Evidence-based Healthcare最新文献

{"title":"After a stroke, ability with daily tasks of living improves after therapy based rehabilitation services","authors":"Michael Power MB, FRCP (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.018","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.018","url":null,"abstract":"<div><h3>Question</h3><p>Do post-discharge rehabilitation services change recovery after stroke?</p></div><div><h3>Study design</h3><p>Systematic review with meta-analysis.</p></div><div><h3>Main results</h3><p>Fourteen trials met inclusion criteria; 12 trials comparing therapy-based rehabilitation services were included in the meta-analysis (occupational therapy = 6 trials, physiotherapy = 2 trials and mixed services = 4 trials). At a median follow-up of 6 months, therapy-based rehabilitation services reduced the risk of deterioration in ability to undertake daily living tasks compared with control, (OR 0.72, 95% CI 0.57 to 0.92). Ability to carry out extended activities of daily living significantly improved in people undergoing therapy-based rehabilitation services compared with control (mean difference 0.17 95% CI 0.04 to 0.30). When similar categories of therapy were compared, only occupational therapy significantly reduced deterioration rate (occupational therapy: OR 0.73, 95% CI 0.55 to 0.96; physiotherapy OR 0.67, 95% CI 0.24 to 1.89; mixed services OR 0.72, 95% CI 0.41 to 1.27). Data were inconclusive with respect to mood, quality of life, need for long-term care and hospital readmission.</p></div><div><h3>Authors’ conclusions</h3><p>People discharged to their homes after stroke are less likely to deteriorate if therapy-based rehabilitation services are provided compared with usual care or no routine intervention.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 188-189"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attending a single care site associated with improved glycaemic control in people with diabetes","authors":"Peter Harvey (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.016","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.016","url":null,"abstract":"<div><h3>Question</h3><p>Does continuity of care improve control of clinical risk factors in people with diabetes?</p></div><div><h3>Study design</h3><p>Cross-sectional community-based survey.</p></div><div><h3>Main results</h3><p>85.5% of participants had continuity of care (single care site and usual provider), 9.3% had a single care site but different providers, and 5.2% had no usual source of care. Good glycaemic control was more likely with continuity of care or single care site compared with no usual source of care (continuity of care: OR 4.62, 95% CI 2.02 to 10.60; single care site: OR 6.13, 95% CI 2.08 to 18.04). There were no significant differences between groups with a usual site. There was no increased likelihood of good control of blood pressure or lipid level among groups.</p></div><div><h3>Authors’ conclusions</h3><p>There is evidence that good glycaemic control is more likely among people whose diabetic care is provided from one site, regardless of whether it is provided by the same practitioner.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 192-194"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Link between diagnostic X-rays and cancer uncertain","authors":"John R Cameron PhD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.011","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.011","url":null,"abstract":"<div><h3>Question</h3><p>Do diagnostic X-rays increase the risk of developing cancer?</p></div><div><h3>Study design</h3><p>Epidemiological risk analysis.</p></div><div><h3>Main results</h3><p>By age 75, the cumulative risks of cancer resulting from diagnostic X-rays were estimated to be between 0.6% (in the UK and Poland) and 3.2% (Japan). In all other populations the estimated risk was between 0.7% and 1.8%. The UK risk correlates to 700 cases per year including 111 bladder cancers, 107 colon cancers and 61 lung cancers.</p></div><div><h3>Authors’ conclusions</h3><p>According to their model, the estimated cumulative risk of cancer caused by diagnostic X-rays varied between countries, however most were fewer than 2%. In Japan the estimated cumulative risk exceeded 3%.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 205-206"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six monthly follow-up is as effective as 3 monthly follow-up for people with hypertension","authors":"Mark R Nelson MBBS(Hons), MFM, FRACGP, PhD, FAFPHM (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.020","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.020","url":null,"abstract":"<div><h3>Question</h3><p>In people with treated hypertension, how effective is 3 month follow-up by a family physician compared with 6 month follow-up, in terms of blood pressure control, patient satisfaction and adherence to drug treatment over 3 years?</p></div><div><h3>Study design</h3><p>Randomised controlled trial.</p></div><div><h3>Main results</h3><p>At 36 months, mean blood pressure, patient satisfaction and adherence to treatment was equivalent between treatment groups (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Outcome measures at 36 months for people receiving 3 or 6 month follow-up by a family practitioner.</td></tr><tr><td></td><td>3 months (<span><math><mtext>N=302</mtext></math></span>)</td><td>6 months (<span><math><mtext>N=307</mtext></math></span>)</td><td>Difference (SE)</td><td>Equivalence 90% CI^†</td></tr><tr><td>% Participants with out of control blood pressure^*</td><td>18%</td><td>16%</td><td>Not stated</td><td></td></tr><tr><td>Mean systolic blood pressure</td><td>133.50</td><td>135.84</td><td>−2.35 (1.52)</td><td>−4.84 to 0.15</td></tr><tr><td>Mean diastolic blood pressure</td><td>81.70</td><td>81.45</td><td>0.25 (1.12)</td><td>−1.61 to 2.11</td></tr><tr><td>General satisfaction with clinical care</td><td>73%</td><td>75%</td><td>−2.69</td><td>−5.76 to 0.38</td></tr><tr><td>% of participants answering ‘yes’ to the question: ‘Did I ever forget to take my pills?’</td><td>78/263 (30%)</td><td>71/263 (27%)</td><td>2.96 (3.92)</td><td>−3.48 to 9.41</td></tr><tr><td>^*As assessed by doctor; authors state no significant difference between groups, but statistics not presented.</td></tr><tr><td>^†If the 90% CI falls entirely within the predefined equivalence range (±5<!--> <!-->mmHg for both systolic and diastolic blood pressure and ±10% for patient satisfaction and adherence), the groups are considered equivalent.</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>In people with controlled hypertension, 6 monthly follow-up is as effective as 3 monthly follow-up over 3 years for control of blood pressure, patient satisfaction and adherence to treatment, and has no effect on the proportion of participants with out of control blood pressure.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 183-185"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous magnesium sulphate does not improve survival or disability outcomes in people with stroke","authors":"S. Selco, B. Ovbiagele","doi":"10.1016/J.EHBC.2004.05.002","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.002","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"116 1","pages":"227-229"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83701161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes","authors":"S. Gallus","doi":"10.1016/J.EHBC.2004.05.009","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.009","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"21 1","pages":"207-209"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78859226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast feeding support from volunteer counsellors does not increase rates of breast feeding","authors":"A. Mitra","doi":"10.1016/J.EHBC.2004.05.012","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.012","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"6 3","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72600894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast feeding support from volunteer counsellors does not increase rates of breast feeding","authors":"Amal K Mitra MD,MPH,DrPH (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.012","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.012","url":null,"abstract":"<div><h3>Question</h3><p>Does breast feeding support from volunteer counsellors increase the number of women who breast feed?</p></div><div><h3>Study design</h3><p>Randomised controlled trial.</p></div><div><h3>Main results</h3><p>At both 6 weeks and 4 months, there was no significant difference in rates of breast feeding between women receiving breast feeding counselling and those that did not (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Number of women breast feeding (%)</td></tr><tr><td></td><td>With breast feeding counselling (<em>N</em>=363)</td><td>Without counselling (<em>N</em>=357)</td><td>RR (95% CI)</td><td><em>p</em> value</td></tr><tr><td>Breast feeding at birth</td><td>320 (95%)</td><td>324 (96%)</td><td>0.99 (0.84 to 1.16)</td><td>0.44</td></tr><tr><td>Breast feeding at 6 weeks</td><td>218 (65%)</td><td>213 (63%)</td><td>1.02 (0.84 to 1.24)</td><td>0.69</td></tr><tr><td>Breast feeding at 4 months</td><td>143/310 (46%)^∗</td><td>131/310 (42%)^∗</td><td>1.09 (0.86 to 1.39)</td><td>0.33</td></tr><tr><td>^∗Only 310/363 (85%) women in the intervention group and 310/357 (87%) in the control group responded at 4 months. Analysis was not by intention to treat.</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Breast feeding support by volunteer counsellors did not increase breast feeding rates.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 202-204"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes","authors":"Silvano Gallus ScD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.009","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.009","url":null,"abstract":"<div><h3>Question</h3><p>What is the relationship between lung cancer mortality and tar rating of smoker's cigarette brand?</p></div><div><h3>Study Design</h3><p>Multivariate analysis of data from prospective cohort study.</p></div><div><h3>Main results</h3><p>Risk of death due to lung cancer was significantly higher in smokers of high-tar cigarettes compared with people smoking low, very low and medium tar cigarettes (see Table 1). There were no significant differences in the risk of lung cancer mortality for people smoking very low or low tar cigarettes compared with smokers of medium tar cigarettes. Stopping smoking considerably reduced risk of lung cancer. People quitting before age 35 years had a very similar risk to those who had never smoked.<span><div><div><table><tbody><tr><td>Table 1 Risk of mortality from lung cancer by tar level of cigarette smoked in the whole cohort</td></tr><tr><td>Tar level</td><td>Males</td><td>Females</td></tr><tr><td></td><td>Hazard ratio (95% CI)</td><td>Hazard ratio (95% CI)</td></tr><tr><td></td><td></td><td></td></tr><tr><td>0–7<!--> <!-->mg</td><td>1.17 (0.95 to 1.45)</td><td>0.98 (0.80 to 1.21)</td></tr><tr><td>8–14<!--> <!-->mg</td><td>1.02 (0.90 to 1.16)</td><td>0.95 (0.82 to 1.11)</td></tr><tr><td>15–21<!--> <!-->mg</td><td>1.0</td><td>1.0</td></tr><tr><td>⩾22<!--> <!-->mg</td><td>1.44 (1.20 to 1.73)</td><td>1.64 (1.26 to 2.15)</td></tr><tr><td>Unclassifiable</td><td>1.10 (0.97 to 1.25)</td><td>0.72 (0.56 to 0.93)</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>There was no detectable difference in risk of lung cancer among people who smoked very low, low or medium tar cigarettes. An increased risk was identified in people who smoked high tar cigarettes. These findings persisted after adjustment for demographics, diet and medical history and for cigarettes/day.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 207-209"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consuming less than 4 alcoholic drinks per week does not increase risk of pre-term delivery","authors":"H. Paladine","doi":"10.1016/J.EHBC.2004.05.006","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.006","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"40 3 1","pages":"216-217"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80910801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}