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Minimum clinically important difference

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https://www.readbyqxmd.com/read/28821444/circumferential-fusion-a-comparative-analysis-between-anterior-lumbar-interbody-fusion-with-posterior-pedicle-screw-fixation-and-transforaminal-lumbar-interbody-fusion-for-l5-s1-isthmic-spondylolisthesis
#1
Erik Y Tye, Joseph E Tanenbaum, Andrea S Alonso, Roy Xiao, Michael P Steinmetz, Thomas E Mroz, Jason W Savage
BACKGROUND CONTEXT: Transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion with percutaneous pedicle screws (ALIFPS) offer significantly higher radiographic fusion rates than other fusion techniques for L5-S1 isthmic spondylolisthesis (IS). As it stands, there is a relative paucity of comparative data of the two techniques. PURPOSE: To define the clinical, radiographic, and financial differences between TLIF and ALIFPS for L5-S1 IS. STUDY DESIGN/SETTING: A retrospective cohort study conducted at a single-tertiary care center...
August 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28820272/a-comparison-of-clinical-outcomes-after-unilateral-or-bilateral-hip-arthroscopic-surgery-age-and-sex-matched-cohort-study
#2
Benjamin D Kuhns, Charles P Hannon, Eric C Makhni, Jennifer Alter, Richard C Mather, Michael J Salata, Shane J Nho
BACKGROUND: A significant number of patients undergoing hip arthroscopic surgery for femoroacetabular impingement (FAI) have bilateral deformities and may require surgery for both hips. PURPOSE: To compare outcomes between patients who underwent bilateral hip arthroscopic surgery to a matched cohort of patients who underwent unilateral hip arthroscopic surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A consecutive series of patients who underwent primary hip arthroscopic surgery for FAI by a single fellowship-trained surgeon from January 2012 to January 2014 and had a minimum follow-up of 2 years were evaluated...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28803652/long-term-follow-up-evaluation-of-autologous-chondrocyte-implantation-for-symptomatic-cartilage-lesions-of-the-knee-a-single-centre-prospective-study
#3
M Berruto, P Ferrua, S Pasqualotto, F Uboldi, A Maione, D Tradati, E Usellini
INTRODUCTION: Autologous Chondrocyte Implantation (ACI) has been the first technique in reconstruction of a valid articular surface. The aim of this study was to evaluate clinical results of this technique at an average follow up of 162±27months (range 88-208) in a group of patients who underwent ACI. MATERIALS AND METHODS: 32 patients were operated between 1997 and 2007 for chondral lesions or osteochondritis dissecans of the knee. Mean size of the defect was 5...
August 4, 2017: Injury
https://www.readbyqxmd.com/read/28800273/assessing-the-impact-of-a-remote-digital-coaching-engagement-program-on-patient-reported-outcomes-in-asthma
#4
Mazi Rasulnia, Billy Stephen Burton, Robert P Ginter, Tracy Y Wang, Roy Alton Pleasants, Cynthia L Green, Njira Lugogo
BACKGROUND: Low adherence and poor outcomes provide opportunity for digital coaching to engage patients with uncontrolled asthma in their care to improve outcomes. OBJECTIVES: To examine the impact of a remote digital coaching program on asthma control and patient experience. METHODS: We recruited 51 adults with uncontrolled asthma, denoted by albuterol use of > 2 times per week and/or exacerbations requiring corticosteroids, and applied a 12-week patient-centered remote digital coaching program using a combination of educational pamphlets, symptom trackers, best peak flow establishment, physical activity, and dietary counseling, as well as coaches who implemented emotional enforcement  to motivate disease self-management through telephone, text, and email...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28799837/effectiveness-of-deformity-correction-surgery-for-primary-degenerative-sagittal-imbalance-a-meta-analysis
#5
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim, Seung-Jae Hyun
OBJECTIVE As life expectancy continues to increase, primary degenerative sagittal imbalance (PDSI) is diagnosed in an increasing number of elderly people. Although corrective surgery for this sagittal deformity is becoming more popular, the effectiveness of the procedure remains unclear. The authors aimed to collate the available evidence on the effectiveness and complications of deformity-correction surgery in patients with PDSI. METHODS The authors carried out a meta-analysis of clinical studies regarding deformity correction in patients with PDSI...
August 11, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28791144/machine-learning-landscapes-and-predictions-for-patient-outcomes
#6
Ritankar Das, David J Wales
The theory and computational tools developed to interpret and explore energy landscapes in molecular science are applied to the landscapes defined by local minima for neural networks. These machine learning landscapes correspond to fits of training data, where the inputs are vital signs and laboratory measurements for a database of patients, and the objective is to predict a clinical outcome. In this contribution, we test the predictions obtained by fitting to single measurements, and then to combinations of between 2 and 10 different patient medical data items...
July 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28779963/partial-breast-radiotherapy-after-breast-conservation-surgery-for-patients-with-early-breast-cancer-uk-import-low-trial-5-year-results-from-a-multicentre-randomised-controlled-phase-3-non-inferiority-trial
#7
Charlotte E Coles, Clare L Griffin, Anna M Kirby, Jenny Titley, Rajiv K Agrawal, Abdulla Alhasso, Indrani S Bhattacharya, Adrian M Brunt, Laura Ciurlionis, Charlie Chan, Ellen M Donovan, Marie A Emson, Adrian N Harnett, Joanne S Haviland, Penelope Hopwood, Monica L Jefford, Ronald Kaggwa, Elinor J Sawyer, Isabel Syndikus, Yat M Tsang, Duncan A Wheatley, Maggie Wilcox, John R Yarnold, Judith M Bliss
BACKGROUND: Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that partial-breast radiotherapy restricted to the vicinity of the original tumour in women at lower than average risk of local relapse will improve the balance of beneficial versus adverse effects compared with whole-breast radiotherapy. METHODS: IMPORT LOW is a multicentre, randomised, controlled, phase 3, non-inferiority trial done in 30 radiotherapy centres in the UK...
August 2, 2017: Lancet
https://www.readbyqxmd.com/read/28754429/assessment-of-minimum-important-difference-and-substantial-clinical-benefit-with-the-vascular-quality-of-life-questionnaire-6-when-evaluating-revascularisation-procedures-in-peripheral-arterial-disease
#8
J Nordanstig, M Pettersson, M Morgan, M Falkenberg, C Kumlien
OBJECTIVES: Patient reported outcomes are increasingly used to assess outcomes after peripheral arterial disease (PAD) interventions. VascuQoL-6 (VQ-6) is a PAD specific health-related quality of life (HRQoL) instrument for routine clinical practice and clinical research. This study assessed the minimum important difference for the VQ-6 and determined thresholds for the minimum important difference and substantial clinical benefit following PAD revascularisation. MATERIALS AND METHODS: This was a population-based observational cohort study...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28753467/the-association-of-scn1a-p-thr1067ala-polymorphism-with-epilepsy-risk-and-the-response-to-antiepileptic-drugs-in-slovenian-children-and-adolescents-with-epilepsy
#9
Sara Bertok, Vita Dolžan, Katja Goričar, Katarina Trebušak Podkrajšek, Tadej Battelino, Zvonka Rener-Primec
PURPOSE: The voltage-gated sodium channel SCN1A mutations are involved in epileptogenesis and may be associated with different epilepsy phenotypes. The SCN1A channel is also an important antiepileptic drug (AED) target. The aim of this study was to investigate if the SCN1A c.3184A>G/p.Thr1067Ala polymorphism modifies the epilepsy risk or is associated with the responsiveness to AEDs in Slovenian children and adolescents with epilepsy. METHODS: In total, 216 paediatric patients with epilepsy were consecutively recruited during routine outpatient follow-up visits between January 2011 and December 2014...
July 20, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28741095/phenotype-microarray-analysis-of-the-aders-two-component-system-in-acinetobacter-baumannii
#10
J-R Sun, Y-S Chiang, H-S Shang, C-L Perng, Y-S Yang, T-S Chiueh
Acinetobacter baumannii is a nosocomial pathogen capable of resistance to multiple antimicrobials. The AdeRS two-component system (TCS) is associated with antimicrobial resistance by controlling the AdeABC efflux pump. To elucidate modulation by AdeRS, we made an A. baumannii mutant lacking the AdeRS TCS and characterized it using phenotype microarray (PM) analysis. After disrupting the adeRS operon, lower expression of AdeABC efflux pump was observed in the mutant strain. PM analysis showed that the AdeRS deletion strain and parental strain presented different tolerances to 91 compounds...
July 24, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28733283/osmotic-compounds-enhance-antibiotic-efficacy-against-acinetobacter-baumannii-biofilm-communities
#11
Azeza Falghoush, Haluk Beyenal, Thomas E Besser, Anders Omsland, Douglas R Call
Biofilm-associated infections are a clinical challenge in part because a hydrated matrix protects the bacterial community from antibiotics. Herein, we evaluated how different osmotic compounds [maltodextrin, sucrose and polyethylene glycol (PEG)] enhance antibiotic efficacy against Acinetobacter baumannii biofilm communities. Established test-tube biofilms (24 h, strain ATCC 17978) were treated with osmotic compounds in the presence or absence of 10X the minimum inhibitory concentration of different antibiotics (50 μg/ml tobramycin, 20 μg/ml ciprofloxacin, 300 μg/ml chloramphenicol, 30 μg/ml nalidixic acid or 100 μg/ml erythromycin)...
July 21, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28727937/preoperative-short-form-health-survey-score-is-predictive-of-return-to-play-and-minimal-clinically-important-difference-at-a-minimum-2-year-follow-up-after-anterior-cruciate-ligament-reconstruction
#12
Benedict U Nwachukwu, Brenda Chang, Pramod B Voleti, Patricia Berkanish, Matthew R Cohn, David W Altchek, Answorth A Allen, Riley J Williams
BACKGROUND: There is increased interest in understanding the preoperative determinants of postoperative outcomes. Return to play (RTP) and the patient-reported minimal clinically important difference (MCID) are useful measures of postoperative outcomes after anterior cruciate ligament reconstruction (ACLR). PURPOSE: To define the MCID after ACLR and to investigate the role of preoperative outcome scores for predicting the MCID and RTP after ACLR. STUDY DESIGN: Case-control study; Level of evidence, 3...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28717629/ultrasound-measures-of-tendon-thickness-intra-rater-inter-rater-and-inter-machine-reliability
#13
María Elena Del Baño-Aledo, Jacinto Javier Martínez-Payá, José Ríos-Díaz, Silvia Mejías-Suárez, Sergio Serrano-Carmona, Ana de Groot-Ferrando
BACKGROUND: Ultrasound imaging is often used by physiotherapists and other healthcare professionals but the reliability of image acquisition with different ultrasound machines is unknown. The objective was to compare the intra-rater, inter-rater and intermachine reliability of thickness measurements of the plantar fascia (PF), Achilles tendon (AT), patellar tendon (PT) and elbow common extensor tendon (ECET) with musculoskeletal ultrasound imaging (MSUS). METHODS: Tendon thickness was measured in four anatomical structures (14 participants, 28 images per tendon) by two sonographers and with two different ultrasound machines...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28716065/the-validity-of-the-sf-12-and-sf-6d-instruments-in-people-living-with-hiv-aids-in-kenya
#14
Anik R Patel, Richard T Lester, Carlo A Marra, Mia L van der Kop, Paul Ritvo, Lidia Engel, Sarah Karanja, Larry D Lynd
BACKGROUND: Health-related quality of life (HRQoL) and health state utility value (HSUV) measurements are vital components of healthcare clinical and economic evaluations. Accurate measurement of HSUV and HRQoL require validated instruments. The 12-item Short-Form Health Survey (SF-12) is one of few instruments that can evaluate both HRQoL and HSUV, but its validity has not been assessed in people living with HIV/AIDS (PLWHA) in east Africa, where the burden of HIV is high. METHODS: This cross-sectional study used baseline data from a randomized trial involving PLWHA in Kenya...
July 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28711423/randomized-trial-of-intelligent-sensor-system-for-early-illness-alerts-in-senior-housing
#15
Marilyn Rantz, Lorraine J Phillips, Colleen Galambos, Kari Lane, Gregory L Alexander, Laurel Despins, Richelle J Koopman, Marjorie Skubic, Lanis Hicks, Steven Miller, Andy Craver, Bradford H Harris, Chelsea B Deroche
OBJECTIVES: Measure the clinical effectiveness and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. This sensor system has demonstrated in pilot studies to detect changes in function and in chronic diseases or acute illnesses on average 10 days to 2 weeks before usual assessment methods or self-reports of illness. DESIGN: Prospective intervention study in 13 assisted living (AL) communities of 171 residents randomly assigned to intervention (n=86) or comparison group (n=85) receiving usual care...
July 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28702747/management-of-supine-hypertension-complicating-neurogenic-orthostatic-hypotension
#16
Jacquie Baker, Kurt Kimpinski
Neurogenic orthostatic hypotension (NOH) can be present in a number of disorders, including synucleinopathies, autoimmune disorders, and various genetic disorders. All are characterized by defective norepinephrine release from sympathetic terminals upon standing, resulting in impaired vasoconstriction. NOH is defined as a drop in systolic blood pressure ≥20 mmHg or diastolic blood pressure ≥10 mmHg, or both, within 3 minutes of standing or head up-tilt at a minimum of 60°. However, approximately 50% of patients have associated supine hypertension, which greatly complicates treatment...
August 2017: CNS Drugs
https://www.readbyqxmd.com/read/28699595/effectiveness-of-non-steroidal-anti-inflammatory-drugs-for-the-treatment-of-pain-in-knee-and-hip-osteoarthritis-a-network-meta-analysis
#17
Bruno R da Costa, Stephan Reichenbach, Noah Keller, Linda Nartey, Simon Wandel, Peter Jüni, Sven Trelle
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are the backbone of osteoarthritis pain management. We aimed to assess the effectiveness of different preparations and doses of NSAIDs on osteoarthritis pain in a network meta-analysis. METHODS: For this network meta-analysis, we considered randomised trials comparing any of the following interventions: NSAIDs, paracetamol, or placebo, for the treatment of osteoarthritis pain. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the reference lists of relevant articles for trials published between Jan 1, 1980, and Feb 24, 2015, with at least 100 patients per group...
July 8, 2017: Lancet
https://www.readbyqxmd.com/read/28699370/adc-quantification-in-basilar-artery-occlusion-as-an-indicator-of-clinical-outcome-after-endovascular-treatment
#18
Daniela Pereira, Isabel Fragata, José Amorim, João Reis
Background Acute ischemic stroke due to basilar artery occlusion (BAO) is associated with a dismal prognosis and, even though endovascular treatment (EVT) contributed to an improvement in clinical outcomes, patient selection is difficult and frequently results in futile recanalization. We investigated the prognostic value of baseline ADC quantification in patients with BAO undergoing EVT. Methods We retrospectively evaluated MRI at admission in 11 patients with BAO undergoing EVT. Ischemic lesions were defined on baseline DWI and minimum ADC (minADC), ADC ratio and total area were quantified...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28681707/the-comet-handbook-version-1-0
#19
REVIEW
Paula R Williamson, Douglas G Altman, Heather Bagley, Karen L Barnes, Jane M Blazeby, Sara T Brookes, Mike Clarke, Elizabeth Gargon, Sarah Gorst, Nicola Harman, Jamie J Kirkham, Angus McNair, Cecilia A C Prinsen, Jochen Schmitt, Caroline B Terwee, Bridget Young
The selection of appropriate outcomes is crucial when designing clinical trials in order to compare the effects of different interventions directly. For the findings to influence policy and practice, the outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. It is now widely acknowledged that insufficient attention has been paid to the choice of outcomes measured in clinical trials. Researchers are increasingly addressing this issue through the development and use of a core outcome set, an agreed standardised collection of outcomes which should be measured and reported, as a minimum, in all trials for a specific clinical area...
June 20, 2017: Trials
https://www.readbyqxmd.com/read/28676557/effect-of-specialist-palliative-care-services-on-quality-of-life-in-adults-with-advanced-incurable-illness-in-hospital-hospice-or-community-settings-systematic-review-and-meta-analysis
#20
REVIEW
Jan Gaertner, Waldemar Siemens, Joerg J Meerpohl, Gerd Antes, Cornelia Meffert, Carola Xander, Stephanie Stock, Dirk Mueller, Guido Schwarzer, Gerhild Becker
Objective To assess the effect of specialist palliative care on quality of life and additional outcomes relevant to patients in those with advanced illness.Design Systematic review with meta-analysis.Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and trial registers searched up to July 2016.Eligibility criteria for selecting studies Randomised controlled trials with adult inpatients or outpatients treated in hospital, hospice, or community settings with any advanced illness...
July 4, 2017: BMJ: British Medical Journal
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