Evidence-based Healthcare最新文献

{"title":"Attending a single care site associated with improved glycaemic control in people with diabetes","authors":"P. Harvey","doi":"10.1016/J.EHBC.2004.05.016","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.016","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"19 1","pages":"192-194"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87172860","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":"Retaplase plus abciximab improves non-fatal outcomes, but not overall survival in people with diabetes and acute ST-segment elevation myocardial infarction","authors":"V. Serebruany","doi":"10.1016/J.EHBC.2004.05.001","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.001","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"21 1","pages":"230-231"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77958079","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":"After a stroke, ability with daily tasks of living improves after therapy based rehabilitation services ☆","authors":"M. Power","doi":"10.1016/J.EHBC.2004.05.018","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.018","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"7 2 1","pages":"188-189"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83333252","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":"Exercise training programmes improve survival and delay hospital admission in people with chronic heart failure","authors":"Neil Smart MSc (Commentary Author),&nbsp;Thomas H Marwick MBBS, PhD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.013","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.013","url":null,"abstract":"<div><h3>Question</h3><p>Do exercise training programmes improve survival in people with chronic heart failure?</p></div><div><h3>Study design</h3><p>Systematic review with meta-analysis.</p></div><div><h3>Main results</h3><p>Fewer deaths occurred in the exercise group compared with control at a median follow-up of about 2 years (exercise: 22% [88/395]; control 26% [105/406]; hazard ratio 0.65, 95% CI 0.46 to 0.92). Fewer deaths or hospital admissions occurred in the exercise group compared with control (exercise: 32% [127/395]; control 43% [173/406]; hazard ratio HR 0.72, 95% CI 0.56 to 0.93).</p></div><div><h3>Authors’ conclusions</h3><p>Exercise training improves survival and time to death or admission to hospital in people with chronic heart failure due to left ventricular systolic dysfunction.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 200-201"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824436","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":"Lowering homocysteine levels does not reduce rates of stroke, coronary heart disease or death in people with ischaemic stroke","authors":"Yi-Chia Huang PhD, RD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.008","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.008","url":null,"abstract":"<div><h3>Question</h3><p>Do high doses of vitamins B₆ and B₁₂ and folic acid, which lower total homocysteine levels, reduce the risk of recurrent stroke, myocardial infarction or death compared with low doses in people with non disabling acute ischaemic stroke?</p></div><div><h3>Study design</h3><p>Multicentre randomised controlled trial.</p></div><div><h3>Main results</h3><p>High dose vitamins reduced mean total homocysteine levels by 2 μmol/l more than low dose vitamins. In people surviving a non disabling acute ischaemic stroke, no significant differences in rates of recurrent ischaemic stroke, coronary heart disease or death occurred between people receiving high dose or low dose vitamins over 2 years (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Outcomes at 2 years in people with ischemic stroke receiving high versus low doses of vitamins.</td></tr><tr><td>Event</td><td>Low-dose (AR^∗)(<span><math><mtext>N=1853</mtext></math></span>)</td><td>High-dose (AR^∗) (<span><math><mtext>N=1827</mtext></math></span>)</td><td>Adjusted hazard ratio^† (95% CI)</td><td><em>p</em> value^∗</td></tr><tr><td>Death</td><td>117 (6.9%)</td><td>99 (5.9%)</td><td>0.9 (0.6 to 1.1)</td><td>0.24</td></tr><tr><td>Ischaemic stroke</td><td>148 (8.8%)</td><td>152 (9.2%)</td><td>1.1 (0.8 to 1.3)</td><td>0.68</td></tr><tr><td>Coronary heart disease</td><td>123 (7.4%)</td><td>114 (7.0%)</td><td>0.9 (0.7 to 1.1)</td><td>0.62</td></tr><tr><td>^∗ Kaplan Meier estimates of events within 2 years.</td></tr><tr><td>^†Analysis was performed with proportional hazards models adjusting for characteristics that differed significantly between treatment groups at baseline (see method notes).</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>In people with ischaemic stroke, lowering homocysteine levels does not reduce the rate of recurrent stroke, coronary heart disease or death.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 210-212"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824447","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":"Practice-based continuing education combined with process improvement methods improves delivery of preventive services to children","authors":"James L. Vacek MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.021","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.021","url":null,"abstract":"<div><h3>Question</h3><p>Does continuing medical education in combination with process improvement methods to implement office systems, increase rates of delivery of preventive care to children?</p></div><div><h3>Study design</h3><p>Cluster randomised controlled trial.</p></div><div><h3>Main results</h3><p>Significantly more children enrolled in intervention practices received all four preventive services compared with control practices after 30 months (change in proportion of children receiving all four preventive services: 7% to 34% with intervention vs 9% to 10% with no intervention; 4.6-fold increase with intervention compared with control, 95% CI 1.6 to 13.2, see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Mean percentage of children receiving preventive services at baseline and 30 months follow up.</td></tr><tr><td></td><td>Baseline</td><td>At 30 months follow-up</td><td>Significance</td></tr><tr><td>Preventive service</td><td>Intervention 22 practices (%)</td><td>Control 22 practices (%)</td><td>Intervention 22 practices (%)</td><td>Control 22 practices (%)</td><td>Ratio of change in prevalence, intervention v control</td></tr><tr><td>All 4 services</td><td>11</td><td>12</td><td>34</td><td>10</td><td>4.6, 95 CI 1.6 to 13.2</td></tr><tr><td>Immunisations</td><td>66</td><td>64</td><td>Data presented graphically, no absolute numbers given</td><td></td><td>No significant difference between groups</td></tr><tr><td>Tuberculosis screening</td><td>39</td><td>36</td><td>54</td><td>32</td><td><span><math><mtext>p&lt;0.05</mtext></math></span></td></tr><tr><td>Anaemia screening</td><td>65</td><td>64</td><td>79</td><td>71</td><td><span><math><mtext>p&lt;0.05</mtext></math></span></td></tr><tr><td>Lead screening</td><td>32</td><td>29</td><td>68</td><td>30</td><td><span><math><mtext>p&lt;0.05</mtext></math></span></td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Practice-based continuing medical education in combination with process improvement methods increases the rate of delivery of preventive care services to children.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 177-179"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824468","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":"Intensive follow-up for colorectal cancer is cost-effective","authors":"B. Ohlsson","doi":"10.1016/J.EHBC.2004.05.019","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.019","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"16 1","pages":"186-187"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73895167","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":"Appointment attendance predicts level of glycaemic control in people with diabetes","authors":"B. Rohland","doi":"10.1016/J.EHBC.2004.05.015","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.05.015","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"46 1","pages":"195-196"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80015513","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":"Intensive follow-up for colorectal cancer is cost-effective","authors":"Björn Ohlsson MD, PhD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.019","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.019","url":null,"abstract":"<div><h3>Question</h3><p>Is intensive follow-up after curative resection for colorectal cancer cost-effective compared with conventional follow-up methods?</p></div><div><h3>Study design</h3><p>Incremental cost-effectiveness analysis based on a meta-analysis of 5 RCTs.</p></div><div><h3>Main results</h3><p>Over 5 years, people having intensive follow-up gained 0.73 to 0.82 life years compared with conventional follow-up (absolute reduction in mortality with intensive follow-up: all trials 7%; 95% CI 5% to 9%; extramural trials only 9%; 95% CI 7% to 11%). Additional costs incurred by intensive follow-up were £3402 per life year gained (or £3077 based on extramural trials only). The net costs per person were £2479 and £2529, respectively.</p></div><div><h3>Authors’ conclusions</h3><p>Intensive follow-up of people with colorectal cancer is cost-effective compared to conventional methods, based on a robust economic model and efficacy evidence from 5 RCTs.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 186-187"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824433","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":"Laparoscopic hysterectomy is not cost effective compared with vaginal hysterectomy","authors":"Benjamin L Crawford MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.014","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.014","url":null,"abstract":"<div><h3>Question</h3><p>What is the cost effectiveness of laparoscopic hysterectomy compared with conventional (vaginal or abdominal) hysterectomy?</p></div><div><h3>Study design</h3><p>Two parallel multicentre randomised controlled trials.</p></div><div><h3>Main results Vaginal hysterectomy:</h3><p>Laparoscopic hysterectomy was significantly more expensive than vaginal hysterectomy, however there were no differences in quality adjusted life years (QALYs; see Table 1).</p></div><div><h3>Abdominal hysterectomy:</h3><p>There were no significant differences between abdominal and laparoscopic hysterectomy for cost or QALYs. For each additional QALY, laparoscopic hysterectomy was estimated to cost £267,333 more than vaginal hysterectomy, and £26,571 more than abdominal hysterectomy.<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Relative cost and effectiveness of laparoscopic versus conventional hysterectomy techniques (£ sterling at 1999/2000 rates).</td></tr><tr><td>Comparison</td><td>Mean difference in cost (95% CI)</td><td>Mean difference in QALYs (95% CI)</td><td>ICER</td></tr><tr><td>Laparoscopic vs vaginal</td><td>£401 (271 to 542)</td><td>0.0015(–0.0015 to 0.018)</td><td>£267,333</td></tr><tr><td>Laparoscopic vs abdominal</td><td>£186 (–26 to +375)</td><td>0.007(–0.008 to 0.023)</td><td>£26,571</td></tr></tbody></table></div></div></span> QALY, quality adjusted life year; ICER, incremental cost effectiveness ratio (mean difference in cost divided by mean difference in QALYs)</p></div><div><h3>Authors’ conclusions</h3><p>Laparoscopic hysterectomy does not offer any cost-effectiveness benefit over vaginal hysterectomy. Laparoscopic hysterectomy was similarly cost effective to abdominal hysterectomy.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 197-199"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824437","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}