(5). doi: 10.1002/sim.9290. Full text in Research Archive
• Hokstad, Ingrid; Greco, Daniela; Deyab, Gia; Fagerland, Morten; Agewall, Stefan & Hjeltnes, Gunnbjørg [Show all 10 contributors for this article] (2022). Effects of Antirheumatic Treatment on Cell Cholesterol Efflux and Loading Capacity of Serum Lipoproteins in Spondylarthropathies. Journal of Clinical Medicine. ISSN 2077-0383. 11(24). doi: 10.3390/jcm11247330. Full text in Research Archive Show summary

  Spondyloarthropathies (SpA) are associated with increased cardiovascular risk. Among possible mechanisms is the dysfunction of serum lipoproteins in regulating cell cholesterol homeostasis. Cholesterol efflux capacity (CEC)—the atheroprotective ability of HDL (high density lipoproteins) to accept cholesterol from macrophages—might predict cardiovascular disease independently of HDL-cholesterol levels. We aimed at evaluating modifications of CEC and of the atherogenic cholesterol loading capacity (CLC) of serum lipoproteins in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) following anti-rheumatic treatment. A total of 62 SpA patients (37 PsA and 25 AS) were evaluated before and after treatment with tumor necrosis factor inhibitor and/or methotrexate. CEC and CLC were measured by radioisotopic and fluorometric techniques, respectively. Endothelial function was assessed by finger plethysmography (Endopat). In the whole SpA group, total and HDL-cholesterol increased after treatment, while lipoprotein(a) decreased and CLC was unchanged. Treatment was associated with increased Scavenger Receptor class B type I (SR-BI)-mediated CEC in the AS group. SR-BI- and ABCG1-mediated CEC were negatively associated with inflammatory parameters and positively related to coffee consumption. SR-BI CEC and CLC were positively and negatively associated with endothelial function, respectively. Our pilot study suggests that anti-rheumatic treatment is associated with favorable modulation of lipoprotein quality and function in SpA, particularly in AS, in spite of the induced increase in total cholesterol levels. If confirmed in a larger population, this might represent an atheroprotective benefit beyond what is reflected by conventional serum lipid profile. Keywords: spondyloarthropathies; psoriatic arthritis; anchylosing spondylitis; psoriatic arthritis; anti-rheumatic treatment; lipoproteins; high density lipoprotein; low density lipoprotein; cell cholesterol efflux; macrophages

• Brunvoll, Sonja Hjellegjerde; Nygaard, Anders Benteson; Fagerland, Morten; Holland, Petter; Ellingjord-Dale, Merete & Dahl, John Arne [Show all 7 contributors for this article] (2022). Post-acute symptoms 3-15 months after COVID-19 among unvaccinated and vaccinated individuals with a breakthrough infection. International Journal of Infectious Diseases. ISSN 1201-9712. 126, p. 10–13. doi: 10.1016/j.ijid.2022.11.009.
• Shah, Kamran; Nergård, Bent Johnny; Fagerland, Morten & Gislason, Hjörtur (2022). Failed Roux-en-Y Gastric Bypass—Long-Term Results of Distalization with Total Alimentary Limb Length of 250 or 300 cm. Obesity Surgery. ISSN 0960-8923. doi: 10.1007/s11695-022-06388-z.
• Bekkenes, Maria Egeland; Fagerland, Morten; Solberg, Ole Geir; Aaberge, Lars; Klingenberg, Olav Inge & Norseth, Jon [Show all 7 contributors for this article] (2022). Exploring cardiac effects after oxytocin 2.5 IU or carbetocin 100 μg: A randomised controlled trial in women undergoing planned caesarean delivery. European Journal of Anaesthesiology. ISSN 0265-0215. 39(12), p. 928–938. doi: 10.1097/EJA.0000000000001763. Full text in Research Archive Show summary

  BACKGROUND Oxytocin can stimulate release of myocardial biomarkers troponin I and T, prolong QTc and induce ST-depression. OBJECTIVE To explore cardiac changes after either intravenous carbetocin or oxytocin. STUDY DESIGN Exploratory phase 4 randomised controlled trial. SETTING Obstetrics units of Oslo University Hospital, Norway between September 2015 and May 2018. PARTICIPANTS Forty healthy, singleton pregnant women aged 18 to 50 years at gestational age at least 36 weeks with a planned caesarean delivery. INTERVENTIONS Participants were randomised to receive either oxytocin 2.5 IU or carbetocin 100 μg immediately after delivery. MAIN OUTCOME MEASURES The primary endpoint was the assessment of troponin I within 48 h of study drug administration. Troponin I and T, and creatine kinase myocardial band assessments were measured before spinal anaesthesia (baseline), and again at 4, 10 and 24 h after delivery. QTc, ST-depression and relative increase in heart rate were recorded from start of study drug administration to 10 min after delivery. All adverse events were monitored. RESULTS Compared with the carbetocin group, higher troponin I levels were observed in the oxytocin group at 4 h and 10 h after delivery. For both treatment groups, an increase from baseline in troponin I and T was most pronounced at 10 h after delivery, and it had begun to decline by 24 h. QTc increased with time after administration of both study drugs, with a mean maximum increase of 10.4 ms observed at 9 min (P< 0.001). No statistical differences were observed in QTc (P = 0.13) or ST-depression (P = 0.11) between the treatment groups. CONCLUSIONS Oxytocin 2.5 IU and carbetocin 100 μg caused a similar increase in QTc. The trial was underpowered with regards to ST-depression and the release of myocardial biomarkers and these warrant further investigation. Data from this trial will inform a larger phase 4 trial to determine potential drug differences in troponin release. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02528136

• Pretorius, Mikkel; Lundstam, Karolina; Heck, Ansgar; Fagerland, Morten; Godang, Kristin & Mollerup, Charlotte [Show all 15 contributors for this article] (2022). Mortality and Morbidity in Mild Primary Hyperparathyroidism: Results From a 10-Year Prospective Randomized Controlled Trial of Parathyroidectomy Versus Observation. Annals of Internal Medicine. ISSN 0003-4819. 175(6), p. 812–819. doi: 10.7326/M21-4416.
• Kvaslerud, Anette Borger; Bardan, Sara; Andresen, Kristoffer; Kløve, Sophie Foss; Fagerland, Morten & Edvardsen, Thor [Show all 8 contributors for this article] (2022). Intravenous iron supplement for iron deficiency in patients with severe aortic stenosis scheduled for transcatheter aortic valve implantation: results of the IIISAS randomised trial. European Journal of Heart Failure. ISSN 1388-9842. 24(7), p. 1269–1279. doi: 10.1002/ejhf.2557. Full text in Research Archive Show summary

  Aims The aim of this trial was to evaluate whether intravenous iron could provide benefit beyond transcatheter aortic valve implantation (TAVI) in iron-deficient patients with severe aortic stenosis. Methods and results In this randomised, placebo-controlled, double-blind, single-centre trial, we enrolled patients with severe aortic stenosis and iron deficiency (defined as ferritin <100 µg/L, or 100–299 µg/L with a transferrin saturation <20%) who were evaluated for TAVI. Patients were randomly assigned (1:1) to receive intravenous ferric derisomaltose or placebo ∼3 months before TAVI. The primary endpoint was the between-group, baseline-adjusted 6-min walk distance measured 3 months after TAVI. Secondary outcomes included quality of life, iron stores, hand grip strength, New York Heart Association (NYHA) class, and safety. Between January 2020 and September 2021, we randomised 74 patients to ferric derisomaltose and 75 patients to placebo. The modified intention-to-treat population comprised the 104 patients who completed the 6-min walk test at baseline and 3 months after successful TAVI. Iron stores were restored in 76% of the patients allocated to iron and 13% of the patients allocated to placebo (p < 0.001). There was no difference in the baseline-adjusted 6-min walk distance between the two treatment arms (p = 0.82). The number of serious adverse events, quality of life, hand grip strength, and NYHA class did not differ between the treatment arms. Conclusion Treatment with intravenous iron did not provide clinical benefit beyond TAVI in iron-deficient patients with severe aortic stenosis. Clinical Trial Registration: ClinicalTrials.gov NCT04206228.

• Cwikiel, Joanna; Fagerland, Morten; Wachtell, Kristian; Arnesen, Harald; Seljeflot, Ingebjørg & Flaa, Arnljot (2022). Exercise-induced change in circulating NT-proBNP could not distinguish between patients with and without coronary artery disease: the CADENCE study. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 56(1), p. 107–113. doi: 10.1080/14017431.2022.2075562. Full text in Research Archive
• Vethe, Nils Tore; Husebye, Einar; Andersen, Anders Mikal; Bergan, Stein; Kristiansen, Oskar & Fagerland, Morten [Show all 7 contributors for this article] (2022). Monitoring Simvastatin Adherence in Patients With Coronary Heart Disease: A Proof-of-Concept Study Based on Pharmacokinetic Measurements in Blood Plasma. Therapeutic Drug Monitoring. ISSN 0163-4356. 44(4), p. 558–567. doi: 10.1097/FTD.0000000000000992. Show summary

  Background:  Poor statin adherence remains a public health concern associated with adverse outcomes. We evaluated the use of pharmacokinetic measurements to monitor adherence to simvastatin in patients with coronary heart disease (CHD). Methods:  Eighteen patients with CHD taking an evening dose of simvastatin 20 mg (n = 7), 40 mg (n = 5), or 80 mg (n = 6) were examined at steady-state pharmacokinetics. Ten patients were instructed to interrupt simvastatin dosing and return for blood sampling for the subsequent 3 days. Dose-normalized plasma concentrations of simvastatin lactone and simvastatin acid and the sum of the 2 were evaluated to discriminate between adherent dosing and dose omission. Bioanalytical quantification was performed using liquid chromatography–tandem mass spectrometry. Results:  A simvastatin acid cutoff of 1.0 × 10−2 nmol−1·L−1·mg−1 identified 100% of those omitting 2 doses and 60% of those omitting a single dose. Simvastatin acid showed superior ability to discriminate dose omission, as well as the best agreement between samples handled at ambient and cool temperatures (median deviation 3.5%; interquartile range −2.5% to 13%). The cutoff for a morning dose schedule, with a similar ability to discriminate, was estimated at 2.0 × 10−3 nmol−1·L−1·mg−1. Conclusions:  The present method discriminated between adherence and reduced adherence to simvastatin therapy in patients with CHD. Sample handling is feasible for routine practice, and the assessment of adherence can be performed by direct measurement of simvastatin acid in a blood sample, according to defined cutoff values. Further studies validating the cutoff value and utility for clinical application are encouraged.

• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Dalen-Lorentsen, Torstein; Clarsen, Benjamin Matthew & Fagerland, Morten (2022). Assessing the cumulative effect of long-term training load on the risk of injury in team sports. BMJ Open sport & exercise medicine. ISSN 2055-7647. 8(2). doi: 10.1136/bmjsem-2022-001342. Full text in Research Archive Show summary

  Objectives: Determine how to assess the cumulative effect of training load on the risk of injury or health problems in team sports. Methods: First, we performed a simulation based on a Norwegian Premier League male football dataset (n players=36). Training load was sampled from daily session rating of perceived exertion (sRPE). Different scenarios of the effect of sRPE on injury risk and the effect of relative sRPE on injury risk were simulated. These scenarios assumed that the probability of injury was the result of training load exposures over the previous 4 weeks. We compared seven different methods of modelling training load in their ability to model the simulated relationship. We then used the most accurate method, the distributed lag non-linear model (DLNM), to analyse data from Norwegian youth elite handball players (no. of players=205, no. of health problems=471) to illustrate how assessing the cumulative effect of training load can be done in practice. Results: DLNM was the only method that accurately modelled the simulated relationships between training load and injury risk. In the handball example, DLNM could show the cumulative effect of training load and how much training load affected health problem risk depending on the distance in time since the training load exposure. Conclusion: DLNM can be used to assess the cumulative effect of training load on injury risk.

• Nguyen, Thao; Hokstad, Ingrid; Fagerland, Morten; Mollnes, Tom Eirik; Hollan, Ivana & Feinberg, Mark W. [Show all 10 contributors for this article] (2022). Antirheumatic therapy is associated with reduced complement activation in rheumatoid arthritis. PLOS ONE. ISSN 1932-6203. 17 (2), p. 1–18. doi: 10.1371/journal.pone.0264628. Full text in Research Archive Show summary

  Background The complement system plays an important role in pathophysiology of cardiovascular disease (CVD), and might be involved in accelerated atherogenesis in rheumatoid arthritis (RA). The role of complement activation in response to treatment, and in development of premature CVD in RA, is limited. Therefore, we examined the effects of methotrexate (MTX) and tumor necrosis factor inhibitors (TNFi) on complement activation using soluble terminal complement complex (TCC) levels in RA; and assessed associations between TCC and inflammatory and cardiovascular biomarkers. Methods We assessed 64 RA patients starting with MTX monotherapy (n = 34) or TNFi with or without MTX co-medication (TNFi±MTX, n = 30). ELISA was used to measure TCC in EDTA plasma. The patients were examined at baseline, after 6 weeks and 6 months of treatment. Results Median TCC was 1.10 CAU/mL, and 57 (89%) patients had TCC above the estimated upper reference limit (<0.70). Compared to baseline, TCC levels were significantly lower at 6-week visit (0.85 CAU/mL, p<0.0001), without significant differences between the two treatment regimens. Notably, sustained reduction in TCC was only achieved after 6 months on TNFi±MTX (0.80 CAU/mL, p = 0.006). Reductions in TCC after treatment were related to decreased C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and interleukin 6, and increased levels of total, high and low-density lipoprotein cholesterol. Similarly, baseline TCC was significantly related to baseline CRP, ESR and interleukin 6. Patients with endothelial dysfunction had higher baseline TCC than those without (median 1.4 versus 1.0 CAU/mL, p = 0.023). Conclusions Patients with active RA had elevated TCC, indicating increased complement activation. TCC decreased with antirheumatic treatment already after 6 weeks. However, only treatment with TNFi±MTX led to sustained reduction in TCC during the 6-month follow-up period. RA patients with endothelial dysfunction had higher baseline TCC compared to those without, possibly reflecting involvement of complement in the atherosclerotic process in RA.

• Sverre, Elise Christine Bjørkholen; Peersen, Kari; Kristiansen, Oscar; Fagerland, Morten; Perk, Joep & Husebye, Einar [Show all 9 contributors for this article] (2022). Tailored clinical management after blinded statin challenge improved the lipid control in coronary patients with self-perceived muscle side effects. Journal of Internal Medicine. ISSN 0954-6820. 291(6), p. 891–893. doi: 10.1111/joim.13454.
• Tarp, Jakob; Fagerland, Morten Wang; Dalene, Knut Eirik; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann & Jefferis, Barbara [Show all 24 contributors for this article] (2021). Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies. British Journal of Sports Medicine. ISSN 0306-3674. 56(13), p. 725–732. doi: 10.1136/bjsports-2021-104827. Full text in Research Archive
• Solberg, Runar Barstad; Steene-Johannessen, Jostein; Fagerland, Morten; Anderssen, Sigmund Alfred; Berntsen, Sveinung & Resaland, Geir Kåre [Show all 9 contributors for this article] (2021). Aerobic fitness mediates the intervention effects of a school-based physical activity intervention on academic performance. The school in Motion study – A cluster randomized controlled trial. Preventive Medicine Reports. ISSN 2211-3355. 24. doi: 10.1016/j.pmedr.2021.101648. Full text in Research Archive
• Deyab, Gia; Reine, Trine M.; Vuong, Tram Thu; Jenssen, Trond Geir; Hjeltnes, Gunnbjørg & Agewall, Stefan [Show all 11 contributors for this article] (2021). Antirheumatic treatment is associated with reduced serum Syndecan-1 in Rheumatoid Arthritis. PLOS ONE. ISSN 1932-6203. 16(7). doi: 10.1371/journal.pone.0253247. Full text in Research Archive Show summary

  The endothelial glycocalyx (EG) is essential for proper function of the endothelium and for vascular integrity, but its role in premature atherogenesis in rheumatoid arthritis (RA) has not been studied yet. EG impairment can play a role in pathogenesis of vascular disease, and one of its characteristics is shedding of syndecan-1 from endothelial cells. Syndecan-1 shedding is mediated by matrix metalloproteinase-9 (MMP-9) and counteracted by tissue inhibitor of metalloproteinases (TIMP)-1. Cardiovascular disease risk in RA is reversible by disease modifying antirheumatic drugs (DMARDs), but the exact modes of action are still unclear. Therefore, we examined effects of DMARDs on syndecan-1, MMP-9 and TIMP-1 in RA patients, and searched for associations between these parameters and inflammatory activity. From the observational PSARA study, we examined 39 patients starting with methotrexate (MTX) monotherapy (in MTX naïve patients, n = 19) or tumor necrosis factor inhibitors (TNFi) in combination with MTX (in MTX non-responders, n = 20) due to active RA. Serum syndecan-1, MMP-9 and TIMP-1 were measured at baseline and after six weeks of treatment. Serum syndecan-1 (p = 0.008) and TIMP-1 (p<0.001) levels decreased after six weeks of anti-rheumatic treatment. Levels of MMP-9 also decreased, but the difference was not statistically significant. The improvement in syndecan-1 levels were independent of changes in inflammatory activity. There was no significant difference in changes in syndecan-1 levels from baseline to 6 weeks between the MTX and TNFi groups, however the change was significant within the MTX group. Six weeks of antirheumatic treatment was associated with reduction in serum levels of syndecan-1, which might reflect reduced syndecan-1 shedding from EG. Thus, it is possible that EG-preserving properties of DMARDs might contribute to their cardioprotective effects. These effects may be at least partly independent of their anti-inflammatory actions. Our findings do not support the notion that syndecan-1 shedding in RA is mediated mainly by increased MMP-9 or decreased TIMP-9 serum concentration.

• Mecinaj, Albulena; Gulati, Geeta; Heck, Siri Lagethon; Holte, Espen; Fagerland, Morten Wang & Larsen, Alf Inge [Show all 10 contributors for this article] (2021). Rationale and design of the PRevention of cArdiac Dysfunction during Adjuvant breast cancer therapy (PRADA II) trial: a randomized, placebo-controlled, multicenter trial. Cardio-Oncology. ISSN 2057-3804. 7. doi: 10.1186/s40959-021-00115-w. Full text in Research Archive Show summary

  Objective To assess if sacubitril/valsartan given concomitantly with early breast cancer treatment regimens including anthracyclines, with or without trastuzumab, may prevent cardiac dysfunction. Methods PRADA II is a randomized, placebo-controlled, double blind, multi-center, investigator-initiated clinical trial. Breast cancer patients from four university hospitals in Norway, scheduled to receive (neo-)adjuvant chemotherapy with epirubicin independently of additional trastuzumab/pertuzumab treatment, will be randomized 1:1 to sacubitril/valsartan or placebo. The target dose is 97/103 mg b.i.d. The patients will be examined with cardiovascular magnetic resonance (CMR), echocardiography, circulating cardiovascular biomarkers and functional testing at baseline, at end of anthracycline treatment and following 18 months after enrolment. The primary outcome measure of the PRADA II trial is the change in left ventricular ejection fraction (LVEF) by CMR from baseline to 18 months. Secondary outcomes include change in LV function by global longitudinal strain by CMR and echocardiography and change in circulating cardiac troponin concentrations. Results The study is ongoing. Results will be published when the study is completed. Conclusion PRADA II is the first randomized, placebo-controlled study of sacubitril/valsartan in a cardioprotective setting during (neo-)adjuvant breast cancer therapy. It may provide new insight in prevention of cardiotoxicity in patients receiving adjuvant or neo-adjuvant therapy containing anthracyclines. Furthermore, it may enable identification of patients at higher risk of developing cardiotoxicity and identification of those most likely to respond to cardioprotective therapy. Trial registration The trial is registered in the ClinicalTrials.gov registry (identifier NCT03760588). Registered 30 November 2018.

• Peersen, Kari; Munkhaugen, John; Sverre, Elise Christine Bjørkholen; Kristiansen, Oskar; Fagerland, Morten & Vethe, Nils Tore [Show all 9 contributors for this article] (2021). Clinical and psychological factors in coronary heart disease patients with statin associated muscle side-effects. BMC Cardiovascular Disorders. ISSN 1471-2261. 21, p. 1–9. doi: 10.1186/s12872-021-02422-7. Full text in Research Archive Show summary

  Background: To compare clinical and psychological factors among patients with self-perceived statin-associated muscle symptoms (SAMS), confirmed SAMS, and refuted SAMS in coronary heart disease patients (CHD). Methods: Data were obtained from a cross-sectional study of 1100 CHD outpatients and a study of 71 CHD outpatients attending a randomized, double-blinded, placebo-controlled, crossover study to test effects of atorvastatin 40 mg/day on muscle symptom intensity. Clinical and psychosocial factors were compared between patients with and without SAMS in the cross-sectional study, and between patients with confirmed SAMS and refuted SAMS in the randomized study. Results: Bilateral, symmetric muscle symptoms in the lower extremities during statin treatment were more prevalent in patients with confirmed SAMS compared to patients with refuted SAMS (75% vs. 41%, p = 0.01) in the randomized study. No significant differences in psychological factors (anxiety, depression, worry, insomnia, type D personality characteristics) were detected between patients with and without self-perceived SAMS in the cross-sectional study, or between patients with confirmed SAMS and refuted SAMS, in the randomized study. Conclusions: Patients with confirmed SAMS more often present with bilateral lower muscle symptoms compared to those with refuted SAMS. Psychological factors were not associated with self-perceived SAMS or confirmed SAMS. A careful pain history and a search for alternative causes of muscle symptoms are likely to promote communication in patients with SAMS, and may reduce the risk for statin discontinuation.

• Nguyen, Thao; Fagerland, Morten; Deyab, Gia; Hjeltnes, Gunnbjørg; Hollan, Ivana & Feinberg, Mark W. [Show all 9 contributors for this article] (2021). Antirheumatic therapy is not associated with changes in circulating N-terminal pro-brain natriuretic peptide levels in patients with autoimmune arthritis. PLOS ONE. ISSN 1932-6203. 16:e0253793(6), p. 1–17. doi: 10.1371/journal.pone.0253793. Full text in Research Archive Show summary

  Background: Patients with autoimmune arthritis (AA) are at increased risk for impaired cardiac function and heart failure. This may be partly due to the effect of inflammation in heart function. The impact of antirheumatic drugs on cardiac dysfunction in AA remains controversial. Therefore, we aimed to examine effects of antirheumatic treatment on serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in AA patients and its relationship to inflammatory markers. Methods: We examined 115 patients with AA (64 rheumatoid arthritis (RA), 31 psoriatic arthritis and 20 ankylosis spondylitis) starting with methotrexate (MTX) monotherapy or tumor necrosis factor inhibitors (TNFi) with or without MTX co-medication. NT-proBNP (measured in serum by ECLIA from Roche Diagnostics), and other clinical and laboratory parameters were evaluated at baseline, after 6 weeks and 6 months of treatment. Results: NT-proBNP levels did not change significantly after 6 weeks and 6 months of antirheumatic therapy (pbaseline-6weeks = 0.939; pbaseline-6months = 0.485), although there was a modest improvement from 6 weeks to 6 months in the MTX only treatment group (median difference = -18.2 [95% CI = -32.3 to -4.06], p = 0.013). There was no difference in the effects of MTX monotherapy and TNFi regimen on NT-proBNP levels. The changes in NT-proBNP after antirheumatic treatment positively correlated with changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Baseline NT-proBNP levels were related to baseline CRP and ESR levels, and some other established markers of disease activities in crude analyses. Conclusion: Circulating levels of NT-proBNP were related to established inflammatory markers at baseline, and the changes in NT-proBNP after antirheumatic treatment were positively related to these markers. Nevertheless, antirheumatic therapy did not seem to affect NT-proBNP levels compared to baseline, even though inflammatory markers significantly improved.

• Salte, Odd Bjørn; Svanevik, Marius; Risstad, Hilde; Hofsø, Dag; Høgestøl, Ingvild Kristine & Johnson, Line Kristin [Show all 11 contributors for this article] (2021). Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial. BJS Open. ISSN 2474-9842. 5(6), p. 1–9. doi: 10.1093/bjsopen/zrab105. Full text in Research Archive Show summary

  Background The optimal surgical weight loss procedure for patients with a BMI of 50 kg/m2 or more is uncertain. This study compared distal Roux-en-Y gastric bypass (RYGB) with standard RYGB. Methods In this double-blind RCT, patients aged 18–60 years with a BMI of 50–60 kg/m2 were allocated randomly to receive standard (150 cm alimentary, 50 cm biliopancreatic limb) or distal (150 cm common channel, 50 cm biliopancreatic limb) RYGB. The primary outcome (change in BMI at 2 years) has been reported previously. Secondary outcomes 5 years after surgery, such as weight loss, health-related quality of life, and nutritional outcomes are reported. Results Between May 2011 and April 2013, 123 patients were randomized, 113 received an intervention, and 92 attended 5-year follow-up. Mean age was 40 (95 per cent c.i. 38 to 41) years and 73 patients (65 per cent) were women; 57 underwent standard RYGB and 56 distal RYGB. BMI was reduced by 15.1 (95 per cent c.i. 13.9 to 16.2) kg/m2 after standard and 15.7 (14.5 to 16.9) kg/m2 after distal RYGB; the between-group difference was −0.64 (−2.3 to 1.0) kg/m2 (P = 0.447). Total cholesterol, low-density lipoprotein cholesterol, and haemoglobin A1c levels declined more after distal than after standard RYGB. High-density lipoprotein cholesterol levels increased more after standard RYGB. Vitamin A and vitamin D levels were lower after distal RYGB. Changes in bone mineral density, resting metabolic rate, and total energy intake were comparable. Conclusion Distal RYGB did not enable greater weight loss than standard RYGB. Differences in other outcomes favouring distal RYGB may not justify routine use of this procedure in patients with a BMI of 50–60 kg/m2.

• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Clarsen, Benjamin & Fagerland, Morten Wang (2021). Handling and reporting missing data in training load and injury risk research. Science and medicine in football. ISSN 2473-3938. doi: 10.1080/24733938.2021.1998587. Show summary

  Purpose: To map the current practice of handling missing data in the field of training load and injury risk and to determine how missing data in training load should be handled. Methods: A systematic review of the training load and injury risk literature was performed to determine how missing data are reported and handled. We ran simulations to compare the accuracy of modelling a predetermined relationship between training load and injury risk following handling missing data with different methods. The simulations were based on a Norwegian Premier League men’s football dataset (n = 39). Internal training load was measured with the session Rating of Perceived Exertion (sRPE). External training load was the total distance covered measured by a global positioning systems (GPS) device. Results: Only 37 (34%) of 108 studies reported whether training load had any missing observations. Multiple Imputation using Predicted Mean Matching was the best method of handling missing data across multiple scenarios. Conclusion: Studies of training load and injury risk should report the extent of missing data, and how they are handled. Multiple Imputation with Predicted Mean Matching should be used when imputing sRPE and GPS variables.

• Vedøy, Ingeborg Barth; Skulberg, Knut Ragnvald; Anderssen, Sigmund Alfred; Fagerland, Morten Wang; Tjomsland, Hege Eikeland & Thurston, Miranda N. (2021). The longitudinal association between objectively measured physical activity and mental health among Norwegian adolescents. International Journal of Behavioral Nutrition and Physical Activity. ISSN 1479-5868. 18:149, p. 1–11. doi: 10.1186/s12966-021-01211-x. Full text in Research Archive Show summary

  Background: Mental health among young people in many countries, including Norway, seems to be deteriorating. Physical activity (PA) has been positively associated with mental health. However, methodological issues related to study design and measurement of PA and mental health outcomes currently limits our understanding of the relationship. The purpose of the present study is to explore the prospective relationship between objectively measured PA and mental health outcomes. More specifically, volume (total PA), intensity (moderate-to-vigorous PA [MVPA]) and sedentary behaviour (SED) were explored in relation to mental health problems (MHP) and mental wellbeing (MWB). Methods: Data from 599 adolescents (54.4% female, mean age at baseline ±SD 13.3 ± 0.3 years) were collected annually during their 3 years (T1, T2 and T3) at lower secondary school. PA was measured using accelerometry. MWB was measured using the ‘Warwick-Edinburgh Mental Wellbeing Scale’ and MHP by the ‘Strengths and Difficulties Questionnaire’. Multiple linear regression was performed to explore relationships between changes in PA/SED (between T1-T3) and MWB/MHP (at T3). The term ‘movement categories’ was used to refer to components on the movement continuum and includes volume (total PA), intensity (MVPA) and SED. Results: Among boys, any increase in SED was positively associated with MWB (β = 0.05, 95% CI: 0.01 to 0.10), whereas a small positive association between an increase in total PA (volume) and MWB was found among girls (β = 1.13, 95% CI: 0.05 to 2.21). There were no associations between changes in any movement categories [total PA (volume), MVPA, SED] and score on MHP at T3, neither for girls nor boys. Conclusion: This study provided no clear evidence of any association between change in volume or intensity of PA and MHP among an overall healthy adolescent study sample. There was, however, evidence of a relationship between increased SED and MWB among boys and increased volume of PA and MWB among girls. The relationship between movement categories and mental health may depend on the measurement used to assess both PA/SED and variables of mental health. Future research would be strengthened by researchers clarifying what construct of mental health is being used and measured.

• Austevoll, Ivar Magne; Hermansen, Erland; Fagerland, Morten Wang; Storheim, Kjersti; Brox, Jens Ivar & Solberg, Tore [Show all 16 contributors for this article] (2021). Decompression with or without Fusion in Degenerative Lumbar Spondylolisthesis. New England Journal of Medicine. ISSN 0028-4793. 385(6), p. 526–538. doi: 10.1056/NEJMoa2100990. Full text in Research Archive Show summary

  BACKGROUND In patients with lumbar spinal stenosis and degenerative spondylolisthesis, it is uncertain whether decompression surgery alone is noninferior to decompression with instrumented fusion. METHODS We conducted an open-label, multicenter, noninferiority trial involving patients with symptomatic lumbar stenosis that had not responded to conservative management and who had single-level spondylolisthesis of 3 mm or more. Patients were randomly assigned in a 1:1 ratio to undergo decompression surgery (decompressionalone group) or decompression surgery with instrumented fusion (fusion group). The primary outcome was a reduction of at least 30% in the score on the Oswestry Disability Index (ODI; range, 0 to 100, with higher scores indicating more impairment) during the 2 years after surgery, with a noninferiority margin of −15 percentage points. Secondary outcomes included the mean change in the ODI score as well as scores on the Zurich Claudication Questionnaire, leg and back pain, the duration of surgery and length of hospital stay, and reoperation within 2 years. RESULTS The mean age of patients was approximately 66 years. Approximately 75% of the patients had leg pain for more than a year, and more than 80% had back pain for more than a year. The mean change from baseline to 2 years in the ODI score was −20.6 in the decompression-alone group and −21.3 in the fusion group (mean difference, 0.7; 95% confidence interval [CI], −2.8 to 4.3). In the modified intentionto- treat analysis, 95 of 133 patients (71.4%) in the decompression-alone group and 94 of 129 patients (72.9%) in the fusion group had a reduction of at least 30% in the ODI score (difference, −1.4 percentage points; 95% CI, −12.2 to 9.4), showing the noninferiority of decompression alone. In the per-protocol analysis, 80 of 106 patients (75.5%) and 83 of 110 patients (75.5%), respectively, had a reduction of at least 30% in the ODI score (difference, 0.0 percentage points; 95% CI, −11.4 to 11.4), showing noninferiority. The results for the secondary outcomes were generally in the same direction as those for the primary outcome. Successful fusion was achieved with certainty in 86 of 100 patients (86.0%) who had imaging available at 2 years. Reoperation was performed in 15 of 120 patients (12.5%) in the decompression- alone group and in 11 of 121 patients (9.1%) in the fusion group. CONCLUSIONS In this trial involving patients who underwent surgery for degenerative lumbar spondylolisthesis, most of whom had symptoms for more than a year, decompression alone was noninferior to decompression with instrumented fusion over a period of 2 years. Reoperation occurred somewhat more often in the decompressionalone group than in the fusion group. (NORDSTEN-DS ClinicalTrials.gov number, NCT02051374.)

• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Dalen-Lorentsen, Torstein; Clarsen, Benjamin Matthew & Fagerland, Morten (2021). Not straightforward: modelling non-linearity in training load and injury research. BMJ Open sport & exercise medicine. ISSN 2055-7647. 7(3), p. 1–9. doi: 10.1136/bmjsem-2021-001119. Full text in Research Archive Show summary

  Objectives: To determine whether the relationship between training load and injury risk is non-linear and investigate ways of handling non-linearity. Methods: We analysed daily training load and injury data from three cohorts: Norwegian elite U-19 football (n=81, 55% male, mean age 17 years (SD 1)), Norwegian Premier League football (n=36, 100% male, mean age 26 years (SD 4)) and elite youth handball (n=205, 36% male, mean age 17 years (SD 1)). The relationship between session rating of perceived exertion (sRPE) and probability of injury was estimated with restricted cubic splines in mixed-effects logistic regression models. Simulations were carried out to compare the ability of seven methods to model non-linear relationships, using visualisations, root-mean-squared error and coverage of prediction intervals as performance metrics. Results: No relationships were identified in the football cohorts; however, a J-shaped relationship was found between sRPE and the probability of injury on the same day for elite youth handball players (p<0.001). In the simulations, the only methods capable of non-linear modelling relationships were the quadratic model, fractional polynomials and restricted cubic splines. Conclusion: The relationship between training load and injury risk should be assumed to be non-linear. Future research should apply appropriate methods to account for non-linearity, such as fractional polynomials or restricted cubic splines. We propose a guide for which method(s) to use in a range of different situations.

• Kristiansen, Oskar; Sverre, Elise Christine Bjørkholen; Peersen, Kari; Fagerland, Morten; Gjertsen, Erik & Gullestad, Lars [Show all 11 contributors for this article] (2021). The relationship between directly measured statin adherence, self-reported adherence measures and cholesterol levels in patients with coronary heart disease. Atherosclerosis. ISSN 0021-9150. 336, p. 23–29. doi: 10.1016/j.atherosclerosis.2021.09.020. Full text in Research Archive Show summary

  Background and aims: We aimed to determine the relationship between statin adherence measured directly, and by self-report measures and serum cholesterol levels. Methods: Patients prescribed atorvastatin (N = 373) participated in a cross-sectional study 2–36 months after a coronary event. Self-reported adherence included statin adherence the past week, the 8-item Morisky medication adherence scale (MMAS-8), and the Gehi et al. adherence question. Atorvastatin was measured directly in spot blood plasma by a novel liquid chromatography tandem mass-spectrometry method discriminating adherence (0–1 doses omitted) and reduced adherence (≥2 doses omitted). Participants were unaware of the atorvastatin analyses at study participation. Results: Mean age was 63 (SD 9) years and 8% had reduced atorvastatin adherence according to the direct method. In patients classified with reduced adherence by the direct method, 40% reported reduced statin adherence, 32% reported reduced adherence with the MMAS-8 and 22% with the Gehi question. In those adherent by the direct method, 96% also reported high statin adherence, 95% reported high adherence on the MMAS-8 whereas 94% reported high adherence on the Gehi question. Cohen’s kappa agreement score with the direct method was 0.4 for self-reported statin adherence, 0.3 for the Gehi question and 0.2 for the MMAS-8. Adherence determined by the direct method, self-reported statin adherence last week, and the Gehi question was inversely related to LDL-cholesterol levels with a p-value of <0.001, 0.001 and 0.004, respectively. Conclusions: Plasma-statin measurements reveal reduced adherence with higher sensitivity than self-report measures, relate to cholesterol levels, and may prove to be a useful tool to improve lipid management.

• Traaen, Gunn Marit; Aakerøy, Lars; Hunt, Tove Elizabeth Frances; Øverland, Britt; Bendz, Christina & Sande, Lars Øivind [Show all 16 contributors for this article] (2021). Effect of continuous positive airway pressure on arrhythmia in atrial fibrillation and sleep apnea a randomized controlled trial. American Journal of Respiratory and Critical Care Medicine. ISSN 1073-449X. 204(5), p. 573–582. doi: 10.1164/rccm.202011-4133OC. Show summary

  Rationale: Sleep apnea (SA) is highly prevalent in patients with atrial fibrillation (AF), and both conditions are associated with adverse cardiovascular outcomes. Objectives: To determine the effect of continuous positive airway pressure (CPAP) on AF burden. Methods: This open-label, parallel-group, randomized controlled trial included patients with paroxysmal AF and moderate to severe SA (apnea–hypopnea index ⩾15). A computerized system randomized eligible patients (1:1) to 5 months’ treatment with CPAP plus usual care (CPAP, n = 55) or usual care alone (control, n = 54). The outcome assessment was blinded. The planned primary outcome was the difference between CPAP treatment and control groups in change of AF burden (percentage of time in AF) as measured by implantable loop recorder. Measurements and Main Results: A total of 579 patients with paroxysmal AF had respiratory polygraphy, of whom 244 (42%) had moderate to severe SA. Of these, 158 (65%) participated in the CPAP run-in period, of whom 39 (25%) patients did not tolerate the treatment. A total of 108 patients were available for the primary analysis. The mean time in AF decreased from 5.6% at baseline to 4.1% during the last 3 months of CPAP intervention and from 5.0% to 4.3% in the control group. The adjusted between-group difference at follow-up was −0.63 (95% confidence interval, −2.55 to 1.30) percentage points (P = 0.52). Seven serious adverse events (13%) occurred in the CPAP group, and two (4%) occurred in the control group. Conclusions: In patients with paroxysmal AF and SA, treatment with CPAP did not result in a statistically significant reduction in the burden of AF.Clinical trial registered with www.clinicaltrials.gov (NCT02727192).

• Heck, Siri Lagethon; Mecinaj, Albulena; Ree, Anne Hansen; Hoffmann, Pavel; Schulz-Menger, Jeanette & Fagerland, Morten [Show all 12 contributors for this article] (2021). Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): Extended follow-up of a 2×2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. Circulation. ISSN 0009-7322. 143(25), p. 2431–2440. doi: 10.1161/CIRCULATIONAHA.121.054698. Full text in Research Archive
• Dalen-Lorentsen, Torstein; Andersen, Thor Einar; Bjørneboe, John Andreas; Vagle, Markus; Martin, Kevin Nordanger & Kleppen, Michael [Show all 8 contributors for this article] (2021). A Cherry, Ripe for Picking: The Relationship Between the Acute-Chronic Workload Ratio and Health Problems. Journal of Orthopaedic and Sports Physical Therapy. ISSN 0190-6011. 51(4), p. 162–173. doi: 10.2519/jospt.2021.9893. Full text in Research Archive Show summary

  Objective: To investigate whether the relationship between the acute-chronic workload ratio (ACWR) and health problems varies when different methodological approaches are used to quantify it. Design: Prospective cohort study. Methods: An online questionnaire was used to collect daily health and training information from 86 elite youth footballers for 105 days. The relationship between players' training load and health was analyzed using a range of different definitions of ACWR and health problems. We used 21-day and 28-day chronic periods, coupled and uncoupled calculations, and the exponentially weighted moving average and rolling average. Acute-chronic workload ratio data were categorized as low, medium, or high, using predefined categories and z scores. We compared medium to high, medium to low, and low to high categories. The outcome was defined in 3 ways: “all health problems,” “all injuries,” and “new noncontact injuries.” We performed random-effects logistic regression analyses of all combinations, for a total of 108 analyses. Results: We recorded 6250 athlete-days and 196 health problems. Of the 108 analyses performed, 23 (21%) identified a statistically significant (P<.05) association between the ACWR and health problems. A greater proportion of significant associations were identified when using an exponentially weighted moving average (44% of analyses), when comparing low to high categories (33%), and when using the “all health problems” definition (33%). Conclusion: The relationship between the ACWR and health problems was dependent on methodological approach.

• Pretorius, Mikkel; Lundstam, Karolina; Hellström, Mikael; Fagerland, Morten; Godang, Kristin & Mollerup, Charlotte [Show all 15 contributors for this article] (2020). Effects of Parathyroidectomy on Quality of Life: 10 Years of Data From a Prospective Randomized Controlled Trial on Primary Hyperparathyroidism (the SIPH-Study). Journal of Bone and Mineral Research. ISSN 0884-0431. 36(1), p. 3–11. doi: 10.1002/jbmr.4199.
• Kåsine, Trine; Romundstad, Luis Georg; Rosseland, Leiv Arne; Fagerland, Morten; Kessler, Paul & Omenås, Ivar Nagelgaard [Show all 8 contributors for this article] (2020). Ultrasonographic needle tip tracking for in-plane infraclavicular brachialis plexus blocks: A randomized controlled volunteer study. Regional anesthesia and pain medicine. ISSN 1098-7339. 45(8), p. 634–639. doi: 10.1136/rapm-2020-101349. Full text in Research Archive
• Kalstad, Are; Myhre, Peder Langeland; Laake, Kristian; Tveit, Sjur Hansen; Schmidt, Erik Berg & Smith, Pål [Show all 12 contributors for this article] (2020). Effects of n-3 fatty acid supplementations in elderly patients after myocardial infarction: A randomized controlled trial. Circulation. ISSN 0009-7322. 143(6), p. 528–539. doi: 10.1161/CIRCULATIONAHA.120.052209. Full text in Research Archive
• Ekelund, Ulf; Tarp, Jakob; Fagerland, Morten Wang; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann & Jefferis, Barbara [Show all 23 contributors for this article] (2020). Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals. British Journal of Sports Medicine. ISSN 0306-3674. 54(24), p. 1499–1506. doi: 10.1136/bjsports-2020-103270. Full text in Research Archive Show summary

  Objectives: To examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality. Methods: We conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis. Results: Across cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16%; 95% CI 0.87% to 1.54%) and highest (40%; 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time; 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively. Conclusion: Higher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.

• Aghayan, Davit; Kazaryan, Airazat; Dagenborg, Vegar Johansen; Røsok, Bård Ingvald; Fagerland, Morten Wang & Bjørnelv, Gudrun Maria Waaler [Show all 10 contributors for this article] (2020). Long-term oncologic outcomes after laparoscopic versus open resection for colorectal liver metastasis. Annals of Internal Medicine. ISSN 0003-4819. 174(2), p. 175–182. doi: 10.7326/M20-4011.
• Nielsen, Rasmus Oestergaard; Shrier, Ian; Casals, Marti; Nettel-Aguirre, Alberto; Møller, Merete & Bolling, Caroline [Show all 24 contributors for this article] (2020). Statement on methods in sport injury research from the 1st METHODS MATTER Meeting, Copenhagen, 2019. British Journal of Sports Medicine. ISSN 0306-3674. 54(15), p. 941–947. doi: 10.1136/bjsports-2019-101323. Show summary

  High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.

• Langseth, Miriam Sjåstad; Helseth, Ragnhild; Ritschel, Vibeke Nordmo; Hansen, Charlotte Holst; Andersen, Geir Øystein & Eritsland, Jan [Show all 12 contributors for this article] (2020). Double-Stranded DNA and NETs Components in Relation to Clinical Outcome After ST-Elevation Myocardial Infarction. Scientific Reports. ISSN 2045-2322. 10(1). doi: 10.1038/s41598-020-61971-7. Full text in Research Archive
• Hansen, Bjørge Hermann; Dalene, Knut Eirik; Ekelund, Ulf; Fagerland, Morten; Kolle, Elin & Steene-Johannessen, Jostein [Show all 8 contributors for this article] (2020). Step by step: Association of device‐measured daily steps with all‐cause mortality - A prospective cohort Study. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(9), p. 1705–1711. doi: 10.1111/sms.13726. Full text in Research Archive Show summary

  Introduction: Walking is free, does not require special training, and can be done almost everywhere. Therefore, walking is a feasible behavior on which to tailor public health messages. This study assesses the prospective association and dose‐response relationship between daily steps and all‐cause mortality. Materials and Methods: Daily steps were measured by waist‐mounted accelerometers in 2183 individuals (53% women) for seven consecutive days at baseline (2008‐09). Participants were followed for a median period of 9.1 years and associations between steps and all‐cause mortality determined by registry linkage were assessed using Cox proportional hazard regression with adjustment for relevant covariates. Results: Mean age was 57.0 (SD 10.9) years at baseline. Median (IQR) daily steps across ascending quartiles were 4651 (3495‐5325), 6862 (6388‐7350), 8670 (8215‐9186), and 11 467 (10 556‐13 110), respectively. During follow‐up, 119 individuals died (68% men). Higher number of daily steps was associated with a lower risk of all‐cause mortality with hazard ratios of 1.00 (referent), 0.52 (0.29‐0.93), 0.50 (0.27‐0.94), and 0.43 (0.21‐0.88) across ascending quartiles of daily steps in the multivariable‐adjusted model with follow‐up commencing 2 years after baseline. Risk differences per 1000 individuals for ascending quartiles were 6.8 (2.9‐9.3), 7.1 (0.8‐11.1), and 8.0 (1.7‐12.1), respectively. Conclusions: Daily steps were associated with lower mortality risk in a non‐linear dose‐response pattern. The risk is almost halved when comparing the least active referent against the second quartile equivalent to a difference of about 2200 daily steps. Encouraging those least active to increase their daily steps may have substantial public health implications.

• Brunvoll, Sonja Hjellegjerde; Thune, Inger; Bertheussen, Gro Falkener; Fjeldheim, Frøydis Nyborg; Flote, Vidar Gordon & Frydenberg, Hanne [Show all 13 contributors for this article] (2020). Dietary changes in early-stage breast cancer patients from pre-surgery and over the 12 months post-surgery. British Journal of Nutrition. ISSN 0007-1145. 125(2), p. 172–182. doi: 10.1017/S0007114520002627. Full text in Research Archive Show summary

  The time after a breast cancer diagnosis is a potential period for making positive dietary changes, but previous results are conflicting. The main aim of the present study was to study breast cancer patients’ dietary changes during the 12 months post-surgery and from 12 months pre-surgery to 12 months post-surgery with repeated administration of a 7-d pre-coded food diary and an FFQ, respectively. Women (n 506), mean age 55·3 years diagnosed with invasive breast cancer (stages I and II), were included. The dietary intake was quite stable over time, but the intake was lower for energy (0·3 and 0·4 MJ/d), alcohol (1·9 and 1·5 g/d) and vegetables (17 and 22 g/d) at 6 months than 3 weeks post-surgery (food diary) and at 12 months post-surgery than pre-surgery (FFQ), respectively. Furthermore, energy percentage (E%) from carbohydrates increased between 0·8 and 1·2 E% and E% from fat decreased between 0·6 and 0·8 E% over time, measured by both dietary assessment methods. We observed a higher intake of dairy products (11 g/d) at 6 months post-surgery (food diary), and a lower intake of dairy products (34 g/d) and red and processed meat (7·2 g/d) at 12 months post-surgery (FFQ). Moreover, 24 % of the patients claimed they made dietary changes, but mostly they did not change their diet differently compared with those patients who claimed no changes. In conclusion, breast cancer patients reported only minor dietary changes from 12 months pre-surgery and during the 12 months post-surgery.

• Dalen-Lorentsen, Torstein; Bjørneboe, John Andreas; Clarsen, Benjamin Matthew; Vagle, Markus; Fagerland, Morten & Andersen, Thor Einar (2020). Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes. British Journal of Sports Medicine. ISSN 0306-3674. 55(2), p. 108–114. doi: 10.1136/bjsports-2020-103003. Full text in Research Archive Show summary

  Background: The acute:chronic workload ratio (ACWR) is commonly used to manage training load in sports, particularly to reduce injury risk. However, despite its extensive application as a prevention intervention, the effectiveness of load management using ACWR has never been evaluated in an experimental study. Aim: To evaluate the effectiveness of a load management intervention designed to reduce the prevalence of health problems among elite youth football players of both sexes. Methods: We cluster-randomised 34 elite youth football teams (16 females, 18 males) to an intervention group (18 teams) and a control group (16 teams). Intervention group coaches planned all training based on published ACWR load management principles using a commercially available athlete management system for a complete 10-month season. Control group coaches continued to plan training as normal. The prevalence of health problems was measured monthly in both groups using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Results: The between-group difference in health problem prevalence (primary outcome) was 1.8%-points (−4.1 to 7.7 %-points; p=0.55) with no reduction in the likelihood of reporting a health problem in the intervention group (relative risk 1.01 (95% CI 0.91 to 1.12); p=0.84) compared with the control group. Conclusions: We observed no between-group difference, suggesting that this specific load management intervention was not successful in preventing health problems in elite youth footballers.

• Nielsen, Rasmus Østergaard; Shrier, Ian; Casals, Martí; Nettel-Aguirre, Alberto; Møller, Merete & Bolling, Caroline [Show all 24 contributors for this article] (2020). Statement on methods in sport injury research from the first methods matter meeting, Copenhagen, 2019. Journal of Orthopaedic and Sports Physical Therapy. ISSN 0190-6011. 50(5), p. 226–233. doi: 10.2519/jospt.2020.9876.
• Tarp, Jakob; Hansen, Bjørge Hermann; Fagerland, Morten; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred & Ekelund, Ulf (2020). Accelerometer-measured physical activity and sedentary time in a cohort of US adults followed for up to 13 years: The influence of removing early follow-up on associations with mortality. International Journal of Behavioral Nutrition and Physical Activity. ISSN 1479-5868. 17. doi: 10.1186/s12966-020-00945-4. Full text in Research Archive Show summary

  Background: Observational studies linking physical activity with mortality are susceptible to reverse causation bias from undiagnosed and prevalent diseases. Researchers often attempt to deal with reverse causation bias by excluding deaths occurring within the first 1 or 2 years from the analysis, but it is unclear if excluding deaths within this time-frame is sufficient to remove bias. Methods: We examined associations between total and intensity-specific physical activity and sedentary time with all-cause mortality in a prospective cohort of 3542 individuals from the 2003–2006 NHANES cycles. In order to yield measures of association hypothesized as minimally influenced by reverse causation bias the primary analysis excluded individuals with < 5 years of follow-up. Accelerometer-measured physical activity was linked with recently updated vital status from the National Death Index with a median follow-up of 10.8 years. Results: Hazard ratios (95% confidence intervals) were 0.74 (0.53, 1.04), 0.52 (0.37, 0.73), and 0.61 (0.38, 1.01) for ascending quartiles of total physical activity against the least active reference. Hazard ratios for ascending moderate-to-vigorous physical activity quartiles against the reference were 0.67 (0.47, 1.96), 0.67 (0.47, 0.95), and 0.68 (0.39, 1.18). Associations for light intensity physical activity and sedentary time were smaller in magnitude and all confidence intervals included unity. Total activity and moderate-to-vigorous physical activity hazard ratios from analyses only excluding deaths within the first 2 years were inflated by 13 and 26% relative to analysis restricted to ≥5 years of follow-up. Conclusions: The pattern of associations suggested total physical activity and moderate-to-vigorous physical activity were associated with lower mortality after more than 10 years of follow-up and excluding the first 5 years of observation time to minimize the impact of reverse causation bias. Excluding deaths within the first 2 years appeared insufficient to minimize the impact of reserve causation bias.

• Kristiansen, Oskar; Vethe, Nils Tore; Peersen, Kari; Fagerland, Morten; Sverre, Elise Christine Bjørkholen & Jensen, Elena Prunès [Show all 15 contributors for this article] (2020). Effect of Atorvastatin on Muscle Symptoms in Coronary Heart Disease Patients With Self-Perceived Statin Muscle Side-Effects: A Randomized, Double Blinded Crossover Trial . European Heart Journal (EHJ) - Cardiovascular Pharmacotherapy. ISSN 2055-6837. 7(6), p. 507–516. doi: 10.1093/ehjcvp/pvaa076. Full text in Research Archive
• Aftab, Hira; Fagerland, Morten; Gondal, Ghous; Ghanima, Waleed Khalid; Olsen, Magnus Kringstad & Nordby, Tom (2019). Gastric sleeve resection as day-case surgery: what affects the discharge time? Surgery for Obesity and Related Diseases. ISSN 1550-7289. 15(12), p. 2018–2024. doi: 10.1016/j.soard.2019.09.070. Full text in Research Archive
• Kristiansen, Oscar; Vethe, Nils Tore; Fagerland, Morten; Bergan, Stein; Munkhaugen, John & Husebye, Einar (2019). A novel direct method to determine adherence to atorvastatin therapy in patients with coronary heart disease. British Journal of Clinical Pharmacology. ISSN 0306-5251. p. 1–8. doi: 10.1111/bcp.14122. Full text in Research Archive
• Ekelund, Ulf; Tarp, Jakob; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Jefferis, Barbara & Fagerland, Morten [Show all 20 contributors for this article] (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. The BMJ. ISSN 1756-1833. 366. doi: 10.1136/bmj.l4570. Full text in Research Archive
• Lydersen, Stian; Fagerland, Morten & Laake, Petter (2019). Alternativer til Fishers eksakte test. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(14), p. 1397–1397. doi: 10.4045/tidsskr.19.0238. Full text in Research Archive
• Kåsine, Trine; Romundstad, Luis Georg; Rosseland, Leiv Arne; Ullensvang, Kyrre; Fagerland, Morten & Kessler, Paul [Show all 8 contributors for this article] (2019). The effect of needle tip tracking on procedural time of ultrasound-guided lumbar plexus block: a randomised controlled trial. Anaesthesia. ISSN 0003-2409. 75(1), p. 72–79. doi: 10.1111/anae.14846. Full text in Research Archive
• Shah, Kamran; Nergård, Bent Johnny; Fagerland, Morten & Gislason, Hjørtur (2019). Distal gastric bypass: 2-m biliopancreatic limb construction with varying lengths of common channel. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 15(9), p. 1520–1526. doi: 10.1016/j.soard.2019.05.003.
• Moseid, Christine Holm; Myklebust, Grethe; Slåstuen, Marit Kyte; Bar-Yaacov, Jonathan Brun; Kristiansen, Åse & Fagerland, Morten [Show all 7 contributors for this article] (2019). The association between physical fitness level and number and severity of injury and illness in youth elite athletes. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. doi: 10.1111/sms.13498. Show summary

  Youth elite athletes often double their training and competition load after enrollment into specialized sport academy high school programs. The least fit athletes may be exposed to an excessive and too rapid increase in training load, with negative adaptations such as injury and illness as a consequence. In this study, our aim was to determine whether these least fit athletes were at greater risk of injury or illness during their first school year. Participants were 166 youth elite athletes (72% boys) from a variety of team, technical, and endurance sports newly enrolled into specialized sport academy high schools. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to self‐report injuries and illnesses weekly for 26 weeks. Athletes completed the Ironman Jr physical fitness test battery at baseline, evaluating endurance, strength, agility, and speed properties. We ranked the athletes based on their combined test scores and identified the least fit quartile. The main outcome was the number and severity of health problems, comparing the least fit quartile of athletes to the rest of the cohort. Overall, the least fit quartile of athletes did not report more health problems (mean 3.7, 95% CI 3.0‐4.4) compared with the rest of the cohort (3.6, 3.2‐3.9). In conclusion, we demonstrated no association between low physical fitness level and number and severity of injury and illness in youth elite athletes after enrollment into a specialized sport academy high school program.

• Hokstad, Ingrid; Deyab, Gia; Fagerland, Morten; Lyberg, Torstein; Hjeltnes, Gunnbjørg & Førre, Øystein Thorleiv [Show all 9 contributors for this article] (2019). Tumor necrosis factor inhibitors are associated with reduced complement activation in spondylarthropathies: An observational study. PLOS ONE. ISSN 1932-6203. 14(7), p. 1–16. doi: 10.1371/journal.pone.0220079. Full text in Research Archive Show summary

  Background The complement system is involved in pathogenesis of cardiovascular disease, and might play a role in accelerated atherogenesis in spondylarthropathies (SpA). Hence, we examined complement activation in SpA, and its relationship to antirheumatic treatment, inflammatory and cardiovascular markers. Methods From PSARA, a prospective observational study, we examined 51 SpA patients (31 psoriatic arthritis (PsA), and 20 ankylosing spondylitis (AS)), starting tumor necrosis factor (TNF) inhibitor alone (n = 25), combined with methotrexate (MTX) (n = 10), or MTX monotherapy (n = 16). Complement activation was determined by the soluble terminal complement complex (sC5b-9), inflammation by erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and endothelial function by finger plethysmography (Endopat) at baseline, after 6 weeks and 6 months of treatment. Results SpA patients had sC5b-9 levels at (PsA) or above (AS) the upper limit of the estimated reference range. Median sC5b-9 levels decreased significantly from baseline to 6 weeks, with no significant difference between the AS and PsA group. Notably, a significant reduction in sC5b-9 was observed after administration of TNF inhibitor ± MTX, whereas no significant changes were observed in patients treated with MTX alone. Between 6 weeks and 6 months, sC5b-9 remained stable across all subgroups. Reduction in sC5b-9 was independently related to decreased ESR and CRP, and to increased high density cholesterol and total cholesterol. Reduction in sC5b-9 from baseline to 6 weeks was associated with improved EF in age and gender adjusted analyses. Conclusion TNF-inhibition, but not MTX monotherapy, led to rapid and sustained reduction of complement activation in SpA. Thus, the observed decrease in cardiovascular morbidity in patients treated with TNF-inhibitors might be partly due to its beneficial effect on complement. Trial registration Clinical Trials (NCT00902005), retrospectively registered on the 14th of May 2009.

• Kåsine, Trine; Romundstad, Luis Georg; Rosseland, Leiv Arne; Ullensvang, Kyrre; Fagerland, Morten & Hol, Per Kristian [Show all 8 contributors for this article] (2019). Needle tip tracking for ultrasound-guided peripheral nerve block procedures-An observer blinded, randomised, controlled, crossover study on a phantom model. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. doi: 10.1111/aas.13379. Full text in Research Archive Show summary

  Background: The Onvision™ needle tip tracking (NTT) is new technology consisting of a needle with an ultrasound sensor close to the needle tip and a console for computerized signal processing. The aim of the study was to evaluate NTT technology during ultrasound guided simulated peripheral nerve block procedures in a porcine phantom model. Methods: Forty anaesthesiologists performed in-plane and out-of-plane simulated nerve blocks with and without NTT guidance. The primary outcome measure was procedure time. Secondary outcomes were hand movements and the path length travelled by the hands measured by motion analysis, precision of the needle tip related to the target structure, success rates, violations of the target structure, and the participants confidence whether their procedure would be successful or not. Results: Procedure time, was reduced from 66.7 (SD 47.5) sec to 43.8 (SD 29.2) sec when NTT was used for out-of-plane procedures (p = 0.002). The number of hand movements of the probe hand was 13.9 (SD 30.2) with NTT and 22.8 (SD 30.0) without NTT (p = 0.019). No significant differences were registered during the performance of in-plane procedures. The participants confidence in a presumed block success was increased with both in-plane procedures (8.50 (SD 1.18) with NTT vs 7.65 (SD 1.96), P = 0.004) and out-of-plane procedures (8.50 (SD 1.09) vs 7.10 (SD 1.89) P = 0.0001). Conclusions: The new NTT technology, significantly reduced procedure time and the number of hand movements for ultrasound guided out-of-plane PNB procedures. No significant differences were found for the in-plane procedures.

• Bjelland, Thor Wilhelm; Yates, Thomas G. R.; Fagerland, Morten; Frøyen, Jan Kåre; Lysebråten, Karl Raimo & Spreng, Ulrich Johannes (2019). Quadratus lumborum block for postoperative analgesia after full abdominoplasty: a randomized controlled trial. Scandinavian Journal of Pain. ISSN 1877-8860. doi: 10.1515/sjpain-2019-0013.
• Shah, Kamran; Nergård, Bent Johnny; Fagerland, Morten & Gislason, Hjørtur (2019). Limb Length in Gastric Bypass in Super-Obese Patients?Importance of Length of Total Alimentary Small Bowel Tract. Obesity Surgery. ISSN 0960-8923. doi: 10.1007/s11695-019-03836-1.
• Fretland, Åsmund Avdem; Dagenborg, Vegar Johansen; Bjørnelv, Gudrun Maria Waaler; Aghayan, Davit; Kazaryan, Airazat M. & Barkhatov, Leonid [Show all 10 contributors for this article] (2019). Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. British Journal of Surgery. ISSN 0007-1323. 106(10), p. 1372–1380. doi: 10.1002/bjs.11227. Full text in Research Archive
• Aftab, Hira; Fagerland, Morten; Gondal, Ghous; Ghanima, Waleed Khalid; Olsen, Magnus Kringstad & Nordby, Tom (2019). Pain and nausea after bariatric surgery with total intravenous anesthesia versus desflurane anesthesia: a double blind, randomized, controlled trial. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 15, p. 1505–1512. doi: 10.1016/j.soard.2019.05.010.
• Cwikiel, Joanna; Seljeflot, Ingebjørg; Fagerland, Morten; Wachtell, Kristian; Arnesen, Harald & Berge, Eivind [Show all 7 contributors for this article] (2019). High-sensitive cardiac Troponin T and exercise stress test for evaluation of angiographically significant coronary disease. International Journal of Cardiology. ISSN 0167-5273. 287, p. 1–6. doi: 10.1016/j.ijcard.2019.04.019. Full text in Research Archive
• Munkhaugen, John; Vethe, Nils Tore; Fagerland, Morten; Dammen, Toril; Perk, Joep & Gjertsen, Erik [Show all 10 contributors for this article] (2019). Statin-associated muscle symptoms in coronary patients: design of a randomized study. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 53(3), p. 162–168. doi: 10.1080/14017431.2019.1612085. Full text in Research Archive
• Austevoll, Ivar Magne; Hermansen, Erland; Fagerland, Morten; Rekeland, Frode; Solberg, Tore & Storheim, Kjersti [Show all 12 contributors for this article] (2019). Decompression alone versus decompression with instrumental fusion the NORDSTEN degenerative spondylolisthesis trial (NORDSTEN-DS); study protocol for a randomized controlled trial. BMC Musculoskeletal Disorders. ISSN 1471-2474. 20:7, p. 1–10. doi: 10.1186/s12891-018-2384-0. Full text in Research Archive
• Munkhaugen, John; Ruddox, Vidar; Halvorsen, Sigrun; Dammen, Toril; Fagerland, Morten & Hernæs, Kjersti Helene [Show all 23 contributors for this article] (2019). BEtablocker Treatment After acute Myocardial Infarction in revascularized patients without reduced left ventricular ejection fraction (BETAMI): Rationale and design of a prospective, randomized, open, blinded end-point study. American Heart Journal. ISSN 0002-8703. 208, p. 37–46. doi: 10.1016/j.ahj.2018.10.005. Full text in Research Archive
• Moseid, Christine Holm; Myklebust, Grethe; Fagerland, Morten & Bahr, Roald (2018). The Association between Early Specialization and Performance Level with Injury and Illness Risk in Youth Elite Athletes. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(3), p. 460–468. doi: 10.1111/sms.13338. Full text in Research Archive Show summary

  A trend is observed towards more specialized training and selection into talent programs at an early age for youth athletes. Little is known how this might influence the risk of illness and injury. The aim of the study was to assess whether, in a group of youth elite athletes, those specializing early or performing best were at increased risk of incurring injury or illness after entering a specialized Sport Academy High School program. We enrolled 259 16‐year old elite athletes. They completed a baseline web‐based questionnaire covering their age at specialization, single‐ versus multi‐sport involvement during the previous 2 years and current performance level (rated by themselves and their coach). Subsequently, the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems was used to self‐report injuries and illnesses weekly for 26 weeks from October to May. In this specialized Sport Academy High School program, 39% of the athletes reported early specialization (at 12 years or younger). However, early specialization did not increase the risk of injury or illness during the 26 weeks, nor did being a single‐sport athlete the previous two years increase this risk. The best performing athletes at the time of enrollment were not at greater risk of becoming injured or ill during the 26 weeks. In conclusion, in a group of youth elite athletes entering a specialized Sport Academy High School program neither early single‐sport specialization nor performance level appears to represent risk factors for injury or illness after enrollment.

• Oma, Ingvild; Olstad, Ole Kristoffer; Andersen, Jacqueline Kirsti; Lyberg, Torstein; Molberg, Øyvind & Fostad, Ida [Show all 13 contributors for this article] (2018). Differential expression of Vitamin D associated genes in the aorta of coronary artery disease patients with and without rheumatoid arthritis. PLOS ONE. ISSN 1932-6203. 13:e0202346(8), p. 1–13. doi: 10.1371/journal.pone.0202346. Full text in Research Archive
• Ekelund, Ulf; Brown, Wendy J; Steene-Johannessen, Jostein; Fagerland, Morten; Owen, Neville & Powell, Kenneth E. [Show all 8 contributors for this article] (2018). Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants. British Journal of Sports Medicine. ISSN 0306-3674. 53(14), p. 886–894. doi: 10.1136/bjsports-2017-098963. Show summary

  Objective: To examine whether the associations between sedentary behaviours (ie, daily sitting/TV-viewing time) and mortality from cardiovascular disease (CVD) and cancer differ by different levels of physical activity (PA). Design: Harmonised meta-analysis of prospective cohort studies. Data on exposure variables were harmonised according to a predefined protocol and categorised into four groups for sedentary behaviours and into quartiles of PA (MET-hour/week). Data sources: PubMed, PsycINFO, Embase, Web of Science, Sport Discus and Scopus. Eligibility criteria for selecting studies: Individual level data on both sedentary behaviours and PA and reported effect estimates for CVD or cancer mortality. Results: Nine studies (n=850 060; deaths=25 730) and eight studies (n=777 696; deaths=30 851) provided data on sitting time and CVD and cancer mortality, respectively. Five studies had data on TV-viewing time and CVD (n=458 127; deaths=13 230) and cancer (n=458 091; deaths=16 430) mortality. A dose–response association between sitting time (9%–32% higher risk; p for trend <0.001) and TV time (3%–59% higher risk; p for trend <0.001) with CVD mortality was observed in the ‘inactive’, lowest quartile of PA. Associations were less consistent in the second and third quartiles of PA, and there was no increased risk for CVD mortality with increasing sedentary behaviours in the most active quartile. Associations between sedentary behaviours and cancer mortality were generally weaker; 6%–21% higher risk with longer sitting time observed only in the lowest quartile of PA. Conclusion: PA modifies the associations between sedentary behaviours and CVD and cancer mortality. These findings emphasise the importance of higher volumes of moderate and vigorous activity to reduce, or even eliminate these risks, especially for those who sit a lot in their daily lives.

• Baekelandt, Bart Maria Gilbert; Fagerland, Morten; Hjermstad, Marianne Jensen; Heiberg, Turid; Labori, Knut Jørgen & Buanes, Trond (2018). Survival, Complications and Patient Reported Outcomes after Pancreatic Surgery. HPB. ISSN 1365-182X. doi: 10.1016/j.hpb.2018.07.023. Full text in Research Archive
• Aga, Cathrine; Risberg, May Arna; Fagerland, Morten; Johansen, Steinar; Trøan, Ingrid & Heir, Stig [Show all 7 contributors for this article] (2018). No Difference in the KOOS Quality of Life Subscore Between Anatomic Double-Bundle and Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction of the Knee: A Prospective Randomized Controlled Trial With 2 Years’ Follow-up . American Journal of Sports Medicine. ISSN 0363-5465. 46(10), p. 2341–2354. doi: 10.1177/0363546518782454. Full text in Research Archive Show summary

  Background: The double-bundle reconstruction technique was developed to resemble the properties of the native anterior cruciate ligament (ACL) more closely than the conventional single-bundle technique. The clinical benefit of the operative procedure is controversial, and there is a need for studies with a focus on patient-reported outcomes (PROs). Study Design: Randomized controlled trial; Level of evidence, 1. Hypothesis: Anatomic double-bundle ACL reconstruction would be superior to anatomic single-bundle reconstruction regarding the change in the Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QoL) subscore from baseline to 2-year follow-up. Methods: According to sample size calculations, 120 patients aged 18 to 40 years with a primary ACL injury of their knee were randomized to the anatomic double-bundle or anatomic single-bundle reconstruction groups. Patients with posterior cruciate ligament, posterolateral corner, or lateral collateral ligament injuries or with established osteoarthritis were excluded. Patients with residual laxity from a coexistent medial collateral ligament injury were excluded. Data were registered at baseline, 1 year, and 2 years. In 24 patients, postoperative 3-dimensional computed tomography was performed to verify the positioning of the bundles. The outcome measures were the change in KOOS subscores and the International Knee Documentation Committee 2000 subjective score, pivot-shift test result, Lachman test finding, KT-1000 arthrometer measurement, activity level, return-to-sports rate, and osteoarthritic changes on radiographs. A linear mixed model was used for the analysis of all the PROs, including the primary outcome. Results: The change in the KOOS QoL subscore from baseline to 2-year follow-up was not different between the double- and single-bundle groups (mean change, 29.2 points vs 28.7 points, respectively; –0.5-point difference; 95% CI, –8.4 to 7.4 points; P = .91). Neither were there any differences between the 2 groups in the remaining PROs, knee laxity measurements, or activity levels of the patients. Radiological signs of osteoarthritis were found in 2 patients. Eleven patients had a graft rupture: 8 in the single-bundle group and 3 in the double-bundle group (P = .16). Three-dimensional computed tomography of the knees verified the positioning of the anteromedial bundle, posterolateral bundle, and single-bundle grafts to be within acceptable limits. Conclusion: There was no difference in the KOOS QoL subscore, the remaining PROs, knee laxity measurements, or activity levels comparing the double- and single-bundle ACL reconstruction techniques. The number of bundles does not seem to influence clinical and subjective outcomes, as long as the tunnels are adequately positioned.

• Moseid, Christine Holm; Myklebust, Grethe; Fagerland, Morten; Clarsen, Benjamin & Bahr, Roald (2018). The prevalence and severity of health problems in youth elite sports: a 6-month prospective cohort study of 320 athletes. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 28(4), p. 1412–1423. doi: 10.1111/sms.13047. Show summary

  Little is known regarding the overall health of youth elite athletes. Our aim was to describe the prevalence and severity of health problems in a cohort of youth elite athletes representing a variety of endurance, team and technical sports. Elite sport athletes (N=260, 16.2 yrs) from different Sport Academy High Schools in Norway, and a group of their teammates (N=60, 16.4 yrs) attending regular high schools, were included in the study. The Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems was used to self report injuries and illnesses for 26 weeks. At any given time, an average of 43% [95% CI: 37-49%] of the elite sport athletes had some form of health problem and 25% [20-31%] had substantial health problems. The prevalence of health problems was similar between the elite team sport athletes versus their teammates, except for substantial injuries (22% [16-30%] vs. 10% [5-20%]). Endurance sport athletes reported more illnesses (23% [15-35%]) than technical and team sport athletes (10% [5-20%] and 8% [4-14%]). In contrast, technical and team sport athletes reported more injuries (36% [95% CI: 25-48] and 37% [95% CI 29-45]) compared to endurance sport athletes (15% [8-25%]). The total impact of health problems was roughly split in thirds between overuse injuries (37%), acute injuries (34%) and illnesses (30%). This is the first prospective study to present self-reported injury and illness data in a large heterogeneous group of youth elite athletes, documenting a substantial impact of both injuries and illnesses on the health of this population.

• Fretland, Åsmund Avdem; Dagenborg, Vegar Johansen; Bjørnelv, Gudrun Maria Waaler; Kazaryan, Airazat M.; Kristiansen, Ronny & Fagerland, Morten [Show all 17 contributors for this article] (2018). Laparoscopic Versus Open Resection for Colorectal Liver Metastases: The OSLO-COMET Randomized Controlled Trial . Annals of Surgery. ISSN 0003-4932. 267(2), p. 199–207. doi: 10.1097/SLA.0000000000002353. Full text in Research Archive Show summary

  Objective: To perform the first randomized controlled trial to compare laparoscopic and open liver resection. Summary Background Data: Laparoscopic liver resection is increasingly used for the surgical treatment of liver tumors.However, high-level evidence to conclude that laparoscopic liver resection is superior to open liver resection is lacking. Methods: Explanatory, assessor-blinded, single center, randomized superiority trial recruiting patients from Oslo University Hospital, Oslo, Norway from February 2012 to January 2016. A total of 280 patients with resectable liver metastases from colorectal cancer were randomly assigned to undergo laparoscopic (n ¼ 133) or open (n ¼ 147) parenchyma-sparing liver resection. The primary outcome was postoperative complications within 30 days (Accordion grade 2 or higher). Secondary outcomes included cost-effectiveness, postoperative hospital stay, blood loss, operation time, and resection margins. Results: The postoperative complication rate was 19% in the laparoscopicsurgery group and 31% in the open-surgery group (12 percentage points difference [95% confidence interval 1.67–21.8; P ¼ 0.021]). The postoperative hospital stay was shorter for laparoscopic surgery (53 vs 96 hours, P < 0.001), whereas there were no differences in blood loss, operation time, and resection margins. Mortality at 90 days did not differ significantly from the laparoscopic group (0 patients) to the open group (1 patient). In a 4-month perspective, the costs were equal, whereas patients in the laparoscopicsurgery group gained 0.011 quality-adjusted life years compared to patients in the open-surgery group (P ¼ 0.001). Conclusions: In patients undergoing parenchyma-sparing liver resection for colorectal metastases, laparoscopic surgery was associated with significantly less postoperative complications compared to open surgery. Laparoscopic resection was cost-effective compared to open resection with a 67% probability. The rate of free resection margins was the same in both groups. Our results support the continued implementation of laparoscopic liver resection. Keywords: colorectal liver metastases, cost and cost analysis, hepatectomy, laparoscopic, laparoscopy, liver resection, minimally invasive surgery, parenchyma-sparing liver surgery, randomized clinical trial, randomized controlled trial

• Skatteboe, Sigrid; Røe, Cecilie; Fagerland, Morten & Granan, Lars-Petter (2017). The influence of expectations on improvements in pain and function in patients with neck/back/shoulder complaints: a cohort study. European Journal of Physical and Rehabilitation Medicine. ISSN 1973-9087. 53(6), p. 936–943. doi: 10.23736/S1973-9087.17.04608-1.

View all works in Cristin

• Pivoriunas, Jonas; Engebretsen, Ingrid; Vethe, Nils Tore; Kristiansen, Oscar; Dammen, Toril & Fagerland, Morten Wang [Show all 9 contributors for this article] (2024). Statin adherence in coronary outpatients: a novel direct method compared with pharmacy registry data . European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 31(Supplement_1). doi: 10.1093/eurjpc/zwae175.063.
• Pivoriunas, Jonas; Engebretsen, Ingrid; Vethe, Nils Tore; Kristiansen, Oscar; Dammen, Toril & Husebye, Einar [Show all 9 contributors for this article] (2024). Statin adherence in coronary outpatients: the relationship between a novel direct method and pharmacy registry data. Show summary

  Introduction An optimal method to assess adherence to statin therapy is needed. We developed a novel blood test to determine adherence to atorvastatin and simvastatin therapy. The relationship between statin adherence measured in blood and long-term adherence is yet to be defined. Purpose To compare statin adherence measured by single blood test with pharmacy registry data: i. the three months period prior to the blood test, and ii. from six months before until six months after the blood test. Methods In a cross-sectional study including 451 patients using either atorvastatin or simvastatin, a spot blood sample was collected median 18 months after a coronary heart disease event. Participants were unaware of the forthcoming statin analyses. Adherence (0 or 1 omitted dose) and reduced adherence, defined as ≥2 consecutively omitted doses of atorvastatin and simvastatin was determined by drug concentration measurements using liquid chromatography - tandem mass spectrometry. Study data was linked to the pharmacy registry. Indirect reduced adherence was defined as statin treatment gap exceeding 90 days. Results Thirty-nine (9%) out of 412 patients had reduced adherence to statins, determined by the novel blood test. Among patients classified as adherent by the blood test, only three (0.7%) had a treatment gap exceeding 90 days during the preceding three months. Correspondingly, of 39 patients with reduced adherence by the blood test, 11 (28%) had treatment gaps exceeding 90 days. The positive agreement between the methods was 96% and the negative agreement 42%. Among patients classified as adherent by the blood test, 21 (5%) had treatment gaps exceeding 90 days from six months before until six months after the blood test. Correspondingly, of 39 patients with reduced adherence by the blood test, 15 (39%) had at least one treatment gap exceeding 90 days. The positive agreement between measurements was 95% and the negative agreement 40%. Conclusions Among coronary patients classified as adherent by the statin blood test, registry data only identified three patients (0.7%) with a treatment gap exceeding 90 days in the three months prior to the blood test. The novel blood test emerges as a promising tool to identify patients adherent to statins, and thus may improve lipid management in clinical practice.

• Moseid, Nils Fredrik Holm; Lemyre, Nicolas; Roberts, Glyn; Fagerland, Morten Wang; Moseid, Christine Holm & Bahr, Roald (2024). No Pain No Gain: Associations Between Health Problems, Motivation and Coach Relation.
• Aga, Cathrine; Trøan, Ingrid; Tariq, Rana; Heir, Stig; Risberg, May Arna & Johansen, Steinar [Show all 8 contributors for this article] (2023). Ingen forskjell i artroseutvikling etter 5 år - anatomisk Double-bundle versus Singlebundle ACL rekonstruksjons teknikk.
• Bekkenes, Maria Egeland; Fagerland, Morten; Solberg, Ole Geir; Aaberge, Lars; Klingenberg, Olav Inge & Norseth, Jon [Show all 7 contributors for this article] (2023). Reply to: Exploring cardiac effects after oxytocin 2.5 IU or carbetocin 100 μg - A randomised controlled trial in women undergoing planned caesarean delivery. European Journal of Anaesthesiology. ISSN 0265-0215. 40(6), p. 453–454. doi: 10.1097/EJA.0000000000001841.
• Munkhaugen, John; Kristiansen, Oscar; Pivoriunas, Jonas; Fagerland, Morten; Bergan, Stein & Sverre, Elise Christine Bjørkholen [Show all 8 contributors for this article] (2023). Validation of a novel direct method to determine reduced adherence to atorvastatin therapy. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 30. doi: 10.1093/eurjpc/zwad125.339.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Dalen-Lorentsen, Torstein; Tabben, Montassar; Chamari, Karim & Clarsen, Benjamin Matthew [Show all 7 contributors for this article] (2023). A new methodological approach to training load and injury risk.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar & Fagerland, Morten (2022). Modelling non-linearity in training load and injury risk research: A simulation study.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar & Fagerland, Morten (2022). Estimating cumulative protracted time-lagged effects of training load on sports injury.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar & Fagerland, Morten (2022). Developments in injury prevention methodology research – missing data in training load.
• Leoncio Netto, Waldir; Fagerland, Morten; Lydersen, Stian; Laake, Petter & Lingjærde, Ole Christian (2022). contingencytables: Statistical Analysis of Contingency Tables.
• Dalen-Lorentsen, Torstein; Bjørneboe, John Andreas; Vagle, Markus; Clarsen, Benjamin Matthew; Fagerland, Morten & Andersen, Thor Einar (2021). Kan styring av treningsbelastning redusere helseproblemer? En cluster-randomisert kontrollert studie av 482 junior-elite fotballspillere av begge kjønn.
• Moseid, Nils Fredrik Holm; Moseid, Christine Holm; Lemyre, Nicolas; Fagerland, Morten & Bahr, Roald (2021). Injury, illness and coaching style - associations with burnout in young elite athletes . British Journal of Sports Medicine. ISSN 0306-3674. 55. doi: 10.1136/bjsports-2021-IOC.55.
• Bekkenes, Maria Egeland; Jørgensen, Marte Morin; Jacobsen, Anne Flem; Fagerland, Morten; Rakstad-Larsen, Helene & Solberg, Ole Geir [Show all 10 contributors for this article] (2021). A study protocol for the cardiac effects of a single dose of either oxytocin 2.5 IU or carbetocin 100 µg after caesarean delivery: A prospective randomized controlled multi-centre trial in Norway. F1000 Research. ISSN 2046-1402. 10:973, p. 1–17. doi: 10.12688/f1000research.73112.1. Full text in Research Archive
• Moseid, Nils Fredrik Holm; Moseid, Christine Holm; Bahr, Roald; Lemyre, Nicolas & Fagerland, Morten (2021). Injury, illness and coaching style: associations with burnout in young elite athletes.
• Bache-Mathiesen, Lena Kristin; Andersen, Thor Einar; Dalen-Lorentsen, Torstein; Clarsen, Benjamin Matthew & Fagerland, Morten (2021). A peek behind the study... [Journal]. BMJ Open Sport & Exercise Medicine.
• Lydersen, Stian & Fagerland, Morten (2020). Hvilken t-test er best? Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.20.0750.
• Kåsine, Trine; Romundstad, Luis Georg; Rosseland, Leiv Arne; Ullensvang, Kyrre; Fagerland, Morten & Kessler, Paul [Show all 8 contributors for this article] (2019). The effect of needle tip tracking on procedural time of ultrasound-guided lumbar plexus block: a randomised controlled trial. Anaesthesia. ISSN 0003-2409. doi: 10.1111/anae.14846. Show summary

  Technologythatfacilitatesperformanceofdeepperipheralnerveblocksisofclinicalinterest.TheOnvisionTM is anewdeviceforultrasonographic needletiptrackingthat incorporatesanultrasound sensorontheneedletip that is then represented by a green circle on the ultrasound screen. The primary aim of this study was to investigate the effect of needle tip tracking on procedural time in the first human volunteer study. Secondary outcome measures included: number of hand movements; hand movement path length; block success rate; block onset time; block duration; discomfortexperienced by thevolunteers; and the anaesthetists’ confidence as to whether their block would be successful. Two anaesthetists performed ultrasound-guided lumbar plexus blocks with an out-of-plane technique, with and without the use of needle tip tracking. In total, data from 25 volunteers were studied. Mean (SD) procedural time was 163 (103) s with needle tip tracking and 216 (117) s without (p = 0.10). Hand motion analysis showed that needle tip tracking was associated with a significant decrease in the mean (SD) number of intended needling hand movements (39 (29) vs. 59 (36); p = 0.03) and path lengths (3.2 (3.1) m vs. 5.5 (4.5) m; p = 0.03). No differences were found for any other secondary outcomes.TheuseofOnvisionneedletiptrackingdidnotreduceproceduraltimeforout-of-planeultrasoundguided lumbar plexus block but did reduce the number of hand movements and path lengths. This may indicateimprovedneedlecontrolbutfurtherstudiesareneededtoconfirmthisfinding.

• Lydersen, Stian; Fagerland, Morten & Laake, Petter (2019). Pearsons khikvadrattest. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(12), p. 1183–1183. doi: 10.4045/tidsskr.18.0125.
• Lydersen, Stian; Fagerland, Morten & Laake, Petter (2019). Fishers eksakte test - hvordan smaker teen? Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(13), p. 1292–1292. doi: 10.4045/tidsskr.19.0237. Show summary

  Et enkelt eksperiment med te og melk kan ha inspirert den britiske statistikeren Ronald Aylmer Fisher (1890–1962) til å lage en av verdens mest kjente statistiske tester.

• Lydersen, Stian; Fagerland, Morten & Laake, Petter (2018). Evaluation of methods for analysis of 2x2 contingency tables. Show summary

  Evaluation of methods for analysis of 2x2 contingency tables Introduction: Literally hundreds of methods for hypothesis tests and confidence intervals for contingency tables are described in the literature. This is the case even for the seemingly simple 2 × 2 table. The Pearson chi squared test, the Fisher exact test, and the Wald confidence interval are widely used methods. Unfortunately, these methods are also commonly used in situations when they perform poorly, and better alternatives exist. Aims: To show how to evaluate and choose appropriate methods for hypothesis testing and confidence interval estimation for 2x2 tables Methods: Important properties of a hypothesis test are the actual significance level and power. Important properties for a confidence interval are coverage probability, expected interval width, and symmetry. We have studied these properties for alternative methods. Conclusion: For large samples, the asymptotic Pearson chi squared test performs well. Yates’s continuity correction should never be used. In small samples, the traditional advice is the Fisher exact test. But unconditional tests are generally more powerful than Fisher’s exact test for small samples. Unconditional tests also preserve the significance level. That is, the actual significance level does not exceed the nominal significance level, which is often 5%. Unconditional tests were but previously disadvantaged by being computationally demanding. Alternatively, Fisher’s exact test with mid-p adjustment is easy to compute, and gives approximately the same results as an unconditional test. The Wald confidence interval is a traditional choice for the difference between two proportions. But its coverage can dip substantially below the nominal coverage, which is usually 95%. The Agresti-Caffo interval and the Newcombe hybrid score interval are also easy to compute with closed form expressions. They have better coverage, and also narrower expected interval width, and better symmetry than the Wald interval. Reference: Fagerland MW, Lydersen S, Laake P (2017). Statistical Analysis of Contingency Tables. Chapman and Hall/CRC.

• Vaysse, Charlotte; Lømo, Jon; Garred, Øystein; Fjeldheim, Frøydis Nyborg; Lofteroed, Trygve & Schlichting, Ellen [Show all 15 contributors for this article] (2017). Erratum to: Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer (npj Breast Cancer (2017), 10.1038/s41523-017-0015-9). NPJ breast cancer. ISSN 2374-4677. 3(1). doi: 10.1038/S41523-017-0030-X.
• Bache-Mathiesen, Lena Kristin; Fagerland, Morten & Andersen, Thor Einar (2023). Improving the Methodology of Training Load and Injury Risk Research: An Analysis of Analyses. Norges idrettshøgskole.
• Dalen-Lorentsen, Torstein; Bjørneboe, John Andreas; Vagle, Markus; Clarsen, Benjamin Matthew; Fagerland, Morten & Andersen, Thor Einar (2021). Kan styring av treningsbelastning redusere helseproblemer? En cluster-randomisert kontrollert studie av 482 junior-elite fotballspillere av begge kjønn. NIMF.

View all works in Cristin