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Minimum clinically important difference

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https://www.readbyqxmd.com/read/28324093/association-between-radiation-therapy-surgery-or-observation-for-localized-prostate-cancer-and-patient-reported-outcomes-after-3-years
#1
Daniel A Barocas, JoAnn Alvarez, Matthew J Resnick, Tatsuki Koyama, Karen E Hoffman, Mark D Tyson, Ralph Conwill, Dan McCollum, Matthew R Cooperberg, Michael Goodman, Sheldon Greenfield, Ann S Hamilton, Mia Hashibe, Sherrie H Kaplan, Lisa E Paddock, Antoinette M Stroup, Xiao-Cheng Wu, David F Penson
Importance: Understanding the adverse effects of contemporary approaches to localized prostate cancer treatment could inform shared decision making. Objective: To compare functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. Design, Setting, and Participants: Prospective, population-based, cohort study involving 2550 men (≤80 years) diagnosed in 2011-2012 with clinical stage cT1-2, localized prostate cancer, with prostate-specific antigen levels less than 50 ng/mL, and enrolled within 6 months of diagnosis...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28303847/trends-in-drug-resistance-of-acinetobacter-baumannii-over-a-10-year-period-nationwide-data-from-the-china-surveillance-of-antimicrobial-resistance-program
#2
Lei Gao, Yuan Lyu, Yun Li
BACKGROUND: Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. METHODS: Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28300046/final-year-nursing-students-in-nigeria-how-knowledgeable-and-prepared-are-they-to-offer-medical-care-to-patients-with-chronic-kidney-disease
#3
Chimezie Godswill Okwuonu, Hannah Sylvanus Kanu, Ojeh-Oziegbe Odigie
BACKGROUND: Nurses play an important role in the management of chronic kidney disease (CKD) patients at primary, secondary, and tertiary levels of care. In other to perform their functions, it is pertinent that they have a good understanding of kidney functions and CKD. We do not know if the current educational curriculum prepares them adequately for this role. AIM: To assess the knowledge level of kidney functions and diseases among final year nursing students in Abia State Nigeria...
January 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28298057/defining-the-substantial-clinical-benefit-after-arthroscopic-treatment-of-femoroacetabular-impingement
#4
Benedict U Nwachukwu, Brenda Chang, Kara Fields, Brian J Rebolledo, Danyal H Nawabi, Bryan T Kelly, Anil S Ranawat
BACKGROUND: The minimal clinically important difference (MCID) has been defined in orthopaedics and is the smallest change that a patient considers meaningful. Less is known about improvements that the patient perceives as clinically considerable, or the substantial clinical benefit (SCB). For the young, highly functioning patient cohort with femoroacetabular impingement (FAI), the SCB is an important measure of clinical success. PURPOSE: To derive the SCB for FAI treatment and identify outcome score thresholds and patient variables predictive of the SCB...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28298056/outcomes-after-biologically-augmented-isolated-meniscal-repair-with-marrow-venting-are-comparable-with-those-after-meniscal-repair-with-concomitant-anterior-cruciate-ligament-reconstruction
#5
Chase S Dean, Jorge Chahla, Lauren M Matheny, Justin J Mitchell, Robert F LaPrade
BACKGROUND: Meniscal repair in the setting of anterior cruciate ligament (ACL) reconstruction has demonstrated superior outcomes compared with isolated meniscal repair. Limited evidence exists for the effects of biological augmentation in isolated meniscal repair, particularly as compared with meniscal repair with concomitant ACL reconstruction. Purpose/Hypothesis: The purpose of this study was to compare the outcomes and survivorship of meniscal repair in 2 cohorts of patients: meniscal repair with biological augmentation using a marrow venting procedure (MVP) of the intercondylar notch, and meniscal repair with concomitant ACL reconstruction...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28290117/what-influence-does-progression-of-a-nonhealing-rotator-cuff-tear-have-on-shoulder-pain-and-function
#6
Yoon Sang Jeon, Rag Gyu Kim, Sang-Jin Shin
BACKGROUND: There have been numerous reports of clinical outcomes associated with tendon healing after repair that suggest a nonhealed tendon has a negative effect on postoperative clinical outcomes. However, to our knowledge, there has been no report on the relationship between tear size progression of nonhealed tendons and clinical outcomes. QUESTIONS/PURPOSES: (1) Do patients with healed arthroscopic rotator cuff repairs have better outcomes, less pain, and more strength than patients whose repair did not heal? (2) In patients with nonhealed rotator cuff tendons, does tear size progression (increase or decrease) affect outcomes, pain, and strength? (3) Is there continued improvement beyond 6 months in outcomes, pain, and strength; and how do the improvements differ based on whether the tear size has increased or decreased? METHODS: Between May 2008 and December 2012, 647 patients underwent arthroscopic rotator cuff repair for full-thickness tears at our institution...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28286320/earwax-a-neglected-body-secretion-or-a-step-ahead-in-clinical-diagnosis-a-pilot-study
#7
Engy Shokry, Anselmo Elcana de Oliveira, Melissa Ameloti Gomes Avelino, Mariana Moreira de Deus, Nelson Roberto Antoniosi Filho
This work combines the advantages of volatile metabolites profiling as a young growing research field with a non-invasive sampling technique using earwax "a neglected body secretion" for detection and monitoring of biomarkers for diabetes mellitus (types 1 and 2). Earwax samples were collected from 26 diabetic patients of both types, analyzed by headspace gas chromatography mass spectrometry and confronted to the volatile earwax composition of 33 healthy individuals. Data mining analysis was conducted using different models to discriminate the healthy individuals from the diabetic patients and to discriminate between both types of diabetes as well...
March 9, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28285001/associations-between-changes-in-knee-pain-location-and-clinical-symptoms-in-people-with-medial-knee-osteoarthritis-using-footwear-for-self-management-an-exploratory-study
#8
Ans Van Ginckel, Kim L Bennell, Penny K Campbell, Jessica Kasza, Tim V Wrigley, David J Hunter, Rana S Hinman
OBJECTIVE: To examine whether change in pain location is associated with clinically-relevant improvements in walking pain severity and physical dysfunction in people with medial tibiofemoral osteoarthritis (OA) using footwear for self-management. DESIGN: We analysed a sub-set of 91 participants pooled from both arms of a 6-month randomised controlled trial of footwear for knee OA. The Photographic Knee Pain Map was self-administered to generate changes in the number of painful zones ('unchanged', 'increased', 'decreased') and anatomical patterns of pain ('unchanged', 'no longer diffuse', 'becoming diffuse', 'other pattern changes')...
March 8, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28278268/highs-and-lows-ups-and-downs-meteorology-and-mood-in-bipolar-disorder
#9
Ben Bullock, Greg Murray, Denny Meyer
Seasonal variation of manic and depressive symptoms is a controversial topic in bipolar disorder research. Several studies report seasonal patterns of hospital admissions for depression and mania and variation in symptoms that appear to follow a seasonal pattern, whereas others fail to report such patterns. Differences in research methodologies, data analysis strategies, and temporal resolution of data may partly explain the variation in findings between studies. The current study adds a novel perspective to the literature by investigating specific meteorological factors such as atmospheric pressure, hours of sunshine, relative humidity, and daily maximum and minimum temperatures as more proximal predictors of self-reported daily mood change in people diagnosed with bipolar disorder...
2017: PloS One
https://www.readbyqxmd.com/read/28276996/therapeutic-options-for-carbapenem-resistant-enterobacteriaceae-infections
#10
Enrico Maria Trecarichi, Mario Tumbarello
In recent years, carbapenem resistance among Enterobacteriaceae has dramatically increased and represents an important threat to global health. The optimal therapeutic management of carbapenem-resistant Enterobacteriaceae (CRE) infections has not been established, because to date, no clinical trials have been performed with this objective. We aimed to summarize in the present review data provided by previous observational clinical studies that have investigated the impact of different treatment strategies on the outcome of CRE infections...
February 8, 2017: Virulence
https://www.readbyqxmd.com/read/28276990/how-are-we-measuring-clinically-important-outcome-for-operative-treatments-in-sports-medicine
#11
Benedict U Nwachukwu, R Scott Runyon, Cynthia A Kahlenberg, Elizabeth B Gausden, William W Schairer, Answorth A Allen
OBJECTIVES: Minimal clinically important difference (MCID) and other measures of minimum clinical importance are increasingly recognized as important clinical considerations for evaluating the efficacy of an intervention. As our interpretation of clinical outcome evolves beyond statistical significance, psychometric properties such as MCID will be increasingly important to various stakeholders in the orthopaedic community. The purpose of this study was to: 1) describe the state of clinically important outcome reporting and 2) describe the methods used to derive these psychometric values for sports medicine patients undergoing operative treatments...
February 23, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28263940/early-detection-of-heart-failure-using-electronic-health-records-practical-implications-for-time-before-diagnosis-data-diversity-data-quantity-and-data-density
#12
Kenney Ng, Steven R Steinhubl, Christopher deFilippi, Sanjoy Dey, Walter F Stewart
BACKGROUND: Using electronic health records data to predict events and onset of diseases is increasingly common. Relatively little is known, although, about the tradeoffs between data requirements and model utility. METHODS AND RESULTS: We examined the performance of machine learning models trained to detect prediagnostic heart failure in primary care patients using longitudinal electronic health records data. Model performance was assessed in relation to data requirements defined by the prediction window length (time before clinical diagnosis), the observation window length (duration of observation before prediction window), the number of different data domains (data diversity), the number of patient records in the training data set (data quantity), and the density of patient encounters (data density)...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28254639/psychometric-and-clinimetric-properties-of-the-melbourne-assessment-2-in-children-with-cerebral-palsy
#13
Tien-Ni Wang, Kai-Jie Liang, Yi-Chia Liu, Jeng-Yi Shieh, Hao-Ling Chen
OBJECTIVE: The Melbourne Assessment 2 (MA2) is increasingly used as an outcome measurement in clinical studies. The purposes of this study were to examine its psychometric and clinimetric properties. DESIGN: Psychometric and clinimetric study. SETTING: Community. PARTICIPANTS: Seventeen children with CP from 5 to 12 years were recruited for the estimation of the test-retest reliability and minimal detectable change (MDC)...
February 27, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28251584/improvements-in-fatigue-in-1536-patients-with-rheumatoid-arthritis-and-correlation-with-other-treatment-outcomes-a-post-hoc-analysis-of-three-randomized-controlled-trials-of-abatacept
#14
Laure Gossec, Souhila Ahdjoudj, Evo Alemao, Vibeke Strand
INTRODUCTION: A post hoc analysis of three randomized controlled trials of abatacept in rheumatoid arthritis (RA) was conducted to explore the effect of abatacept on fatigue in RA and its correlation with other outcomes. METHODS: In this analysis of AGREE (early RA) and AIM and ATTAIN (established RA), changes in baseline fatigue (0-100 mm scale), pain, sleep (AIM and ATTAIN only) and Disease Activity Score (DAS) 28 (C-reactive protein; CRP) were calculated at days 29, 85, and 169...
March 1, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#15
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28244407/long-term-patient-reported-outcomes-from-a-phase-3-randomized-prospective-trial-of-conventional-versus-hypofractionated-radiation-therapy-for-localized-prostate-cancer
#16
Talha Shaikh, Tianyu Li, Elizabeth A Handorf, Matthew E Johnson, Lora S Wang, Mark A Hallman, Richard E Greenberg, Robert A Price, Robert G Uzzo, Charlie Ma, David Chen, Daniel M Geynisman, Alan Pollack, Eric M Horwitz
PURPOSE: To assess the long-term quality of life (QoL) outcomes from a phase 3 trial comparing 2 modes of intensity modulated radiation therapy (IMRT): conventional IMRT (CIMRT) versus hypofractionated IMRT (HIMRT) in patients with localized prostate cancer. METHODS AND MATERIALS: Between 2002 and 2006, 303 men with low-risk to high-risk prostate cancer were randomized to 76 Gy in 38 fractions (CIMRT) versus 70.2 Gy in 26 fractions (HIMRT). QoL was compared by use of the Expanded Prostate Cancer Index Composite (EPIC), the International Prostate Symptom Score (IPSS), and EuroQoL (EQ5D) questionnaires...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28231647/outcome-of-acl-reconstruction-for-chronic-acl-injury-in-knees-without-the-posterior-horn-of-the-medial-meniscus-comparison-with-acl-reconstructed-knees-with-an-intact-medial-meniscus
#17
Kevin Syam, Devendra K Chouhan, Mandeep Singh Dhillon
Purpose: Cadaveric studies have shown that deficiency of the posterior horn of the medial meniscus (PHMM) increases strain on the anterior cruciate ligament (ACL) graft. However, its influence on the clinical and radiological outcome after ACL reconstruction is less discussed and hence evaluated in this study. Materials and Methods: This study included 77 cases of ACL reconstruction with a minimum 18-month follow-up. Of the 77 cases, 41 patients with intact menisci were compared clinically and radiologically with 36 patients with an injury to the PHMM that required various grades of meniscectomy...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28215182/pain-relief-that-matters-to-patients-systematic-review-of-empirical-studies-assessing-the-minimum-clinically-important-difference-in-acute-pain
#18
Mette Frahm Olsen, Eik Bjerre, Maria Damkjær Hansen, Jørgen Hilden, Nino Emanuel Landler, Britta Tendal, Asbjørn Hróbjartsson
BACKGROUND: The minimum clinically important difference (MCID) is used to interpret the clinical relevance of results reported by trials and meta-analyses as well as to plan sample sizes in new studies. However, there is a lack of consensus about the size of MCID in acute pain, which is a core symptom affecting patients across many clinical conditions. METHODS: We identified and systematically reviewed empirical studies of MCID in acute pain. We searched PubMed, EMBASE and Cochrane Library, and included prospective studies determining MCID using a patient-reported anchor and a one-dimensional pain scale (e...
February 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28210464/evaluation-of-efflux-pumps-gene-expression-in-resistant-pseudomonas-aeruginosa-isolates-in-an-iranian-referral-hospital
#19
Babak Pourakbari, Sahar Yaslianifard, Somaye Yaslianifard, Shima Mahmoudi, Sepideh Keshavarz-Valian, Setareh Mamishi
BACKGROUND AND OBJECTIVES: Pseudomonas aeruginosa (PA) is one of the most important causes of nosocomial infections and has an intrinsic resistance to many antibiotics. Among all the resistance-nodulation-division (RND) pumps of P. aeruginosa, MexAB-OprM is the first efflux pump found to target multiple classes of antibiotics. This study was aimed to evaluate the expression level of genes expressing MexAB-OprM in clinical isolates of P. aeruginosa. MATERIALS AND METHODS: In this study, 45 P...
August 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28196255/effect-of-2-years-of-treatment-with-sublingual-grass-pollen-immunotherapy-on-nasal-response-to-allergen-challenge-at-3-years-among-patients-with-moderate-to-severe-seasonal-allergic-rhinitis-the-grass-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Guy W Scadding, Moises A Calderon, Mohamed H Shamji, Aarif O Eifan, Martin Penagos, Florentina Dumitru, Michelle L Sever, Henry T Bahnson, Kaitie Lawson, Kristina M Harris, Audrey G Plough, Joy Laurienzo Panza, Tielin Qin, Noha Lim, Nadia K Tchao, Alkis Togias, Stephen R Durham
Importance: Sublingual immunotherapy and subcutaneous immunotherapy are effective in seasonal allergic rhinitis. Three years of continuous treatment with subcutaneous immunotherapy and sublingual immunotherapy has been shown to improve symptoms for at least 2 years following discontinuation of treatment. Objective: To assess whether 2 years of treatment with grass pollen sublingual immunotherapy, compared with placebo, provides improved nasal response to allergen challenge at 3-year follow-up...
February 14, 2017: JAMA: the Journal of the American Medical Association
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