Thomas Piggott

Thomas Piggott
McMaster University | McMaster · Department of Health Research Methods, Evidence, and Impact

MD MSc CCFP FRCPC

About

65
Publications
15,144
Reads
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3,193
Citations
Introduction
Thomas Piggott currently works at the Department of Health Evidence and Impact, McMaster University. Thomas does research in Public Health.
Additional affiliations
September 2019 - present
Labrador-Grenfell Regional Health
Labrador-Grenfell Regional Health
Position
  • Medical Officer of Health
September 2018 - October 2019
McMaster University
Position
  • Medical Doctor
July 2014 - present
McMaster University
Position
  • PHPM Resident

Publications

Publications (65)
Article
Introduction GRADE guidance to rate the certainty domain of imprecision is presently not fully operationalized for rating down by two levels and when different or uncertainty in baseline risks are considered. In addition, there are scenarios in which lowering the certainty of evidence by three levels for imprecision is more appropriate than lowerin...
Article
In an effort to enhance the trustworthiness of its clinical practice guidelines, the Endocrine Society has recently adopted new policies and more rigorous methodologies for its guideline program. In this Clinical Practice Guideline Communication, we describe these recent enhancements—many of which reflect greater adherence to the Grading of Recomme...
Article
Objectives: Analytical frameworks are graphical representation of the key questions answered by a systematic review and can support the development of guideline recommendations. Our objectives were to a) conduct a systematic review to identify, describe and compare all analytical frameworks published as part of a systematic and guideline developme...
Article
Full-text available
Objectives To evaluate the development and quality of actionable statements that qualify as good practice statements (GPS) reported in COVID-19 guidelines. Design and setting Systematic review . We searched MEDLINE, MedSci, China National Knowledge Infrastructure (CNKI), databases of Grading of Recommendations Assessment, Development and Evaluatio...
Article
Full-text available
An evidence-based approach is considered the gold standard for health decision-making. Sometimes, a guideline panel might judge the certainty that the desirable effects of an intervention clearly outweigh its undesirable effects as high, but the body of supportive evidence is indirect. In such cases, the application of the Grading of Recommendation...
Article
Background “Biological plausibility” is a concept frequently referred to in environmental and public health when researchers are evaluating how confident they are in the results and inferences of a study or evidence review. Biological plausibility is not, however, a domain of one of the most widely-used approaches for assessing the certainty of evi...
Article
Clinicians, patients, policy makers, funders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, coverage decisions, selection of essential medicines and diagno...
Article
Objective Our objective was to develop an extension of the widely used GIN-McMaster Guideline Development Checklist and Tool for the integration of quality assurance and improvement (QAI) schemes with guideline development. Study Design and Setting We used a mixed-methods approach incorporating evidence from a systematic review, an expert workshop...
Article
Full-text available
Hospitals continue to face challenges in reducing incorrect antibiotic use due to social and cultural factors at the level of the health system, the care facility, the provider, and the patient. The objective of this paper is to highlight the social and cultural drivers of antimicrobial use and resistance and targeted interventions for secondary an...
Article
Full-text available
Introduction The Grading of Recommendations Assessment, Development and Evaluation (GRADE) and similar Evidence to Decision (EtD) frameworks require its users to judge how substantial the effects of interventions are on desirable and undesirable people-important health outcomes. However, decision thresholds (DTs) that could help understand the magn...
Article
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Objectives Examining the availability of essential medicines is a necessary step to monitor country-level progress towards universal health coverage. We compared the 2017 essential medicine lists (EML) of 137 countries to the WHO Model List to assess differences by drug class and country setting. Methods We extracted all medicines prioritised at c...
Article
Full-text available
Background “Biological plausibility” is a concept frequently referred to in environmental and public health when researchers are evaluating how confident they are in the results and inferences of a study or evidence review. Biological plausibility is not, however, a domain of one of the most widely-used approaches for assessing the certainty of evi...
Article
Background Grading of Recommendations Assessment, Development and Evaluation (GRADE)Evidence-to-Decision (EtDs) frameworks are increasingly applied by health guideline developers to improve the use of evidence and transparency of health recommendations. Typically, EtDs include 12 criteria but these are flexible and EtDs have been adapted to differe...
Article
Full-text available
Background: COVID-19 related acute illness is associated with an increased risk of venous thromboembolism (VTE). Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis...
Article
Full-text available
Background: COVID-19 related acute illness is associated with an increased risk of venous thromboembolism (VTE). Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in decisions about the use of anticoagulation for thromboprophylax...
Article
Full-text available
Introduction: Hypercalcaemia of malignancy (HCM) is the second most common cause of hypercalcaemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids and calcimimetics, as well as conventional therapy with hydration a...
Article
Full-text available
Background A total of 2.8 million people are living with multiple sclerosis and due to disparities in access to medicines, the ability to treat this condition varies widely. Off-label disease-modifying therapies are sometimes more available or affordable in different health systems. Appropriate methodology is integral in creating high-quality and t...
Article
Full-text available
Background: COVID-19 related critical illness is associated with an increased risk of venous thromboembolism (VTE). Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in decisions about the use of anticoagulation for thromboprophy...
Article
Objectives: To propose a taxonomy and framework that identifies and presents actionable statements in guidelines. Study design and setting: We took an iterative approach reviewing case studies of guidelines produced by the World Health Organization and the American Society of Hematology to develop an initial conceptual framework. We then tested...
Article
Full-text available
Objectives: Guidelines that include antimicrobial recommendations should explicitly consider contextual factors that influence antimicrobial resistance and their downstream effects on resistance selection. The objectives were to analyse (1) how, and to what extent, tuberculosis, gonorrhoea and respiratory tract infection guidelines are considering...
Article
Full-text available
Objective Having up-to-date health policy recommendations accessible in one location is in high demand by guideline users. We developed an easy to navigate interactive approach to organize recommendations and applied it to tuberculosis (TB) guidelines of the World Health Organization (WHO). Study Design We used a mixed-methods study design to deve...
Article
Full-text available
Background In 2017, the European Commission’s Joint Research Centre (JRC) started developing a methodological framework for a guideline-based quality assurance (QA) scheme to improve cancer quality of care. During the first phase of the work, inconsistency emerged about the use of terminology for the definition, the conceptual underpinnings and the...
Article
Full-text available
Background Although quality indicators are frequently derived from guidelines, there is a substantial gap in collaboration between the corresponding parties. To optimise workflow, guideline recommendations and quality assurance should be aligned methodologically and practically. Learning from the European Commission Initiative on Breast Cancer (ECI...
Article
Background Coronavirus disease 2019 (COVID-19)–related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE). Objective These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of a...
Article
Full-text available
The rapidly unfolding Coronavirus Disease of 2019 (COVID-19) pandemic and an ever-increasing volume of relevant literature presents considerable strain for decision makers. Those decision makers are interested in information not only about benefits and harms of interventions but also contextual information such as people’s values and preferences, c...
Article
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Background Our objective was to determine the impacts of artificial intelligence (AI) on public health practice. Methods We used a fundamental qualitative descriptive study design, enrolling 15 experts in public health and AI from June 2018 until July 2019 who worked in North America and Asia. We conducted in-depth semi-structured interviews, iter...
Article
Background and Objective Guideline development groups or other health care decision makers frequently encounter situations that require a simultaneous comparison of multiple interventions. This sometimes becomes apparent either when they identify questions of interest, before they formulate recommendations, or it may surface only when recommendatio...
Article
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Objective To determine how machine learning has been applied to prediction applications in population health contexts. Specifically, to describe which outcomes have been studied, the data sources most widely used and whether reporting of machine learning predictive models aligns with established reporting guidelines. Design A scoping review. Data...
Article
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Objective: To propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 weeks) in the clinical, public health, and health systems fields. Study design and setting: We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the GRADE Rapi...
Article
Full-text available
Background: Health guidelines are a key knowledge translation tool produced and utilized by numerous stakeholders worldwide. Effective participation in guideline panels or development groups is crucial for guideline success, yet little guidance exists for members of these groups. In this study, we present the Guideline Participant Tool (GPT) to su...
Article
Full-text available
Background: Guidelines and quality indicators (for example as part of a quality assurance scheme) aim to improve health care delivery and health outcomes. Ideally, the development of quality indicators should be grounded in evidence-based, trustworthy guideline recommendations. However, anecdotally, guidelines and quality assurance schemes are dev...
Article
Full-text available
Background The Master of Public Health (MPH) is a common graduate-level professional degree that is offered by Canadian Universities. To date, few studies have examined competency-based MPH education in Canada. Objective To examine the degree to which MPH programs' course descriptions align with the Public Health Agency of Canada's (PHAC) core com...
Preprint
Full-text available
Background Hypercalcemia of malignancy is the second most common cause of hypercalcemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids, and calcimimetics, as well as conventional therapy with hydration and possibly...
Preprint
Full-text available
Background: Hypercalcemia of malignancy is the second most common cause of hypercalcemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids, and calcimimetics, as well as conventional therapy with hydration and possibl...
Article
Objective To evaluate how and to what extent health equity considerations are assessed in WHO guidelines. Study design and Setting We evaluated WHO guidelines published between January 2014 and May 2019. Health equity considerations were assessed in relation to differences in baseline risk, importance of outcomes for socially disadvantaged populat...
Article
Full-text available
Background: During healthcare guideline development, panel members often have implicit, different definitions of health outcomes that can lead to misunderstandings about how important these outcomes are and how to balance benefits and harms. McMaster GRADE Centre researchers developed 'health outcome descriptors' for standardizing descriptions of...
Article
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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review...
Article
Background Simulations aim to supplement historic teacher-centric methods by facilitating experiential, self-guided learning and the application of students’ knowledge in a controlled environment. The objective of our study is to describe the methodology of developing and facilitating simulations, and to assess their effectiveness as an educational...
Article
Full-text available
Background: Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19). Purpose: To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19. (PROSPERO registration: CRD42020178187). Data sources: 21 standar...
Article
Full-text available
Introduction Proper strategies to minimise the risk of infection in individuals handling the bodies of deceased persons infected with 2019 novel coronavirus (2019-nCoV) are urgently needed. The objective of this study was to systematically review the literature to scope and assess the effects of specific strategies for the management of the bodies....
Article
Full-text available
Objective: To examine the degree to which Master of Public Health (MPH) programs' course descriptions align with the Public Health Agency of Canada's (PHAC's) core competency categories in order to identify strengths and training gaps in such programs across Canada. Methods: A content analysis of MPH programs in Canada was conducted from July 20...
Article
Full-text available
KEY POINTS • Clinical assessment and care of homeless and vulnerably housed populations should include tailoring approaches to a person’s gender, age, Indigenous heritage, ethnicity and history of trauma; and advocacy for comprehensive primary health care. • As initial steps in the care of homeless and vulnerably housed populations, permanent suppo...
Article
Objective: The GRADE system for assessing certainty in a body of evidence currently uses two-levels, serious and very serious, for downgrading on a single domain. In the context of newer risk of bias instruments, such as ROBINS-I, evidence generated by non-randomised studies may justify rating down by more than 2 levels on a single domain. Given t...
Book
In this edited collection, academics, heath care professionals, and policy-makers examine the historical, political, and social factors that influence the health and health care of Indigenous, inner-city, and migrant populations in Canada. This crucial text broadens traditional determinants of health—social, economic, environmental, and behavioural...
Article
Objectives: Bullying and violence are common experiences and pose significant lifelong burdens of disease for youth. This study identifies upstream determinants of youth violence and examines the shared characteristics of victims and perpetrators. Methods: Multivariable multinomial logistic regression modeling analyzed a subsample of 5403 studen...
Article
Full-text available
Background There is increasing interest in distributed medical campuses and engagement of physicians in these communities. To date, there has been suboptimal recruitment of physicians to participate in medical education at distributed campuses. The purpose of this project was to identify barriers to engagement in medical education by community phys...
Conference Paper
Full-text available
Article
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We report on a novel approach to the analysis of suspended particulate data in a rural setting in southern Ontario. Analyses of suspended particulate matter and associated air quality standards have conventionally focussed on 24-hour mean levels of total suspended particulates (TSP) and particulate matter <10 microns, <2.5 microns and <1 micron in...
Article
Full-text available
Alcohol abuse is attributed to four percent of the global burden of disease and associated with over 60 medical conditions. This burden is borne disproportionately by the indigenous peoples of our world. Two such indigenous populations, albeit far from one another, who are suffering from alcohol abuse are the San in Botswana and the First Nations i...
Conference Paper
Full-text available
Alcohol abuse is attributed to four percent of the global burden of disease and associated with over 60 medical conditions. This burden is borne disproportionately by the indigenous peoples of our world. Two such indigenous populations, albeit far from one another, who are suffering from alcohol abuse are the San in Botswana and the First Nations i...

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