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Evidence Based Medicine

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https://www.readbyqxmd.com/read/29453548/-big-data-from-clinical-routine
#1
REVIEW
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
February 16, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29451516/-evidence-based-medicine-vs-personalized-medicine
#2
Lucio Capurso
Evidence-based medicine (EBM) and personalized medicine (PM) are driven by two diverse modes of reasoning about «evidence making». EBM has been criticized since his quality mark has been misappropriated by vested interests, the benefits statistically significant may be marginal in clinical practice, rigid rules and technology may produce care that is management driven rather than patient centered. On the contrary PM (or "precision medicine") refers to the tailoring of medical treatment to the specific characteristics of each patient involving the ability to classify individuals into subpopulations that are uniquely susceptible to a specific treatment, sparing expense and side effects and is derived from doubts on the results of subgroup analyses and on non responders in clinical trials typical of EBM...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29451515/-promoting-evidence-based-gastroenterology-back-to-the-future
#3
Maurizio Koch
Evidence-based medicine continues to thrive thanks to the publication of a considerable amount of papers focusing on data collection and sharing. Assessment of the accuracy of diagnostic tests still remains highly deficient, often leading to inappropriate clinical decision-making. Like most other doctors, gastroenterologists as well have to face the ever-growing availability of complex and expensive exams, being charged with the task of choosing the best diagnostic option and interpreting test results. It is therefore advisable to provide specialists with the tools they need to evaluate the available literature data...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29449890/benefits-harms-and-evidence-reflections-from-uk-primary-healthcare
#4
Margaret McCartney
In this paper I examine the relationship between benefits, harms and evidence-based medicine in the context of British primary healthcare. First, I will examine: 'What is a benefit and what is a harm?' Second, what should we know about where the balance of risk and benefit appear to lie? Third, what should we do with this knowledge, particularly in the context of the biopsychosocial gaze of primary care? I conclude that even perfect knowledge about benefits and harms requires to be translated in the context of the individual patient: it also requires to be interpreted according to what that persons' wishes are...
January 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29449771/the-effectiveness-of-manual-physical-therapy-interventions-in-pediatric-patients-with-anterior-hip-pain-a-retrospective-study
#5
Mindy Galleher, Briana Crowe, Mitchell Selhorst
Objectives: The purposes of this study were to: (1) assess the benefit of adding manual therapy (MT) to physical therapy care in pediatric patients with anterior hip pain; (2) assess the relative risk of adverse reactions when MT is used; and (3) report the types of MT used. Methods: This study was a retrospective chart review of patients treated in a hospital-based sports medicine clinic. The charts of 201 patients (mean age = 14.23 ± 2.15 years) met the inclusion criteria and were reviewed...
December 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/29449529/gambogenic-acid-inhibits-fibroblast-growth-factor-receptor-signaling-pathway-in-erlotinib-resistant-non-small-cell-lung-cancer-and-suppresses-patient-derived-xenograft-growth
#6
Linfeng Xu, Xiaoxiao Meng, Naihan Xu, Wenwei Fu, Hongsheng Tan, Li Zhang, Qianjun Zhou, Jianan Qian, Shiwei Tu, Xueting Li, Yuanzhi Lao, Hongxi Xu
Erlotinib resistance causes a high degree of lethality in non-small-cell lung cancer (NSCLC) patients. The high expression and activation of several receptor tyrosine kinases, such as JAK/STAT3, c-Met, and EGFR, play important roles in drug resistance. The development of tyrosine kinase inhibitors is urgently required in the clinic. Our previous study found that Gambogenic acid (GNA), a small molecule derived from the traditional Chinese medicine herb gamboge, induced cell death in several NSCLC cell lines through JAK/STAT3 inhibition...
February 15, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29449443/sex-differences-in-ischemic-heart-disease-advances-obstacles-and-next-steps
#7
Niti R Aggarwal, Hena N Patel, Laxmi S Mehta, Rupa M Sanghani, Gina P Lundberg, Sandra J Lewis, Marla A Mendelson, Malissa J Wood, Annabelle S Volgman, Jennifer H Mieres
Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled "Women's Health Research-Progress, Pitfalls, and Promise," highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29448883/natural-frequencies-do-foster-public-understanding-of-medical-tests-comment-on-pighin-gonzalez-savadori-and-girotto-2016
#8
Michelle McDowell, Mirta Galesic, Gerd Gigerenzer
Patients and doctors often need to make decisions based on the results of medical tests. When these results are presented in the form of conditional probabilities, even doctors find it difficult to interpret them correctly. There is over 20 y of research supporting the finding that people are better able to calculate the correct positive predictive value of a test when given information in natural frequencies, as opposed to conditional probabilities. Natural frequencies are one of a few psychological tools that have made it into evidence-based medicine...
February 1, 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29447711/no-355-physiologic-basis-of-pain-in-labour-and-delivery-an-evidence-based-approach-to-its-management
#9
Julie Bonapace, Guy-Paul Gagné, Nils Chaillet, Raymonde Gagnon, Emmanuelle Hébert, Sarah Buckley
OBJECTIVE: To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. OPTIONS: Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. EVIDENCE: PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29447380/sirtuins-in-gamete-biology-and-reproductive-physiology-emerging-roles-and-therapeutic-potential-in-female-and-male-infertility
#10
Carla Tatone, Giovanna Di Emidio, Arcangelo Barbonetti, Gaspare Carta, Alberto M Luciano, Stefano Falone, Fernanda Amicarelli
BACKGROUND: Sirtuins (SIRT1-7) are a family of NAD+-dependent deacetylases that catalyze post-translational modifications of proteins. Together, they respond to metabolic challenges, inflammatory signals or hypoxic/oxidative stress, and are associated with aging and longevity. The role of Sirtuins in the regulation of fertility emerged in 2003 when a defective reproductive phenotype was observed in SIRT1-null mice. Although studies on Sirtuins in reproductive biology have been increasing in the last years, a recent comprehensive update on this issue is still lacking...
February 13, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29446825/phytomedicines-medicines-derived-from-plants-for-sickle-cell-disease
#11
REVIEW
Oluseyi Oniyangi, Damian H Cohall
BACKGROUND: Sickle cell disease, a common recessively inherited haemoglobin disorder, affects people from sub-Saharan Africa, the Middle East, Mediterranean basin, Indian subcontinent, Caribbean and South America. It is associated with complications and a reduced life expectancy. Phytomedicines (medicine derived from plants in their original state) encompass many of the plant remedies from traditional healers which the populations most affected would encounter. Laboratory research and limited clinical trials have suggested positive effects of phytomedicines both in vivo and in vitro...
February 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29446766/are-whole-exome-and-whole-genome-sequencing-approaches-cost-effective-a-systematic-review-of-the-literature
#12
Katharina Schwarze, James Buchanan, Jenny C Taylor, Sarah Wordsworth
PurposeWe conducted a systematic literature review to summarize the current health economic evidence for whole-exome sequencing (WES) and whole-genome sequencing (WGS).MethodsRelevant studies were identified in the EMBASE, MEDLINE, Cochrane Library, EconLit and University of York Centre for Reviews and Dissemination databases from January 2005 to July 2016. Publications were included in the review if they were economic evaluations, cost studies, or outcome studies.ResultsThirty-six studies met our inclusion criteria...
February 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29446647/management-of-multi-casualty-incidents-in-mountain-rescue-evidence-based-guidelines-of-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#13
Marc Blancher, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R Wheeler, Steven Roy, Hermann Brugger, Mike Greene, Peter Paal
Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. INTRODUCTION: Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas...
February 15, 2018: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/29445922/education-on-the-business-of-plastic-surgery-during-training-a-survey-of-plastic-surgery-residents
#14
Steven A Ovadia, Kriya Gishen, Urmen Desai, Alejandro M Garcia, Seth R Thaller
BACKGROUND: Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training. OBJECTIVE: Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training. METHODS: A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents...
February 14, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29445921/spontaneous-regression-and-resolution-of-breast-implant-associated-anaplastic-large-cell-lymphoma-implications-for-research-diagnosis-and-clinical-management
#15
Daniel Fleming, Jason Stone, Patrick Tansley
BACKGROUND: First described in 1997, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was recognised by the World Health Organisation in 2016 as a specific disease. It typically presents as a late seroma-containing atypical, monoclonal T cells which are CD30+ and anaplastic lymphoma kinase negative. Until recently, it was thought that the disease was very rare. However, it is being diagnosed increasingly frequently with 56 cases confirmed in Australia by September 2017 and the estimated incidence revised from 1 in 300,000 to between 1 in 1000 and 1 in 10,000 patients with bilateral implants...
February 14, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29445521/a-method-for-co-creation-of-an-evidence-based-patient-workbook-to-address-alcohol-use-when-quitting-smoking-in-primary-care-a-case-study
#16
Nadia Minian, Aliya Noormohamed, Laurie Zawertailo, Dolly Baliunas, Norman Giesbrecht, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
Plain English summary: The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients' values, preferences, and needs. Fourteen adult smokers who drink alcohol were invited to the Centre for Addiction and Mental Health (CAMH) to take part in a four-hour event to help design the workbook with the CAMH research team...
2018: Research involvement and engagement
https://www.readbyqxmd.com/read/29445505/the-japanese-clinical-practice-guidelines-for-management-of-sepsis-and-septic-shock-2016-j-sscg-2016
#17
Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda
Background and Purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29445409/suvorexant-for-insomnia-in-older-adults-a-perspective-review
#18
REVIEW
Rajesh R Tampi, Geetha Manikkara, Silpa Balachandran, Piyush Taparia, Stephanie Hrisko, Shilpa Srinivasan, Deena J Tampi
The aim of this review was to identify published randomized control trials (RCTs) that evaluated the efficacy and tolerability of suvorexant for the treatment of insomnia among older adults (≥65 years). A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO and Cochrane collaboration databases for RCTs in any language evaluating suvorexant for the treatment of insomnia in older adults. Additionally, references of full-text articles that were included in this review were searched for further studies...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29443454/voice-quality-outcomes-of-idiopathic-parkinson-disease-medical-treatment-a-systematic-review
#19
Jerome R Lechien, Serge Blecic, Kathy Huet, Véronique Delvaux, Myriam Piccaluga, Virginie Roland, Bernard Harmegnies, Sven Saussez
INTRODUCTION: To investigate voice quality (VQ) impairments in idiopathic Parkinson's disease (IPD) and to explore the impact of medical treatments and L-Dopa challenge testing on voice. METHODS: Relevant studies published between January 1980 and June 2017 describing VQ evaluations in IPD were retrieved using PubMed, Scopus, Biological Abstracts, BioMed Central, and Cochrane databases. Issues of clinical relevance, including IPD treatment efficiency and voice quality outcomes, were evaluated for each study...
February 14, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29442540/management-of-immune-related-adverse-events-in-patients-treated-with-immune-checkpoint-inhibitor-therapy-american-society-of-clinical-oncology-clinical-practice-guideline
#20
Julie R Brahmer, Christina Lacchetti, Bryan J Schneider, Michael B Atkins, Kelly J Brassil, Jeffrey M Caterino, Ian Chau, Marc S Ernstoff, Jennifer M Gardner, Pamela Ginex, Sigrun Hallmeyer, Jennifer Holter Chakrabarty, Natasha B Leighl, Jennifer S Mammen, David F McDermott, Aung Naing, Loretta J Nastoupil, Tanyanika Phillips, Laura D Porter, Igor Puzanov, Cristina A Reichner, Bianca D Santomasso, Carole Seigel, Alexander Spira, Maria E Suarez-Almazor, Yinghong Wang, Jeffrey S Weber, Jedd D Wolchok, John A Thompson
Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process...
February 14, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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