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Trial sequential analysis

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https://www.readbyqxmd.com/read/28646925/stress-ulcer-prophylaxis-versus-placebo-or-no-prophylaxis-in-adult-hospitalised-acutely-ill-patients-protocol-for-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#1
Søren Marker, Anders Perner, Jørn Wetterslev, Marija Barbateskovic, Janus Christian Jakobsen, Mette Krag, Anders Granholm, Carl Thomas Anthon, Morten Hylander Møller
BACKGROUND: Stress ulcer prophylaxis is considered standard of care in many critically ill patients in the intensive care unit (ICU). However, the quality of evidence supporting this has recently been questioned, and clinical equipoise exists. Whether there is overall benefit or harm of stress ulcer prophylaxis in adult hospitalised acutely ill patients is unknown. Accordingly, we aim to assess patient-important benefits and harms of stress ulcer prophylaxis versus placebo or no treatment in adult hospitalised acutely ill patients with high risk of gastrointestinal bleeding irrespective of hospital setting...
June 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28639551/facet-joint-injections-for-people-with-persistent-non-specific-low-back-pain-facet-injection-study-a-feasibility-study-for-a-randomised-controlled-trial
#2
David R Ellard, Martin Underwood, Felix Achana, James Hl Antrobus, Shyam Balasubramanian, Sally Brown, Melinda Cairns, James Griffin, Frances Griffiths, Kirstie Haywood, Charles Hutchinson, Ranjit Lall, Stavros Petrou, Nigel Stallard, Colin Tysall, David A Walsh, Harbinder Sandhu
BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28637424/gabapentin-in-procedure-specific-postoperative-pain-management-preplanned-subgroup-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#3
Maria Louise Fabritius, Anja Geisler, Pernille Lykke Petersen, Jørn Wetterslev, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been argued that postoperative pain treatment should be "procedure-specific", since different analgesics may have specific effects dependent on the surgical procedure. The aim of the present subgroup analysis was to compare the beneficial and harmful effects of perioperative gabapentin treatment in different surgical procedures. METHODS: Relevant databases were searched for randomized clinical trials (RCTs) comparing gabapentin versus placebo...
June 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28636405/conventional-polysomnography-is-not-necessary-for-the-management-of-most-patients-with-suspected-obstructive-sleep-apnea
#4
Jaime Corral, Maria-Ángeles Sánchez-Quiroga, Carmen Carmona-Bernal, Ángeles Sánchez-Armengol, Alicia Sánchez-de-la-Torre, Joaquín Durán-Cantolla, Carlos J Egea, Neus Salord, Carmen Monasterio, Joaquín Terán, M Luz Alonso-Alvarez, Jesús Muñoz-Méndez, Eva M Arias, Marta Cabello, Josep M Montserrat, Mónica De la Peña, José C Serrano, Ferran Barbe, Juan F Masa
RATIONALE: Home respiratory polygraphy may be a simpler alternative to in-laboratory polysomnography for the management of more symptomatic obstructive sleep apnea patients, but its effectiveness has not been evaluated across a broad clinical spectrum. OBJECTIVE: To compare the long-term effectiveness (6 months) of home respiratory polygraphy and polysomnography management protocols in patients with intermediate to high sleep apnea suspicion (most patients requiring a sleep study)...
June 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28631197/prioritizing-future-research-on-allopurinol-and-febuxostat-for-the-management-of-gout-value-of-information-analysis
#5
Eric Jutkowitz, Fernando Alarid-Escudero, Hyon K Choi, Karen M Kuntz, Hawre Jalal
OBJECTIVES: The aim of this study was to quantify the value of conducting additional research and reducing uncertainty regarding the cost effectiveness of allopurinol and febuxostat for the management of gout. METHODS: We used a previously developed Markov model that evaluated the cost effectiveness of nine urate-lowering strategies: no treatment, allopurinol-only fixed dose (300 mg), allopurinol-only dose escalation (up to 800 mg), febuxostat-only fixed dose (80 mg), febuxostat-only dose escalation (up to 120 mg), allopurinol-febuxostat sequential therapy fixed dose, allopurinol-febuxostat sequential therapy dose escalation, febuxostat-allopurinol sequential therapy fixed dose, and febuxostat-allopurinol sequential therapy dose escalation...
June 19, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#6
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28627914/group-motivational-interviewing-for-homeless-young-adults-associations-of-change-talk-with-substance-use-and-sexual-risk-behavior
#7
Elizabeth J D'Amico, Jon M Houck, Joan S Tucker, Brett A Ewing, Eric R Pedersen
Homeless young adults exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors. This study is a secondary analysis of data collected in a randomized clinical trial of AWARE, a new 4 session group motivational interviewing intervention. AWARE mainly focused on alcohol use and sexual risk behavior given focus group feedback. We used sequential coding to analyze how the group process affected both AOD use and sexual risk behavior at 3-month follow up among homeless young adults by examining facilitator behavior and participant change talk (CT) and sustain talk (ST)...
June 19, 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/28627310/comparing-cluster-level-dynamic-treatment-regimens-using-sequential-multiple-assignment-randomized-trials-regression-estimation-and-sample-size-considerations
#8
Timothy NeCamp, Amy Kilbourne, Daniel Almirall
Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28625438/efficacy-of-prophylactic-doses-of-intravenous-nitroglycerin-in-preventing-myocardial-ischemia-under-general-anesthesia-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#9
REVIEW
Hiroshi Hoshijima, Yohei Denawa, Takahiro Mihara, Risa Takeuchi, Norifumi Kuratani, Tsutomu Mieda, Yoshinori Iwase, Toshiya Shiga, Zen'ichiro Wajima, Hiroshi Nagasaka
STUDY OBJECTIVE: To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia. DESIGN: Meta-analysis. SETTING: Operating room, cardiac surgery or non-cardiac surgery, all surgeries were elective measurements...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28624593/double-sequential-defibrillation-therapy-for-out-of-hospital-cardiac-arrests-the-london-experience
#10
Amber C Emmerson, Mark Whitbread, Rachael T Fothergill
BACKGROUND: Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF...
June 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28624524/a-direct-comparison-of-porcine-strattice%C3%A2-and-bovine-surgimend%C3%A2-acellular-dermal-matrices-in-implant-based-immediate-breast-reconstruction
#11
Jessica F Ball, Yezen Sheena, Dina M Tarek Saleh, Parto Forouhi, Sarah L Benyon, Michael S Irwin, Charles M Malata
INTRODUCTION: Acellular dermal matrix (ADM) assisted implant-based breast reconstruction (IBBR) has grown in popularity over traditional submuscular techniques. Numerous human, bovine or porcine derived ADMs are available with the type used varying considerably worldwide. Yet, comparative evidence for the efficacy of different ADMs particularly xenogenic is limited. This study directly compares early outcomes of porcine (Strattice™) and bovine (Surgimend™) ADMs in IBBR. METHOD: Retrospective study of sequential experience of immediate IBBR using Strattice or Surgimend ADM...
May 19, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28619093/serial-immunomonitoring-of-cancer-patients-receiving-combined-antagonistic-anti-cd40-and-chemotherapy-reveals-consistent-and-cyclical-modulation-of-t-cell-and-dendritic-cell-parameters
#12
Alison M McDonnell, Alistair Cook, Bruce W S Robinson, Richard A Lake, Anna K Nowak
BACKGROUND: CD40 signalling can synergise with chemotherapy in preclinical cancer models, and early clinical studies are promising. We set out to define the immunological changes associated with this therapeutic combination to identify biomarkers for a response to the therapy. Here, we present serial immunomonitoring examining dendritic cell and T cell subpopulations over sequential courses of chemoimmunotherapy. METHODS: Fifteen patients with mesothelioma received up to six 21-day cycles of pemetrexed plus cisplatin chemotherapy and anti-CD40 (CP-870,893)...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28617801/gastrointestinal-adverse-events-during-methylphenidate-treatment-of-children-and-adolescents-with-attention-deficit-hyperactivity-disorder-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-randomised-clinical-trials
#13
Mathilde Holmskov, Ole Jakob Storebø, Carlos R Moreira-Maia, Erica Ramstad, Frederik Løgstrup Magnusson, Helle B Krogh, Camilla Groth, Donna Gillies, Morris Zwi, Maria Skoog, Christian Gluud, Erik Simonsen
OBJECTIVES: To study in more depth the relationship between type, dose, or duration of methylphenidate offered to children and adolescents with attention deficit hyperactivity disorder and their risks of gastrointestinal adverse events based on our Cochrane systematic review. METHODS AND FINDINGS: We use data from our review including 185 randomised clinical trials. Randomised parallel-group trials and cross-over trials reporting gastrointestinal adverse events associated with methylphenidate were included...
2017: PloS One
https://www.readbyqxmd.com/read/28604993/association-of-n-acetyltransferase-1-polymorphism-and-bladder-cancer-risk-an-updated-meta-analysis-and-trial-sequential-analysis
#14
Zicheng Xu, Xiao Li, Zhiqiang Qin, Jianxin Xue, Jingyuan Wang, Zhentao Liu, Hongzhou Cai, Bin Yu, Ting Xu, Qin Zou
BACKGROUND: Individual studies of the association between N-acetyltransferase 1 (NAT1)*10 allele and bladder cancer susceptibility have shown inconclusive results. To derive a more precise estimation of any such relationship, we performed this systemic review and updated meta-analysis based on 17 publications. METHODS: A total of 17 studies were investigated with 4,322 bladder cancer cases and 4,944 controls. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association...
June 7, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#15
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28597774/combination-therapy-in-pulmonary-arterial-hypertension-recent-accomplishments-and-future-challenges
#16
Annie-Christine Lajoie, Sebastien Bonnet, Steeve Provencher
Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by a progressive increase in pulmonary vascular resistance, ultimately leading to right heart failure and death. Throughout the past 20 years, numerous specific pharmacologic agents, including phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostaglandins, and more recently, soluble guanylate cyclase stimulators and selective IP prostacyclin receptor agonist, have emerged for the treatment of PAH. Early clinical trials were typically of short-term duration, comparing the effects of PAH-targeted therapies versus placebo and using exercise tolerance as the primary endpoint in most trials...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597236/bayesian-analysis-of-the-piecewise-diffusion-decision-model
#17
William R Holmes, Jennifer S Trueblood
Most past research on sequential sampling models of decision-making have assumed a time homogeneous process (i.e., parameters such as drift rates and boundaries are constant and do not change during the deliberation process). This has largely been due to the theoretical difficulty in testing and fitting more complex models. In recent years, the development of simulation-based modeling approaches matched with Bayesian fitting methodologies has opened the possibility of developing more complex models such as those with time-varying properties...
June 8, 2017: Behavior Research Methods
https://www.readbyqxmd.com/read/28596479/remote-ischemic-conditioning-for-the-prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-intravascular-contrast-administration-a-meta-analysis-and-trial-sequential-analysis-of-16-randomized-controlled-trials
#18
Chang-Cheng Zhou, Wen-Tao Yao, Yu-Zheng Ge, Lu-Wei Xu, Ran Wu, Xiao-Fei Gao, Kai-Wei Song, Xiao-Min Jiang, Min Wang, Wen-Juan Huang, Yun-Peng Zhu, Liang-Peng Li, Liu-Hua Zhou, Zhong-Le Xu, Sheng-Li Zhang, Jia-Geng Zhu, Wen-Cheng Li, Rui-Peng Jia
OBJECTIVE: We conducted this meta-analysis to examine the effect of remote ischemic conditioning (RIC) on contrast-induced acute kidney injury (CI-AKI) in patients undergoing intravascular contrast administrationon. METHODS: Pubmed, Embase, and Cochrane Library were comprehensively searched to identify all eligible studies by 15th March, 2017. Risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI) were used to examine the treatment effect...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28587660/recommendations-for-cerebrospinal-fluid-collection-for-the-analysis-by-elisa-of-neurogranin-trunc-p75-%C3%AE-synuclein-and-total-tau-in-combination-with-a%C3%AE-1-42-a%C3%AE-1-40
#19
Hugo Vanderstichele, Leentje Demeyer, Shorena Janelidze, Els Coart, Erik Stoops, Kimberley Mauroo, Victor Herbst, Cindy François, Oskar Hansson
BACKGROUND: The pathophysiology of neurodegeneration is complex. Its diagnosis requires an early identification of sequential changes in several hallmarks in the brains of affected subjects. The presence of brain pathology can be visualized in the cerebrospinal fluid (CSF) by protein profiling. It is clear that the field of Alzheimer's disease (AD) will benefit from an integration of algorithms including CSF concentrations of individual proteins, especially as an aid in clinical decision-making or to improve patient enrolment in clinical trials...
June 6, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28585310/direct-acting-antivirals-for-chronic-hepatitis-c
#20
REVIEW
Janus C Jakobsen, Emil Eik Nielsen, Joshua Feinberg, Kiran Kumar Katakam, Kristina Fobian, Goran Hauser, Goran Poropat, Snezana Djurisic, Karl Heinz Weiss, Milica Bjelakovic, Goran Bjelakovic, Sarah Louise Klingenberg, Jian Ping Liu, Dimitrinka Nikolova, Ronald L Koretz, Christian Gluud
BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs) are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). However, it is still questionable if eradication of hepatitis C virus in the blood eliminates hepatitis C in the body, and improves survival and leads to fewer complications...
June 6, 2017: Cochrane Database of Systematic Reviews
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