As reported by Hope S. Rugo, MD, and John W. Park, MD, both of the University of California, San Francisco, and colleagues in The New England Journal of Medicine, the multiarm adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of neratinib to standard neoadjuvant therapy have met criteria predictive of success in a phase III trial of the same comparators in early breast cancer patients with specific biomarker signatures.1,2. I-SPY 2 Details. In the I-SPY 2 trial, multi-arm adaptive randomization is being used to evaluate the effectiveness of multiple new agents added to standard neoadjuvant chemotherapy in producing pathologic complete response in high-risk stage II to III breast cancer based on biomarker subtypes. The aim of the multi-arm adaptive randomization scheme is to more rapidly and accurately identify experimental regimens with a higher likelihood of success in phase II trials that can include smaller numbers of ...
Although the effects of physical fitness training on death, dependence, and disability after stroke are unclear, there is sufficient evidence to incorporate cardiorespiratory training that involves walking within poststroke rehabilitation programs to improve speed, tolerance, and independence during walking, say authors of a meta-analysis published in November in the Cochrane Database of Systematic Reviews. The authors searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, SPORTDiscus, and 5 additional databases. They also searched ongoing trials registers, handsearched relevant journals and conference proceedings, screened reference lists, and contacted experts in the field.. Selection criteria included randomized trials comparing either cardiorespiratory training or resistance training, or both, with no intervention, a nonexercise intervention, or usual care in stroke survivors. Two review authors independently selected ...
Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trials (RCT) assessing G-CSF in patients with hyperacute, acute, subacute or chronic stroke, and asked Investigators to share individual patient data on baseline characteristics, stroke severity and type, end-of trial modified Rankin Scale (mRS), Barthel Index, haematological parameters, serious adverse events and death. Multiple variable analyses were adjusted for age, sex, baseline severity and time-to-treatment. Individual patient data were obtained for 6 of 10 RCTs comprising 196 stroke patients (116 G-CSF, 80 placebo), mean age 67.1 (SD 12.9), 92% ischaemic, median NIHSS 10 (IQR 5-15), randomised 11 days (interquartile range IQR 4-238) post ictus; data from three commercial trials were not shared. ...
Objectives: To assess the accuracy in diagnosing heart failure of clinical features and potential primary care investigations, and to perform a decision analysis to test the impact of plausible diagnostic strategies on costs and diagnostic yield in the UK health-care setting. Data sources: MEDLINE and CINAHL were searched from inception to 7 July 2006. Grey literature databases and conference proceedings were searched and authors of relevant studies contacted for data that could not be extracted from the published papers. Review methods: A systematic review of the clinical evidence was carried out according to standard methods. Individual patient data (IPD) analysis was performed on nine studies, and a logistic regression model to predict heart failure was developed on one of the data sets and validated on the other data sets. Cost-effectiveness modelling was based on a decision tree that compared different plausible investigation strategies. Results: Dyspnoea was the only symptom or sign with high
BACKGROUND: Randomized trials without reported adequate allocation concealment have been shown to overestimate the benefit of experimental interventions. We investigated the robustness of conclusions drawn from meta-analyses to exclusion of such trials. MATERIAL: Random sample of 38 reviews from The Cochrane Library 2003, issue 2 and 32 other reviews from PubMed accessed in 2002. Eligible reviews presented a binary effect estimate from a meta-analysis of randomized controlled trials as the first statistically significant result that supported a conclusion in favour of one of the interventions. METHODS: We assessed the methods sections of the trials in each included meta-analysis for adequacy of allocation concealment. We replicated each meta-analysis using the authors methods but included only trials that had adequate allocation concealment. Conclusions were defined as not supported if our result was not statistically significant. RESULTS: Thirty-four of the 70 meta-analyses contained a mixture of
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Our present results are similar to the latest Cochrane review by Cooney et al, 24 who found a moderate effect of exercise on depressive symptoms (−0.62 SMD) when including all trials and no effect when restricting the analysis to trials with less risk of bias (−0.18 SMD). The Cochrane review did find evidence of a small antidepressant effect beyond the intervention, which we could not confirm in our present systematic review. Bridle et al 13 included nine trials allocating old (,60 years) participants with depression to exercise interventions versus control interventions. Restricting the analysis to four trials at lower risk of bias they found small-to-moderate effect estimates (SMD −0.34) in favour of exercise. The studies by Cooney et al 24 and Bridle et al 13 both included trials allocating participants with depressive symptoms and not necessarily diagnosed using a validated diagnostic system, potentially explaining the differences in the effect sizes. However, in our present systematic ...
The role of N-acetylcysteine (NAC) in the treatment of chronic bronchitis is unclear. Since a number of studies have been published on this topic, a systematic review of published studies seems justified. A systematic search (Medline, Embase, Cochrane Library, bibliographies, no language restriction) for published randomized trials comparing oral NAC with placebo in patients with chronic bronchitis was performed. Dichotomous data on prevention of exacerbation, improvement of symptoms and adverse effects were extracted from original reports. The relative benefit and number-needed-to-treat were calculated for both individual trials and combined data. Thirty-nine trials were retrieved; eleven (2,011 analysed patients), published 1976-1994, were regarded as relevant and valid according to preset criteria. In nine studies, 351 of 723 (48.5%) patients receiving NAC had no exacerbation compared with 229 of 733 (31.2%) patients receiving placebo (relative benefit 1.56 (95% confidence interval (CI) ...
Many key RCT methods were not used or not reported. Adequate allocation concealment, adequate double-blinding, and intention-to-treat analysis were reported in only 50% of the trials. These findings suggest that there is much room for improvement in respiratory RCTs. However, improvement was found in the COPD RCTs, in which there was adequate allocation sequence generation, adequate allocation concealment, and intention-to-treat analysis in 27.0%, 11.6%, and 21.8%, respectively.8 Registered trials, trials cited ≥ 10 times, trials in journals with impact factor ≥ 5, and trials in the general medical journals were more likely to be of adequate methodological quality.. Important aspects of RCT methodology, such as randomization methods, allocation concealment, blinding, and sample-size calculation, are commonly inadequate in RCTs.12 That was the reason we conducted the analysis: to find the related facts on these methodological items. We decided to include trials published in leading journals ...
BACKGROUND: Insomnia is a widespread complaint in the general population. Wendan decoction has been widely applied in the treatment of primary insomnia. However, to our knowledge, there has been no systematic review or meta-analysis of randomized controlled trails regarding the effectiveness of this treatment. Here, we provide a protocol to evaluate the efficacy and safety of Wendan decoction for primary insomnia. METHODS AND ANALYSIS: Relevant randomized controlled trials in 5 English databases [EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane Library), PubMed, the Allied and Complementary Medicine Databases (AMED), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)], 4 Chinese databases [Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), and Wanfang Database] will be comprehensively searched by 2 researchers in October 2017 ...
OBJECTIVES: To survey the frequency of use of indirect comparisons in systematic reviews and evaluate the methods used in their analysis and interpretation. Also to identify alternative statistical approaches for the analysis of indirect comparisons, to assess the properties of different statistical methods used for performing indirect comparisons and to compare direct and indirect estimates of the same effects within reviews. DATA SOURCES: Electronic databases. REVIEW METHODS: The Database of Abstracts of Reviews of Effects (DARE) was searched for systematic reviews involving meta-analysis of randomised controlled trials (RCTs) that reported both direct and indirect comparisons, or indirect comparisons alone. A systematic review of MEDLINE and other databases was carried out to identify published methods for analysing indirect comparisons. Study designs were created using data from the International Stroke Trial. Random samples of patients receiving aspirin, heparin or placebo in 16 centres were used
Publication bias has long been associated with funnel plot asymmetry.10 Among published studies, however, the probability of identifying relevant trials for meta-analysis is also influenced by their results. English language bias-the preferential publication of "negative" findings in journals published in languages other than English-makes the location and inclusion of such studies less likely.8 As a consequence of citation bias, "negative" studies are quoted less frequently and are therefore more likely to be missed in the search for relevant trials.7 36 Results of "positive" trials are sometimes reported more than once, increasing the probability that they will be located for meta-analysis (multiple publication bias).37 These biases are likely to affect smaller studies to a greater degree than large trials.. Another source of asymmetry arises from differences in methodological quality. Smaller studies are, on average, conducted and analysed with less methodological rigour than larger studies. ...
This study is designed to provide clear evidence for health and social policymakers about the influence of alternate service-delivery models and practices on enhancing and sustaining low-income family linkages to available services. A challenge faced by Canadian health and social service providers is to promote health for low-income families in a proactive and cost-effective manner. Families with low incomes experience an array of health and social barriers that compromise their resilience, lead to negative family outcomes, and act as barriers to available services. Family barriers are compounded by service delivery barriers and result in reduced opportunities for effective, primary-level services and in increased use of secondary-level services (e.g., emergency room visits, emergency intervention, police involvement), with the obvious increase in costs. Randomized-controlled trials are rare in community-based intervention research.. This Families First Edmonton randomized-controlled trial (RCT) ...
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We pooled treatment effects of LIPUS on similar outcomes across eligible trials, regardless of clinical subgroups, focusing on complete case analysis. We calculated pooled estimates and associated 95% confidence intervals using random effects models for meta-analysis with three or more studies and fixed effects models for meta-analysis with two studies. We examined heterogeneity associated with all pooled analyses using both the χ2 test and I2 statistic. SAS version 9.4, R version 3.1, and Review Manager 5.3 provided software for the statistical analysis.. For time to event outcomes, we pooled hazard ratios. For studies that did not apply methods of survival analysis, we considered time to event reported as a continuous variable (for example, days to return to work) at the longest follow-up time. We used the relative effect measure ratio of means (mean LIPUS/mean control) to account for the baseline difference in fracture healing depending on type of bone and (such as scaphoid, clavicle, tibia, ...
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patients with established coronary artery disease and type-2 diabetes. Brilinta reduced cardiovascular events in patients with no prior heart attack or stroke. The Phase III THEMIS trial met its primary endpoint and demonstrated that Brilinta (ticagrelor), taken in conjunction with aspirin, showed a statistically-significant reduction in a composite of major adverse cardiovascular events (MACE) compared to aspirin alone.. THEMIS was conducted in over 19,000 patients with coronary artery disease (CAD) and type-2 diabetes (T2D) with no prior heart attack (myocardial infarction, MI) or stroke. Preliminary safety results were consistent with the known profile of Brilinta. A full evaluation of the THEMIS data will be presented at a forthcoming medical meeting.. Elisabeth Björk, Senior Vice President, Head of late Cardiovascular, Renal and Metabolism, R&D BioPharmaceuticals, said: "Approaches to help reduce cardiovascular morbidity further in patients with coronary artery disease and type-2 diabetes ...
Rivaroxaban and risk of myocardial infarction: insights from a meta-analysis and trial sequential analysis of randomized clinical trials.
be set to play too loudly. Should all be banned as potentially dangerous? Every practitioner is aware of his/her responsibility to make sure that the device is played at an appropriate level. Basing conclusions on a single, very probably atypical case, is a poor practice-the authors conclusions are not justified.. A good deal of what has been written about AIT is excessively skeptical, negative or derogatory, permeated with the assumption that AIT is ineffective. Our review of all the research on the efficacy of AIT that we have been able to find refutes this negative view.. Probably because AIT lacks a plausible rationale and is counter-intuitive, it has become the target of skepticism and of negatively biased research. Ones opinion about an intervention, like ones opinion about an individual, should be based on evidence rather than prejudice. The present authors were themselves skeptical when first learning about AIT. Their interest was stimulated, despite their initial skepticism, by a ...
Multilevel network meta-regression for population adjustment based on individual and aggregate level data. Abstract: Standard network meta-analysis (NMA) and indirect comparisons combine aggregate data (AgD) from multiple studies on treatments of interest, assuming that any effect modifiers are balanced across populations. We can relax this assumption if individual patient data (IPD) are available from all studies by fitting an IPD meta-regression. However, in many cases IPD are only available from a subset of studies. In the simplest scenario, IPD are available for an AB study but only AgD for an AC study. Methods such as Matching Adjusted Indirect Comparison (MAIC) create a population-adjusted indirect comparison between treatments B and C. However, the resulting comparison is only valid in the AC population without additional assumptions, and the methods cannot be extended to larger treatment networks. Meta-regression-based approaches can be used in larger networks. However, these typically ...
This new Cochrane review looked at school-based interventions aimed at changing behaviour related to toothbrushing habits and the frequency of consumption of cariogenic food and drink in children between the ages of 4 and 12 years. The Cochrane Oral Health Groups Trials Register, and Cochrane Central Register of Controlled Trials (CENTRAL) ,Medline, Embase, CINAHL, PsycINFO, [read the full story…]. ...
Treatment comparisons without head-to-head trials are frequently formed using indirect comparisons across multiple trials, making the assumption that any effect modifiers are balanced between trials. Recently proposed methods which relax this assumption, including Matching-Adjusted Indirect Comparison (MAIC) and Simulated Treatment Comparison (STC), are becoming increasingly common in industry-sponsored treatment comparisons, where a company has individual patient data (IPD) from its own trials but only aggregate data from competitor trials. These methods aim to adjust for between-trial differences to form population-adjusted indirect comparisons, and may even be used for comparisons involving single arm studies or disconnected networks. However, additional assumptions and complexities are introduced which must be carefully considered. Since the premise of population adjustment methods is that relative treatment effects can differ between populations, a core component of population adjustment in ...
In this course, students will learn about common types of miscommunication and misunderstandings associated with visual representation of data and about best practices for data visualization. Through a series of case studies, students will critically evaluate relevant data, the format of its presentation, and the impact the method of presentation has on the reader. Specifically, through critical analysis of the format of the graphs, figures, and tables students will determine whether the chosen methods enable straightforward, independent analysis or push the reader to accept the authors conclusions. Students will reformat the presentation of the data to determine whether other representations would reveal / support different conclusions. In a final project, students will use and build up on previous knowledge to analyze data to related to a global, national, or policy decision. [STSC ...
This study describes the implementation of minimal sufficient balance randomization, a covariate adaptive randomization strategy, in the ESCAPE trial. Our results demonstrate that overall group balance was achieved in dynamically allocating subjects to treatment arms in the ESCAPE trial both at the time of the interim analysis and at the time that the trial was stopped. This suggests that this covariate adaptive randomization strategy can assist data and safety monitoring boards to make reliable decisions about futility or efficacy in a randomized controlled trial.. Similar to all adaptive trial design approaches, the integrity of this approach relies upon the immediate availability and accuracy of data used, and, in this case, data on the covariates used to implement the randomized minimization approach. Because of the nature of stroke treatment, fast treatment decisions are necessarily taken without certainty on all preclinical data. For example, a patients age might be determined just upon ...
TY - JOUR. T1 - Revisión de las infusiones continuas y prolongadas de antibióticos betalactámicos en la población pediátrica. AU - Walker, Mary Covington. AU - Lam, Weng Man. AU - Manasco, Kalen B.. PY - 2012/11/1. Y1 - 2012/11/1. N2 - OBJECTIVE: To conduct a systematic review of available data on the use of extended or continuous infusion of b-lactam and monobactam therapy in the pediatric population (aged 0-18 years). DATA SOURCES: A literature search was performed using PubMed (1975-May 2012), International Pharmaceutical Abstracts (1970-May 2012), and Web of Science (1977-May 2012) to identify studies for inclusion. In addition, reference citations from identified publications were reviewed. The following search terms were used: pediatric, children, neonate, infant, adolescent, b-lactam, cephalosporin, carbapenem, penicillin, monobactam, continuous infusion, extended infusion, and/or prolonged infusion. Individual names of drugs in each class of antibiotics were also included in the ...
Basis for Current Recommendations Scheduled cesarean delivery, defined as cesarean delivery performed before the onset of labor and before rupture of membranes, is recommended for prevention of perinatal transmission of HIV in women with HIV RNA levels ,1,000 copies/mL near delivery and for women with unknown HIV RNA levels. This recommendation is based on findings from a multicenter, randomized clinical trial1 and from a large individual patient data meta-analysis.2 These two studies were conducted at a time when the majority of women with HIV received no antiretroviral (ARV) drugs or zidovudine as a single drug and before the availability of viral load information. Study results have since been extrapolated to make current recommendations about the mode of delivery in an era when antiretroviral therapy (ART) during pregnancy is recommended and viral load information is readily available.. HIV RNA Level of ,1000 copies/mL as a Threshold for Recommendation of Scheduled Cesarean Delivery The ...
Background: Gene-diet interactions have been reported to contribute to the development of type 2 diabetes (T2D). However, to our knowledge, few examples have been consistently replicated to date.Objective: We aimed to identify existing evidence for gene-macronutrient interactions and T2D and to examine the reported interactions in a large-scale study.Design: We systematically reviewed studies reporting gene-macronutrient interactions and T2D. We searched the MEDLINE, Human Genome Epidemiology Network, and WHO International Clinical Trials Registry Platform electronic databases to identify studies published up to October 2015. Eligibility criteria included assessment of macronutrient quantity (e.g., total carbohydrate) or indicators of quality (e.g., dietary fiber) by use of self-report or objective biomarkers of intake. Interactions identified in the review were subsequently examined in the EPIC (European Prospective Investigation into Cancer)-InterAct case-cohort study (n = 21,148, with 9403 ...
Background: Gene-diet interactions have been reported to contribute to the development of type 2 diabetes (T2D). However, to our knowledge, few examples have been consistently replicated to date.Objective: We aimed to identify existing evidence for gene-macronutrient interactions and T2D and to examine the reported interactions in a large-scale study.Design: We systematically reviewed studies reporting gene-macronutrient interactions and T2D. We searched the MEDLINE, Human Genome Epidemiology Network, and WHO International Clinical Trials Registry Platform electronic databases to identify studies published up to October 2015. Eligibility criteria included assessment of macronutrient quantity (e.g., total carbohydrate) or indicators of quality (e.g., dietary fiber) by use of self-report or objective biomarkers of intake. Interactions identified in the review were subsequently examined in the EPIC (European Prospective Investigation into Cancer)-InterAct case-cohort study (n = 21,148, with 9403 ...
Methods We developed a dynamic, mathematical model of IL-6 signaling within a target compartment, with initial steady state IL-6, soluble (s) IL-6R, and sgp130 concentrations. The model encompassed IL-6 interaction with membrane-bound IL-6R (cis) or with both membrane-bound and sIL-6R (cis and trans signaling), including the impact of inhibiting membrane-bound and sgp130 by different targeted strategies. The validity of the model was confirmed by comparison to published PK/PD data for TCZ.3 Four prototypical intervention strategies were modeled: anti-IL-6R, axis 1; anti-IL-6, axis 1; anti-IL-6, axis 2; and anti-IL-6, axis 3. Simulations compared the sensitivity of drug responses to parameter variations at multiple clinically relevant IL-6, sIL-6R, and sgp130 concentration scenarios. All simulated parameters for interactions and responses were based on a one-compartment linear PK model.. ...
Confidence interval(CI): quantifies the uncertainty in measurement; usually reported as 95% CI, which is the range of values within which we can be 95% sure that the true value for the whole population lies.. Equivalence trial1: a trial designed to determine if a new intervention that is less costly, less toxic, or easier to administer than the current standard of care is equally effective.. Factorial design2: a design where 2 independent variables are simultaneously manipulated; permits analysis of the main effects of the independent variables separately plus the interaction of these variables.. Fixed effects model3: gives a summary estimate of the magnitude of effect in meta-analysis. It takes into account within-study variation but not between-study variation and hence is usually not used if there is significant heterogeneity.. Hazard ratio1: the weighted relative risk over the entire study period; often reported in the context of survival analysis.. Intention to treat analysis(ITT): all ...
Confidence interval(CI): quantifies the uncertainty in measurement; usually reported as 95% CI, which is the range of values within which we can be 95% sure that the true value for the whole population lies.. Equivalence trial1: a trial designed to determine if a new intervention that is less costly, less toxic, or easier to administer than the current standard of care is equally effective.. Factorial design2: a design where 2 independent variables are simultaneously manipulated; permits analysis of the main effects of the independent variables separately plus the interaction of these variables.. Fixed effects model3: gives a summary estimate of the magnitude of effect in meta-analysis. It takes into account within-study variation but not between-study variation and hence is usually not used if there is significant heterogeneity.. Hazard ratio1: the weighted relative risk over the entire study period; often reported in the context of survival analysis.. Intention to treat analysis(ITT): all ...
The World Health Organization, through its International Clinical Trials Registry Platform, has developed the ICTRP database to provide patients, family members and members of the public current information about clinical research studies. The ICTRP database contains information about clinical trials being conducted throughout the world. This data is provided to the ICTRP by registries conforming to WHO standards. ICTRP is updated weekly. Trial data posted on this search portal are not endorsed by WHO, but are provided as a service to our users. In no event shall the World Health Organization be liable for any damages arising from the use of the data in the ICTRP database. None of the information obtained through use of the search portal should in any way be used in clinical care without consulting a physician or licensed health professional. WHO is not responsible for the accuracy, completeness and/or use made of the content displayed for any trial record ...
The World Health Organization, through its International Clinical Trials Registry Platform, has developed the ICTRP database to provide patients, family members and members of the public current information about clinical research studies. The ICTRP database contains information about clinical trials being conducted throughout the world. This data is provided to the ICTRP by registries conforming to WHO standards. ICTRP is updated weekly. Trial data posted on this search portal are not endorsed by WHO, but are provided as a service to our users. In no event shall the World Health Organization be liable for any damages arising from the use of the data in the ICTRP database. None of the information obtained through use of the search portal should in any way be used in clinical care without consulting a physician or licensed health professional. WHO is not responsible for the accuracy, completeness and/or use made of the content displayed for any trial record ...
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Downloadable (with restrictions)! One learns two main lessons from studying the great quantity of banking efficiency literature. These lessons regard the heterogeneity in results and the absence of a comprehensive review aimed at understanding the reasons for this variability. Surprisingly, although this issue is well-known, it has not been systematically analyzed before. In order to fill this gap, we perform a Meta-Regression-Analysis (MRA) by examining 1661 efficiency scores retrieved from 120 papers published over the period 2000--2014. The meta-regression is estimated by using the Random Effects Multilevel Model (REML) because it controls for within- and between-study heterogeneity. The analysis yields four main results. First, parametric methods yield lower levels of banking efficiency than nonparametric studies. This holds true even after controlling for the approach used in selecting the inputs and outputs of the frontier. Secondly, we show that banking efficiency is highest when using the value
METHODS AND RESULTS: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with ,1000 participants followed for ,1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring ,30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta-analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the ...
BACKGROUND: There is considerable debate as to the relative merits of using randomised controlled trial (RCT) data as opposed to observational data in systematic reviews of adverse effects. This meta-analysis of meta-analyses aimed to assess the level of agreement or disagreement in the estimates of harm derived from meta-analysis of RCTs as compared to meta-analysis of observational studies. METHODS AND FINDINGS: Searches were carried out in ten databases in addition to reference checking, contacting experts, citation searches, and hand-searching key journals, conference proceedings, and Web sites. Studies were included where a pooled relative measure of an adverse effect (odds ratio or risk ratio) from RCTs could be directly compared, using the ratio of odds ratios, with the pooled estimate for the same adverse effect arising from observational studies. Nineteen studies, yielding 58 meta-analyses, were identified for inclusion. The pooled ratio of odds ratios of RCTs compared to observational ...
Background & aim: Prenatal care is a key strategy for achieving public health goals, primary healthcare objectives, and the Millennium Development Goals. The aim of this study was to investigate the factors influencing the use of prenatal care services in order to design suitable interventions and promote the use of these services. Methods:In this systematic quantitative literature review, studies published in years 2010-2014 were evaluated. For this purpose, two international electronic databases, i.e., Scopus and PubMed, were explored to find English-language articles by using relevant keywords; moreover, the reference lists of the articles were hand-searched. We reviewed all cross-sectional and prospective studies, which focused on factors associated with the use of prenatal care services within the specified period of time. Results: In total, 17 relevant articles were included in our review. The results showed that late initiation and inadequate use of prenatal care services are independently
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Results We identified 139 trials. Seven out of ten trials reported reductions in any STI with five statistically significant results. Three out of four trials reported reductions in pregnancy, although none was statistically significant. Only four trials met all the quality criteria. Trials reported a median of 11 (IQR 7-17) outcome measures. Few trials used the same outcome measure. Altogether, 10 trials (7%) used the outcome any STI, 4 (3%) self-reported pregnancy and 22 (16%) used condom use at last sex. ...
Thirty-eight RCTs (mean number of participants 72, range 16 to 258) were included in the review. Eight trials met eight of the 10 quality criteria; results were fully reported in the review. Some trials did not follow participants after the intervention ended; other studies had follow-up in the range one month to four years.. Meta-analysis indicated a statistically significantly larger beneficial effect on weight and body composition for lifestyle compared to no treatment or a wait-list control over two years (SMD -0.97, 95% CI -1.39 to -0.55; Ι²=90%; 19 trials, 23 comparisons, 1,234 participants). There was no evidence of publication bias.. Change in BMI at the end of active treatment showed a statistically significant reduction in the lifestyle intervention group compared with usual care or minimal intervention (SMD -1.30kg/m², 95% CI -1.58 to -1.03; Ι²=75%; seven trials, 586 participants). Four trials that assessed longer follow-up (seven months to one year after programme completion) ...
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If you are considering a systematic review project, you should first consider its purpose. If you are investigating a well defined problem for which there exists several large clinical trials that follow quantitative research methods you will want to write an analytical review to summarise the results of trials and provide cumulative evidence about the efficacy of one specific intervention/treatment/dose. If you are investigating a less well understood problem for which there are few trials and/or you are reviewing observational data/qualitative research you will want to write a narrative review.. Having decided what type of literature review you wish to carry out, the next decision to think about is what is best way to present the information to your audience. For a small audience such as journal club, grand rounds, or a conference proceedings, an analytical review can be summarised in a short review format such as: Cairns, J. (2012). ACP Journal Club. Review: Dabigatran increases MI and ...
Studies were identified by searching MEDLINE (1980 to 1998), Psychological Abstracts, ERIC, and Healthstar databases and The Journal of Family Practice Web site with the terms physical activity, physical activity counseling, primary care, medical office, exercise interventions, and health promotion. Bibliographies of relevant studies and previous reviews were scanned, and 3 experts in the field were contacted to identify unpublished studies ...
TY - JOUR. T1 - Impact of Structured Pathways for Postcardiac Arrest Care. T2 - A Systematic Review and Meta-Analysis. AU - Storm, Christian. AU - Leithner, Christoph. AU - Krannich, Alexander. AU - Suarez, Jose I.. AU - Stevens, Robert D.. PY - 2019/8/1. Y1 - 2019/8/1. N2 - Objectives: Recent research has demonstrated value in selected therapeutic and prognostic interventions delivered to patients following cardiac arrest. The aim of this work was to determine if the implementation of a structured care pathway, which combines different interventions, could improve outcomes in survivors of cardiac arrest. Data Sources: PubMed and review of citations in retrieved articles. Study Selection: Randomized trials and prospective observational studies conducted in adult cardiac arrest patients, which evaluated the impact on outcome of a structured care pathway, defined as an organized set of interventions designed specifically for postcardiac arrest patients. Data Extraction: Data collected included ...
TY - JOUR. T1 - Interpretation of dichotomous outcomes. T2 - Journal of Physiotherapy. AU - Kent, Peter. AU - Hancock, Mark J.. N1 - Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.. PY - 2016/10/1. Y1 - 2016/10/1. UR - http://www.scopus.com/inward/record.url?scp=84992316719&partnerID=8YFLogxK. U2 - 10.1016/j.jphys.2016.08.008. DO - 10.1016/j.jphys.2016.08.008. M3 - Comment/opinion. VL - 62. SP - 231. EP - 233. JO - Journal of Physiotherapy. JF - Journal of Physiotherapy. SN - 1836-9553. IS - 4. ER - ...
The two studies reported were an observational study and an under-powered randomized-controlled trial. An accompanying editorial bemoans the lack of evidence in this important clinical area and looks at tools like the Swedish registry-based randomization system for future innovation ...
OBJECTIVE: : The aim of this study was to systematically review the applicability (attendance, achieved intensity, adverse events) and effects of physical exercise on physical functions, cognitive functions, and activities of daily living among people with dementia.. DESIGN: : Randomized controlled trials were identified in PubMed, the Cumulative Index to Nursing and Allied Health, the Allied and Complementary Medicine Database, and the Cochrane Library on August 30 and September 1, 2010, according to predefined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodologic quality.. RESULTS: : A qualitative analysis was performed, including ten studies. Most participants were people with Alzheimer disease in residential care facilities. Four studies reached "moderate" methodologic quality, and six reached "low." The studies of moderate quality evaluated the effects of combined functional weight-bearing exercise, combined functional and nonfunctional ...
Outline of Randomization Lectures 1. Background and definitions 2. Generation of schedules 3. Implementation (to ensure allocation concealment, sometimes called blinded randomization) 4. Theory behind randomization Readings • Chapter 6 of Friedman, Furberg and DeMets • Supplemental notes for week 3 on the class web site • Other papers are cited in the notes Key Points • A random process should be used to generate treatment allocations or assignments • Treatment allocations should be concealed until the time of randomization - "allocation concealment" is critical to prevent selection bias. Some refer to this as "blinded randomization". (It should not be confused with blinding of treatments). Randomization Assignment of experimental units to treatment by a random process such that neither investigator nor patient knows the treatment to be assigned at the time the patient is registered. Timing of Randomized Trials Considerations • 1st patient (Chalmers) • Strong degree of equipoise ...
BACKGROUND: Tramadol is an opioid analgesic licensed for use in moderate to severe pain. It is considered as a low risk for abuse, so control regulations are not as stringent as for strong opioids such as morphine. It has a potential role as a step 2 option of the World Health Organization (WHO) analgesic ladder. OBJECTIVES: To assess the benefits and adverse effects of tramadol with or without paracetamol (acetaminophen) for cancer-related pain. SEARCH METHODS: We searched the following databases using a wide range of search terms: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS ...
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In 2006 B. de Bruin published four articles and published three other resultss. In 2007 B. de Bruin published five articles and published one chapter. In 2008 B. de Bruin published six articles, gave three lectures and recieved one award. In 2009 B. de Bruin published ten articles, gave eight lectures and had one journal editorship. In 2010 B. de Bruin published eightteen articles and published one conference proceedings. In 2011 B. de Bruin published sixteen articles, gave four lectures, published one chapter and published one patent . In 2012 B. de Bruin published fourteen articles and published one report. In 2013 B. de Bruin published twenty articles, gave six lectures and recieved one award. In 2014 B. de Bruin published fifteen articles, gave seven lectures, published one conference proceedings and published one other results. In 2015 B. de Bruin published twenty-nine articles, gave eleven lectures and published one chapter. ...
Kelly R. James, Amy N. Adams, Kelli M. Crisp, Brian B. Franklin, Heather J. Heefner, Andreas Kreutzer, Diego X. Montalvo, Marcel G. Turner, Melody D. Phillips, and Joel B. Mitchell. ...
I dont think that we even need this class. Tutoring is really intuitive and the class is pointless." These were the words of a student whose poor performance in our tutor training course meant that she was not invited ...
Perry, N. H., Marrocchelli, D., Bishop, S. R. & Tuller, H. L., 1 1 2016, Mechano-Electro-Chemical Coupling in Energy Related Materials and Devices 2. Bishop, S. R., Mukherjee, P., Rupp, J. & Cheng, Y-T. (版). 24 版 Electrochemical Society Inc., p. 1-8 8 p. (ECS Transactions; 巻数 72, 番号 24).. 研究成果: Chapter in Book/Report/Conference proceeding › Conference contribution ...
The main goal of e-commerce is to improve the usability of website, which nowadays brings a competitive advantage. If todays consumers are not satisfied with websites, they leave them. It is so easy to visit the competitor´s e-shop, it is only one click away. This study is an investigation of the role of emotional arousal (anxiety-like emotion) and engagement when completing online purchasing related tasks. We have chosen one of the most popular e-shops in the world - Amazon [1]. Amazon was a role model for e-commerce design for many years. [2] Nielsen said: "In 2001, we evaluated the usability of 20 e-commerce sites and Amazon was the clear winner, scoring 65% higher than the average of the other 19 sites. Having the Webs best usability served Amazon well: sales increased by 126% from 2001 to 2004". This website was tested, evaluated and then redesigned many times. [3] Despite the fact that many tests were done, we would like to verify the impact to users. There is the potential to find out ...
Quantification of brain function, Tracer kinetics and image analysis in brain PET}, K Uemura and others, editor. Elsevier, ., pp. 409-17, 1993 ...
Research groupsGene regulation and morphogenesis Genetic and molecular mechanisms regulating cell migration and invasion Dr Maria Dolores ..
Results of two phase III trials with dexamethasone intracanalicular depot are highlighted. Both trials met the endpoints for postsurgical pain, but only one trial met the endpoints for postoperative inflammation
Doi and Thalib at first introduced the standard results design.[fifty four] They[fifty five] introduced a whole new method of adjustment for inter-study variability by incorporating the contribution of variance on account of a suitable ingredient (high-quality) In combination with the contribution of variance as a result of random error that is certainly Employed in any fixed outcomes meta-analysis product to crank out weights for every study. The power of the standard effects meta-analysis is usually that it allows readily available methodological proof for use around subjective random consequences, and therefore helps to shut the detrimental gap which has opened up involving methodology and data in medical investigation. To do that a artificial bias variance is computed depending on high-quality details to adjust inverse variance weights and the quality modified bodyweight on the ith study is launched.[54] These adjusted weights are then Employed in meta-analysis ...
Small trial to see if supplements including omega-3, omega-6, vitamin A and vitamin E affected multiple sclerosis - MS Trust research update
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RESEARCH DESIGN AND METHODS We conducted an electronic search on many electronic databases from inception to 27 April 2016. We selected randomized controlled trials and case-control and cohort studies reporting on CVD, all-cause mortality, or hospitalization outcomes by adherence in adults with type 2 diabetes. Two reviewers independently screened for eligible studies and extracted outcome data. Pooled relative risks (RRs) were calculated using a random-effects meta-analysis; risk of bias in each of the included studies was assessed using the GRADE approach. ...
School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.. Mason-Jones AJ, Sinclair D, Mathews C, Kagee A, Hillman A, Lombard C. Cochrane Database Syst Rev. 2016 Nov 8;11:CD006417.. Background: School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs).. Objectives: To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents.. Search methods: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov ...
Diet is an important factor in the causation of cancer. Previous systematic reviews of one-to-one interventions to encourage dietary change have found that such interventions can achieve modest improvements in diet. However, such interventions are resource intensive and unlikely to be good value for money at a population level. Interventions that address groups, communities or whole populations may be less resource intensive and effect change in a wider population. We report a systematic review of such interventions. We set wide inclusion criteria, including before-and-after studies and studies with a non-randomized comparison group as well as randomized trials. We found eighteen studies based in the community, seventeen based on worksites, five based in churches and one based in a supermarket. Interventions which targeted fruit and vegetable intake were most likely to be successful, particularly in worksites and churches. There was also evidence of small positive effects on reducing fat intake ...
Objective. - To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects. Design. - An observational study in which we assessed the methodological quality of 250 controlled trials from 33 meta-analyses and then analyzed, using multiple logistic...
John Eikelboom, MD, of McMaster University discusses the 3 arms of the COMPASS trial and explains the need for it to end earlier than anticipated.
De Bibliotheek van het Instituut voor Tropische Geneeskunde te Antwerpen, een van de belangrijkste instellingen ter wereld voor onderwijs, onderzoek en dienstverlening in de tropische geneeskunde en de gezondheidszorg in de ontwikkelingslanden.
Gholizadeh, H., Pozzoli, M., Traini, D., Young, P., Kourmatzis, A., Cheng, S. & Ong, H. X., 2018, Sydney Surfaces And Soft Stuff meeting 2018: program. p. 14 1 p.. Research output: Chapter in Book/Report/Conference proceeding › Conference abstract ...
The Cochrane Library is a collection of high-quality, independent evidence to inform healthcare decision-making. Six databases are available including the Cochrane Database of Systematic Reviews and a register of controlled trials.
Straipsnis konferencijos medžiagoje Clarivate Analytics Web of Science ar/ir Scopus / Article in Clarivate Analytics Web of Science or Scopus DB conference proceedings (P1a) ...
Policymakers, managed care organizations, medical educators, and the general public are showing an increasing interest in the amount and quality of care provided by generalists and subspecialists. This article reviews studies comparing the knowledge base of and quality of care provided by these 2 groups of physicians. English-language articles...
Learning the Structure of Deep Sparse Graphical Models. Adams, RP, Wallach HM, Ghahramani Z. Journal of Machine Learning Research: Workshop and Conference Proceedings (AISTATS). 9:1-8. 2010. { arXiv:1001.0160 [stat.ML] , PDF , Google Scholar , BibTex } Winner of Best Paper Award ...
This abstract is being presented as a short talk in the scientific program. A full abstract is printed in the Proffered Abstracts section (PR06) of the Conference Proceedings.. Citation Format: Theodore Huang, Danielle Braun, Malka Gorfine, Giovanni Parmigiani. Using frailty models to improve familial cancer risk prediction. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection; Nov 16-19, 2016; Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(5 Suppl):Abstract nr A18. ...
Boxall, A. B. A. & Kretsch, C. E., 2015, Connecting Global Priorities: Biodiversity and Human Health : A State of Knowledge Review. Geneva: World Health Organisation (WHO), p. 170-179 9 p.. Research output: Chapter in Book/Report/Conference proceeding › Chapter (peer-reviewed) ...
Abstract The relative benefit of an active treatment over a control is usually expressed as the relative risk, the relative risk reduction, or the odds ratio. These measures are us..
Ariyaeeinia, A. M., 1992, Proceedings of SPIE - The International Society for Optical Engineering. Svetkoff, D. J. (ed.). Publ by Int Soc for Optical Engineering, Vol. 1614. p. 146-158 13 p.. Research output: Chapter in Book/Report/Conference proceeding › Conference contribution ...
The annual ISOPE Conferences have been held with the worlds largest technical program of its kind with peer-reviewed papers averaging 320-510 papers. ISOPE has held the technical program of 148-188 opening and technical sessions with 650-950 peer-reviewed papers from 49-54 countries in the Conference Proceedings ...
Dhrif, H., Kubat, M., Giraldo, L. G. S. & Wuchty, S., Jul 13 2019, GECCO 2019 - Proceedings of the 2019 Genetic and Evolutionary Computation Conference. Association for Computing Machinery, Inc, p. 13-21 9 p. (GECCO 2019 - Proceedings of the 2019 Genetic and Evolutionary Computation Conference).. Research output: Chapter in Book/Report/Conference proceeding › Conference contribution ...
Milligan, T., 2015, (Accepted/In press) The Meaning of Liberty Beyond Earth. Cockell, C. (ed.). Springer, p. 33-45 (Space and Society).. Research output: Chapter in Book/Report/Conference proceeding › Chapter (peer-reviewed) ...
Martin, D., Nettleton, S. J. & Buse, C., Jun 2019, (Accepted/In press) Ways of Home Making in Care for Later Life. Pasveer, B., Synnes, O. & Moser, I. (eds.). Palgrave Macmillan. Research output: Chapter in Book/Report/Conference proceeding › Chapter ...
The annual ISOPE Conferences have been held with the worlds largest technical program of its kind with peer-reviewed papers averaging 320-510 papers. ISOPE has held the technical program of 148-188 opening and technical sessions with 650-950 peer-reviewed papers from 49-54 countries in the Conference Proceedings ...
Here are some of the comments from our feedback survey:. "It was great to be in a religiously inclusive environment, which in my view assisted the discussion.". "Very good discussions. Always find the people I meet at FbRN very stimulating and a good mix of practical and theoretical.". "It was helpful to put my role in a wider context and to make some networking connections.". For more information on conference proceedings and workshops, watch this space!. ...
Please note that these are just notes, and not a formal write-up of the conference proceedings. Therefore there may be personal bias, and there most definitely is personal opinion, and there are also most definitely grammatical errors. For the latter, you have my apologies, as there is only so much time I can devote to…
Graham, A., Borthwick, F. & Taylor, J. M. W., 2014, Cholesterol Transporters of the START Domain Protein Family in Health and Disease. Clark, B. & Stocco, D. (eds.). Springer, p. 99-117 19 p.. Research output: Chapter in Book/Report/Conference proceeding › Chapter (peer-reviewed) ...
pauca sed maturaPublicationsArticles (Conference Proceedings & Book chapters are below)[63] K. Solarana, J. Liu, Z. Bowen, H.-K. Lee, P. O. Kanold,
Esposito, A., Criscitiello, C., Sawyer, D. B. & Curigliano, G., Apr 11 2017, Cardio-Oncology: The Clinical Overlap of Cancer and Heart Disease. Springer International Publishing AG, p. 241-252 12 p.. Research output: Chapter in Book/Report/Conference proceeding › Chapter ...
Cheirsilp, R., Zang, X., Bascom, R., Allen, T., Mahraj, R. & Higgins, W. E., Jan 1 2016, Medical Imaging 2016: Image Processing. Styner, M. A., Angelini, E. D. & Angelini, E. D. (eds.). SPIE, Vol. 9784. 97843Z. Research output: Chapter in Book/Report/Conference proceeding › Conference contribution ...
Amsterdam [u.a.] / Elsevier (2017) [Contribution to a book, Contribution to a conference proceedings]. 27th European Symposium on Computer Aided Process Engineering / Edited by Antonio Espu a, Mois s Graells and Luis ...
HARTLOVÁ, J., LOBOVSKÝ, L., SALÁŠEK, M., KRYSTEK, J., JANSOVÁ, M., VOTÁPEK, P., TUPÝ, R., FERDA, J., PAVELKA, T., KŘEN, J. Experimental study on sacral bone fixation techniques. In 16th Conference on Human Biomechanics 2016 ? Conference proceedings. Kladno: České vysoké učení technické v Praze, 2016. s. 45-46. ISBN: 978-80-01-06039-1 ...
Medboe, H., Bares, W., Webster, E., Frost Fadnes, P., Inglis, C., Kahr, M., …Heyman, M. (2017). Continental Drift: 50 years of jazz from Europe. In Moir, Z. & Atton, C. (Eds.). Continental Drift: 50 years of jazz from Europe - Conference Proceedings, v, vi. ISBN 978-1-78808-706-3. ...
r) adj.: Only ordinary or moderate quality; barely adequate. (ouch). When I heard Joyce Meyer say "Live on Purpose", it really hit me. Many people are really living on accident. They live a mediocre life, hoping their heart keeps beating, and they keep their job, wife, kids, car, house, etc. by just continuing to show up and go through the barely adequate motions necessary to remain.. By choosing to do the minimum, or even the average (what everyone else does), is living in mediocrity - and no one does great things with mediocre effort. The problem is, most people dont really feel that bad about it because they are comparing themselves to everyone else living the same way. Mediocrity IS the average - unfortunately, its the norm. But dont you want to be EXCELLENT? Dont you want to make the most out of your life?. ...
Doi & Barendregt suggest that whilst the RE product supplies an alternate means of pooling the study data, their simulation final results[53] reveal that employing a a lot more specified probability design with untenable assumptions, as with the RE design, would not essentially offer superior effects. The latter study also stories which the IVhet design resolves the issues associated with underestimation of your statistical mistake, inadequate coverage of The boldness interval and enhanced MSE viewed Using the random consequences model as well as the authors conclude that scientists must henceforth abandon use in the random consequences model in meta-analysis. Even though their knowledge is compelling, the ramifications (with regard to the magnitude of spuriously positive final results in the Cochrane databases) are substantial and thus accepting this conclusion calls for careful independent affirmation. The provision of a cost-free software program (MetaXL)[fifty two] that runs the IVhet ...
The MSL Liaison for the College of Nursing, Cathy Pepper, is happy to search for relevant journal articles for your assignments and/or research. Just shoot an email to Cathy: [email protected] Turn-around is generally 48 hours or less.. ...
When running meta-regression on continuous moderator variables, some of the variable run nicely, while others end with the error message: Cannot run meta-regr…
Our articles are evidence-based and contain scientific references, fact-checked by experts. We source information from studies, clinical trial findings, and meta-analyses published in peer-reviewed journals.. To increase transparency to the user, we provide reference links marked by numbers in parentheses in the copy of the article. The entire list of reference links is also provided at the bottom of the article.. ...