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https://www.readbyqxmd.com/read/29615035/real-world-evidence-how-pragmatic-are-randomized-controlled-trials-labeled-as-pragmatic
#1
Rafael Dal-Ré, Perrine Janiaud, John P A Ioannidis
INTRODUCTION: Pragmatic randomized controlled trials (RCTs) mimic usual clinical practice and they are critical to inform decision-making by patients, clinicians and policy-makers in real-world settings. Pragmatic RCTs assess effectiveness of available medicines, while explanatory RCTs assess efficacy of investigational medicines. Explanatory and pragmatic are the extremes of a continuum. This debate article seeks to evaluate and provide recommendation on how to characterize pragmatic RCTs in light of the current landscape of RCTs...
April 3, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29605206/the-100-most-influential-publications-in-asthma-from-1960-to-2017-a-bibliometric-analysis
#2
REVIEW
Yulan Qu, Chen Zhang, Zhenli Hu, Sha Li, Chen Kong, Yunye Ning, Yan Shang, Chong Bai
BACKGROUND: The area of asthma medicine has produced a large volume of important clinical and scientific papers that can be found in those most influential journals. The purpose of our study was to identify the 100 most cited papers in asthma research and to analyze their characteristics. METHODS: We used the Institute for Scientific Information Web of Knowledge Database to identify the most frequently cited articles published from 1960 to December 2017. Original articles and reviews were included in the study...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29603729/analysis-of-the-distribution-and-scholarly-output-from-national-institute-of-academic-anaesthesia-niaa-research-grants
#3
K El-Boghdadly, A B Docherty, A A Klein
The National Institute of Academic Anaesthesia (NIAA) was founded in 2008 to lead a UK strategy for developing academic anaesthesia. We aimed to assess the distribution of applications and quantify the academic returns of NIAA-supported research grants, as this has hitherto not been analysed. We sought data on the baseline characteristics of all grant applicants and recipients. Every grant recipient from 2008 to 2015 was contacted to ascertain the status of their supported research projects. We also examined Google Scholar, Scopus® database and InCites Journal Citation Reports for citation, author and journal metrics, respectively...
March 30, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29519206/the-top-ten-websites-in-critical-care-medicine-education-today
#4
Traci A Wolbrink, Lucy Rubin, Jeffrey P Burns, Barry Markovitz
INTRODUCTION: The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary. METHODS: A new assessment tool for evaluating critical care medicine education websites, the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET), was modified from existing tools...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29463308/reproducibility-of-clinical-research-in-critical-care-a-scoping-review
#5
Daniel J Niven, T Jared McCormick, Sharon E Straus, Brenda R Hemmelgarn, Lianne Jeffs, Tavish R M Barnes, Henry T Stelfox
BACKGROUND: The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. METHODS: We used scoping review methods to examine reproducibility within a cohort of randomized trials examining clinical critical care research and published in the top general medical and critical care journals...
February 21, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29420456/examining-the-relationship-of-an-all-cause-harm-patient-safety-measure-and-critical-performance-measures-at-the-frontline-of-care
#6
Christine Sammer, Loran D Hauck, Cason Jones, Julie Zaiback-Aldinger, Michael Li, David Classen
BACKGROUND: In 2015, the Institute of Medicine Vital Signs report called for a new patient safety composite measure to lessen the reporting burden of patient harm. Before this report, two patient safety organizations had developed an electronic all-cause harm measurement system leveraging data from the electronic health record, which identified and grouped harms into five broad categories and consolidated them into one all-cause harm outcome measure. OBJECTIVES: The objective of this study was to examine the relationship between this all-cause harm patient safety measure and the following three performance measures important to overall hospital safety performance: safety culture, employee engagement, and patient experience...
February 7, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29415784/peer-reviewed-journal-editors-views-on-real-world-evidence
#7
Elisabeth M Oehrlein, Jennifer S Graff, Eleanor M Perfetto, C Daniel Mullins, Robert W Dubois, Chinenye Anyanwu, Eberechukwu Onukwugha
OBJECTIVES: Peer-review publication is a critical step to the translation and dissemination of research results into clinical practice guidelines, health technology assessment (HTA) and payment policies, and clinical care. The objective of this study was to examine current views of journal editors regarding: (i) The value of real-world evidence (RWE) and how it compares with other types of studies; (ii) Education and/or resources journal editors provide to their peer reviewers or perceive as needed for authors, reviewers, and editors related to RWE...
February 8, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#8
REVIEW
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29321113/top-cited-publications-on-point-of-care-ultrasound-the-evolution-of-research-trends
#9
Shao-Feng Liao, Pai-Jung Chen, Chung-Hsien Chaou, Ching-Hsing Lee
STUDY OBJECTIVES: Point-of-care ultrasound (POCUS) has been a rapidly growing and broadly used modality in recent decades. The purpose of this study was to determine how POCUS is incorporated into clinical medicine by analyzing trends of use in the published literature. METHODS: POCUS-related publications were retrieved from the Web of Science (WoS) database. The search results were ranked according to the number of times an article was cited during three time frames and average annual number of citations...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29303208/journal-club-sessions-in-the-intensive-care-unit-a-conceptual-framework
#10
Bjoern Zante, Patricia Stoecklin, Joerg Christian Schefold
Journal Club sessions are regarded highly effective tools for continued medical education. They aim to keep participants up to date with the current available literature and may enhance one's critical reading, interpretation, and discussion skills. Thus, Journal Clubs should be implemented as part of educational curricula in intensive care medicine. Here, we provide a conceptual framework that may support medical educators and programme directors to successfully implement structured Journal Club sessions. Moreover, we discuss the technical aspects and future perspectives of respective educational formats...
January 5, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29298917/point-of-care-ultrasound-a-trend-in-health-care
#11
Anita M Buerger, Kevin R Clark
PURPOSE: To discuss the current and growing use of point-of-care (POC) ultrasound in the management and care of patients. METHODS: Several electronic research databases were searched to find articles that emphasized the use of POC ultrasound by health care providers who manage and treat critically ill or injured patients. Thirty-five relevant peer-reviewed journal articles were selected for this literature review. RESULTS: Common themes identified in the literature included the use of POC ultrasound in emergency medicine, military medicine, and remote care; comparison of POC ultrasound to other medical imaging modalities; investigation of the education and training required for nonimaging health care professionals who perform POC ultrasound in their practices; and discussion of the financial implications and limitations of POC ultrasound...
November 2017: Radiologic Technology
https://www.readbyqxmd.com/read/29275030/testosterone-and-cardiovascular-health
#12
REVIEW
Andrew Elagizi, Tobias S Köhler, Carl J Lavie
There is an ongoing debate in the medical community regarding the effects of testosterone on cardiovascular (CV) health. For decades, there has been conflicting evidence regarding the association of endogenous testosterone levels and CV disease (CVD) events that has resulted in much debate and confusion among health care providers and patients alike. Testosterone therapy has become increasingly widespread, and after the emergence of studies that reported increased CVD events in patients receiving testosterone therapy, the US Food and Drug Administration (FDA) released a warning statement about testosterone and its potential risk regarding CV health...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29261818/update-in-hospital-palliative-care-symptom-management-communication-caregiver-outcomes-and-moral-distress
#13
Rachel D Havyer, Daniel H Pomerantz, Robert L Jayes, Patricia F Harris, Stephanie M Harman, Aziz A Ansari
BACKGROUND: Updated knowledge of the palliative care (PC) literature is needed to maintain competency and best address the PC needs of hospitalized patients. We critiqued the recent PC literature with the highest potential to impact hospital practice. METHODS: We reviewed articles published between January 2016 and December 2016, which were identified through a handsearch of leading journals and a MEDLINE search. The final 9 articles selected were determined by consensus based on scientific rigor, relevance to hospital medicine, and impact on practice...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#14
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
January 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120700/basket-studies-redefining-clinical-trials-in-the-era-of-genome-driven-oncology
#15
Jessica J Tao, Alison M Schram, David M Hyman
Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncology care. "Basket studies," or histology-agnostic clinical trials in genomically selected patients, represent one important research tool to continue making progress in this field. We review key aspects of genome-driven oncology care, including the purpose and utility of basket studies, biostatistical considerations in trial design, genomic knowledge-base development, and patient matching and enrollment models, which are critical for translating our genomic knowledge into clinically meaningful outcomes...
November 8, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28967117/how-to-write-a-critically-appraised-topic-evidence-to-underpin-routine-clinical-practice
#16
J Callander, A V Anstey, J R Ingram, J Limpens, C Flohr, P I Spuls
Critically appraised topics (CATs) are essential tools for busy clinicians who wish to ensure that their daily clinical practice is underpinned by evidence-based medicine. CATs are short summaries of the most up-to-date, high-quality available evidence that is found using thorough structured methods. They can be used to answer specific, patient-orientated questions that arise recurrently in real-life practice. This article provides readers with a detailed guide to performing their own CATs. It is split into four main sections reflecting the four main steps involved in performing a CAT: formulation of a focused question, a search for the most relevant and highest-quality evidence, critical appraisal of the evidence and application of the results back to the patient scenario...
October 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28960730/reasoning-evidence-and-clinical-decision-making-the-great-debate-moves-forward
#17
EDITORIAL
Michael Loughlin, Robyn Bluhm, Stephen Buetow, Kirstin Borgerson, Jonathan Fuller
When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical practice. Things have changed dramatically. Far from being derided or dismissed as a distraction from practical concerns, the discussion of such fundamental questions, and their implications for matters of practical import, is currently the preoccupation of some of the most influential and insightful contributors to the on-going evidence-based medicine debate...
October 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28924688/the-barrier-to-informed-choice-in-cancer-screening-statistical-illiteracy-in-physicians-and-patients
#18
Odette Wegwarth, Gerd Gigerenzer
An efficient health care requires both informed doctors and patients. Our current healthcare system falls short on both counts. Most doctors and patients do not understand the available medical evidence. To illustrate the extent of the problem in the setting of cancer screening: In a representative sample of some 5000 women in nine European countries, 92% overestimated the reduction of breast cancer mortality by mammography by a factor of 10-200, or did not know. For a similar sample of about 5000 men with respect to PSA screening, this number was 89%...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28922229/micrornas-as-clinical-biomarkers-and-therapeutic-tools-in-perioperative-medicine
#19
Simone Kreth, Max Hübner, Ludwig Christian Hinske
Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28841383/refinement-of-the-affordable-care-act
#20
Vivian Ho
Regardless of what legislation the federal government adopts to address health insurance coverage for nonelderly Americans, private insurance will likely play a major role. This article begins by listing some of the major reasons critics dislike the Affordable Care Act, then discusses the validity of these concerns from an economics perspective. Criticisms of the ACA include the increased role of government in healthcare, the ACA's implicit income redistribution, and concern about high and rising insurance premiums...
August 25, 2017: Annual Review of Medicine
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