Jane Daniels

Publications (36) View all

• Article: Analgesic effectiveness of transversus abdominis plane blocks after hysterectomy: a meta-analysis.

  Rita Champaneria, Laila Shah, James Geoghegan, Janesh K Gupta, Jane P Daniels
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  ABSTRACT: To determine the effectiveness of transversus abdominis plane blocks in gynecological surgery by systematic review and meta-analysis. Embase, MEDLINE and the Cochrane Library (CENTRAL) bibliographic databases were searched using a Cochrane Library search strategy modified for gynecological surgery. We included randomized controlled trials comparing transversus abdominis plane block with no block or placebo block. We retrieved 681 citations from which we included five published studies (225 randomized participants) which fulfilled our inclusion criteria, and identified a further six ongoing studies. Quality was assessed across six risk of bias domains: randomization sequence generation, allocation concealment, blinding, missing outcome data, selective reporting and other biases. Data were meta-analyzed where possible and presented as mean differences with 95% confidence intervals. Study quality was moderate. Compared with no block or saline placebo, transversus abdominis plane block provided significantly less postoperative pain at rest on a 10cm visual analog scale at 2h (mean difference -2.14cm, 95% confidence interval (CI) -3.57 to -0.71) but not at 24h postoperatively (-0.52cm, 95% CI -1.49 to 0.45). Pain on movement showed similar results. Transversus abdominis plane block resulted in significantly less postoperative requirement for morphine use at 24h (-11.76mg, 95% CI -18.77 to -4.75) but not at 48h (-16.01mg, 95% CI -39.40 to 7.39). Evidence exists for the short-term efficacy (within 24h) of transversus abdominis plane blocks during hysterectomy in terms of reported pain and morphine consumption, which may not be sustained at 48h. Updates to this review should be undertaken periodically, and until further robust evidence is available, anesthetists should not rush to adopt this procedure into routine practice.
  European journal of obstetrics, gynecology, and reproductive biology 10/2012; · 1.97 Impact Factor
• Article: Pulse oximetry screening for congenital heart defects in newborn infants: an evaluation of acceptability to mothers.

  Rachael Powell, Helen M Pattison, Abhay Bhoyar, Alexandra T Furmston, Lee J Middleton, Jane P Daniels, Andrew K Ewer
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  ABSTRACT: BACKGROUND: Introducing neonatal screening procedures may not be readily accepted by parents and may increase anxiety. The acceptability of pulse oximetry screening to parents has not been previously reported. OBJECTIVE: To assess maternal acceptability of pulse oximetry screening for congenital heart defects and to identify factors predictive of participation in screening. DESIGN AND SETTING: A questionnaire was completed by a cross-sectional sample of mothers whose babies were recruited into the PulseOx Study which investigated the test accuracy of pulse oximetry screening. PARTICIPANTS: A total of 119 mothers of babies with false-positive (FP) results, 15 with true-positive and 679 with true-negative results following screening. MAIN OUTCOME MEASURES: Questionnaires included measures of satisfaction with screening, anxiety, depression and perceptions of test results. RESULTS: Participants were predominantly satisfied with screening. The anxiety of mothers given FP results was not significantly higher than that of mothers given true-negative results (median score 32.7 vs 30.0, p=0.09). White British/Irish mothers were more likely to participate in screening, with a decline rate of 5%; other ethnic groups were more likely to decline with the largest increase in declining being for Black African mothers (21%, OR 4.6, 95% CI 3.8 to 5.5). White British mothers were also less anxious (p<0.001) and more satisfied (p<0.001) than those of other ethnicities CONCLUSIONS: Pulse oximetry screening was acceptable to mothers and FP results were not found to increase anxiety. Factors leading to differences in participation and satisfaction across ethnic groups need to be identified so that staff can support parents appropriately.
  Archives of Disease in Childhood - Fetal and Neonatal Edition 05/2012; · 3.05 Impact Factor
• Article: Psychological therapies for chronic pelvic pain: systematic review of randomized controlled trials.

  Rita Champaneria, Jane P Daniels, Amer Raza, Helen M Pattison, Khalid S Khan
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  ABSTRACT: Chronic pelvic pain (CPP), a common cause of disability in women, is a condition best viewed in the biopsychosocial framework. Psychological interventions are frequently considered alongside medical and surgical treatments. Our objective was to evaluate the effectiveness of psychological therapies for the treatment of CPP. Electronic literature searches were conducted in Medline, Embase, PsycInfo and DARE databases from database inception to April 2010. Reference lists of selected articles were searched for further articles. The studies selected were randomized controlled trials of psychological therapies in patients with CPP compared with no treatment, standard gynecological treatment or another form of psychological therapy. Two reviewers independently selected articles without language restrictions and extracted data covering study characteristics, study quality and results. Reduction in pain, measured using visual analog scales or other measurements, was the main outcome measure. Of the 107 citations identified, four studies satisfied the inclusion criteria. Compared with no psychological intervention, therapy produced a standardized mean pain score of -3.27 [95% confidence interval (CI) -4.52 to -2.02] and 1.11 (95% CI -0.05 to 2.27) at 3 months and -3.95 (95% CI -5.35 to -2.55) and 0.54 (95% CI -0.78 to 1.86) at 6 months and greater, based on a visual analog scale score of 0-10. The current evidence does not allow us to conclude whether psychological interventions have an effect on self-reported pain scores in women with CPP.
  Acta Obstetricia Et Gynecologica Scandinavica 11/2011; 91(3):281-6. · 1.77 Impact Factor
• Article: Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study.

  Andrew K Ewer, Lee J Middleton, Alexandra T Furmston, Abhay Bhoyar, Jane P Daniels, Shakila Thangaratinam, Jonathan J Deeks, Khalid S Khan
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  ABSTRACT: Screening for congenital heart defects relies on antenatal ultrasonography and postnatal clinical examination; however, life-threatening defects often are not detected. We prospectively assessed the accuracy of pulse oximetry as a screening test for congenital heart defects. In six maternity units in the UK, asymptomatic newborn babies (gestation >34 weeks) were screened with pulse oximetry before discharge. Infants who did not achieve predetermined oxygen saturation thresholds underwent echocardiography. All other infants were followed up to 12 months of age by use of regional and national registries and clinical follow-up. The main outcome was the sensitivity and specificity of pulse oximetry for detection of critical congenital heart defects (causing death or requiring invasive intervention before 28 days) or major congenital heart disease (causing death or requiring invasive intervention within 12 months of age). 20,055 newborn babies were screened and 53 had major congenital heart disease (24 critical), a prevalence of 2·6 per 1000 livebirths. Analyses were done on all babies for whom a pulse oximetry reading was obtained. Sensitivity of pulse oximetry was 75·00% (95% CI 53·29-90·23) for critical cases and 49·06% (35·06-63·16) for all major congenital heart defects. In 35 cases, congenital heart defects were already suspected after antenatal ultrasonography, and exclusion of these reduced the sensitivity to 58·33% (27·67-84·83) for critical cases and 28·57% (14·64-46·30) for all cases of major congenital heart defects. False-positive results were noted for 169 (0·8%) babies (specificity 99·16%, 99·02-99·28), of which six cases were significant, but not major, congenital heart defects, and 40 were other illnesses that required urgent medical intervention. Pulse oximetry is a safe, feasible test that adds value to existing screening. It identifies cases of critical congenital heart defects that go undetected with antenatal ultrasonography. The early detection of other diseases is an additional advantage. National Institute for Health Research Health Technology Assessment programme.
  The Lancet 08/2011; 378(9793):785-94. · 38.28 Impact Factor
• Article: Health technology assessment in obstetrics and gynaecology. Part 1: an overview of the process

  Parveen Abedin MSc MRCOG Professor of Obstetrics and Gynaecology, Jane Daniels BSc MMedSci MSc Professor of Obstetrics and Gynaecology, Khalid S Khan MMEd MRCOG Professor of Obstetrics and Gynaecology
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  ABSTRACT: Key content•A health technology is any method used to promote health; diagnose, prevent or treat disease; or improve long-term rehabilitation and care.•Systematic reviews are summaries of the total evidence on a defined subject, using explicit techniques and critical appraisal of the relevant primary research to generate recommendations for practice and policy.•‘Bias’ exaggerates or underestimates the true effect of an intervention or exposure. There are several possible types of bias such as selection, performance, measurement and attrition.Learning objectives•To learn about the role of health technology assessments (HTAs) in the formulation of health policy and the adoption of new technologies.•To understand the methodology involved in conducting systematic reviews and economic evaluations in HTA.•To learn about the role of institutions (for example, NICE) in utilising HTA to formulate health policy.Ethical issues•Systematic reviews are the highest level of evidence as they incorporate the results of multiple studies but can be biased if individual studies are not published.•Meta-analysis should only be conducted when there is sufficient heterogeneity (decided by statistical tests) between the studies under consideration in a systematic review.•The investigators in a clinical trial should be transparent in any shortcomings of conduct or design that can question the conclusions.Please cite this article as: Abedin P, Daniels JP, Khan KS. Health technology assessment in obstetrics and gynaecology. Part 1: an overview of the process. The Obstetrician & Gynaecologist 2007;9:109–115.
  The Obstetrician & Gynaecologist 01/2011; 9(2):109 - 115.