Evidence-based Healthcare最新文献_第4页

Appointment attendance predicts level of glycaemic control in people with diabetes 预约就诊可以预测糖尿病患者的血糖控制水平

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.015

Barbara M Rohland MD (Commentry Author)

{"title":"Appointment attendance predicts level of glycaemic control in people with diabetes","authors":"Barbara M Rohland MD (Commentry Author)","doi":"10.1016/j.ehbc.2004.05.015","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.015","url":null,"abstract":"<div><h3>Question</h3><p>Do people who miss scheduled healthcare appointments have poorer management of their diabetes?</p></div><div><h3>Study design</h3><p>Retrospective cross-sectional cohort study.</p></div><div><h3>Main results</h3><p>During the year 2000, 12% of participants missed >30% of scheduled appointments, 52% missed 1–30% and 35% missed none. Glycaemic control was poorer in those who missed most appointments (<em>p</em><0.0001), irrespective of how diabetes was controlled (diet, oral agent or insulin). The adjusted mean glycosylated haemoglobin level (HbA<sub>1c</sub>) was higher in people attending appointments compared with people missing >30% of appointments (<em>p</em><0.0001). Daily self-monitoring was associated with a fewer missed appointments (OR 1.8, 95% CI 1.7 to 1.9). People with inadequate medication ⩾20% of the time were more likely to miss appointments (OR 1.5, <em>p</em><0.0001). Living in a poverty area, pharmacologic control of diabetes, use of antidepressants and having fewer scheduled appointments were significantly associated with missing >30% of scheduled appointments.</p></div><div><h3>Authors’ conclusions</h3><p>People with diabetes who frequently miss appointments are likely to have poorer glycaemic control and less frequent self-monitoring. Level of attendance could be monitored and used for clinical risk stratification.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 195-196"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824438","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}

引用次数: 1

H. pylori eradication does not reduce gastric cancer incidence in a high-risk area of China☆ 幽门螺杆菌根除并不能降低中国高危地区胃癌的发病率

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.005

B. Sheu, Xi-Zhang Lin

引用次数: 2

Exercise training programmes improve survival and delay hospital admission in people with chronic heart failure 运动训练方案可提高慢性心力衰竭患者的生存率并延迟住院时间

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.013

N. Smart, T. Marwick

引用次数: 1

Unscheduled care for people with asthma in a multi-ethnic area is reduced following educational outreach programme by specialist nurses 在多民族地区，通过专科护士的教育推广方案，减少了对哮喘患者的计划外护理

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.017

Arvid W.A Kamps MD, PhD (Commentary Author)

{"title":"Unscheduled care for people with asthma in a multi-ethnic area is reduced following educational outreach programme by specialist nurses","authors":"Arvid W.A Kamps MD, PhD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.017","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.017","url":null,"abstract":"<div><h3>Question</h3><p>Do asthma specialist nurses reduce health service use and improve outcomes across different ethnic groups?</p></div><div><h3>Study design</h3><p>Cluster randomised controlled trial.</p></div><div><h3>Main results</h3><p>Specialist nurse intervention reduced the percentage of participants attending unscheduled care in the subsequent year compared with usual care (adjusted odds ratio with clustering 0.61, 95% CI 0.38 to 0.99). First attendance for unscheduled asthma care in the same time period was delayed by specialist nurse intervention (hazard ratio [HR] 0.73, 95% CI 0.54 to 1.00). The effect of specialist nurse intervention on time to attendance was greater in white people (HR 0.57, 95% CI 0.38 to 0.85) compared with South Asian people (HR 0.72, 95% CI 0.48 to 1.09) or other ethnicities (HR 1.29, 95% CI 0.51 to 3.22). There were no significant difference in mean rates of hospital admission between groups.</p></div><div><h3>Authors’ conclusions</h3><p>Unscheduled care for people with asthma was reduced in practices where asthma specialist nurses provided an educational outreach and clinical support programme to staff. Improved outcomes were not equally distributed among ethnic groups.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 190-191"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824434","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}

引用次数: 4

Intravenous magnesium sulphate does not improve survival or disability outcomes in people with stroke 静脉注射硫酸镁不能改善中风患者的生存或残疾结果

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.002

Scott Selco MD, PhD (Commentary Author), Bruce Ovbiagele MD (Commentary Author)

{"title":"Intravenous magnesium sulphate does not improve survival or disability outcomes in people with stroke","authors":"Scott Selco MD, PhD (Commentary Author), Bruce Ovbiagele MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.002","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.002","url":null,"abstract":"<div><h3>Question</h3><p>Does intravenous magnesium sulphate improve survival or disability outcomes if given within 12 hours of stroke onset?</p></div><div><h3>Study design</h3><p>Multicentre randomised controlled trial.</p></div><div><h3>Main results</h3><p>Intravenous magnesium sulphate did not significantly improve survival or disability outcomes at 90 days compared with placebo in people with stroke (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Survival and disability outcomes at 90 days in people with stroke.</td></tr><tr><td></td><td>Placebo (<em>N</em>=1198)</td><td>Magnesium Sulphate (<em>N=</em>1188)</td><td>Odds Ratio (95% CI)</td><td><em>P</em> value</td></tr><tr><td>Combined outcome of death and disability</td><td>Not reported</td><td>Not reported</td><td>0.95 (0.80 to 1.13)</td><td>0.59</td></tr><tr><td>Death</td><td>196 (16.4%)</td><td>227 (19.1%)</td><td>1.22 (0.98 to 1.53)</td><td>0.07</td></tr><tr><td>Barthel score <95</td><td>787 (65.7%)</td><td>775 (65.2%)</td><td>0.99 (0.83 to 1.19)</td><td>0.92</td></tr><tr><td>Barthel score <60</td><td>445 (37.1%)</td><td>449 (37.8%)</td><td>1.03 (0.86 to 1.24)</td><td>0.74</td></tr><tr><td>Modified Rankin score >1</td><td>858 (71.6%)</td><td>826 (69.5%)</td><td>0.91 (0.75 to 1.09)</td><td>0.30</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Intravenous magnesium sulphate given within 12 hours of stroke does not improve survival or disability outcomes.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 227-229"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71823705","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}

引用次数: 1

Consuming less than 4 alcoholic drinks per week does not increase risk of pre-term delivery 每周饮酒少于4杯不会增加早产的风险

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.006

Heather L. Paladine MD (Commentary Author)

{"title":"Consuming less than 4 alcoholic drinks per week does not increase risk of pre-term delivery","authors":"Heather L. Paladine MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.006","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.006","url":null,"abstract":"<div><h3>Question</h3><p>Is there an association between the amount and type of alcohol consumed during pregnancy and the risk of pre-term delivery?</p></div><div><h3>Study design</h3><p>Prospective cohort study.</p></div><div><h3>Main results</h3><p>Of 40, 892 pregnant women, 1880 (4.6%) had pre-term delivery. The adjusted relative risk of pre-term delivery in all women consuming 2–3.5 drinks per week was lower than in non-drinkers (RR 0.80, 95% CI 0.68 to 0.96). The risk was not statistically significant when only nulliparous women were included. Other levels of alcohol consumption were not associated with a statistically significant increased or decreased risk of pre-term delivery compared with non-drinkers except for nulliparous women who drank ⩾7 drinks per week (RR 2.91, 95% CI 1.29 to 6.55). There was no relationship between risk of pre-term delivery and the preferred type of alcohol (wine, beer, spirits or mixed).</p></div><div><h3>Authors’ conclusions</h3><p>Consumption of 7 or more drinks per week was associated with an increased risk of pre-term delivery in woman having their first child. Pre-term delivery was not affected by type of alcohol intake.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 216-217"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71824446","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}

引用次数: 0

Chest pain observation units reduce hospital admission in people with acute chest pain 胸痛观察单位减少了急性胸痛患者的住院率

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.010

M. Ross

引用次数: 2

Rate of major complications is higher in laparoscopic than abdominal hysterectomy but quality of life improves with both procedures 腹腔镜子宫切除术的主要并发症发生率高于腹部子宫切除术，但两种手术的生活质量都有所改善

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.022

Lee A Learman M.D., Ph.D., F.A.C.O.G. (Commentary Author)

{"title":"Rate of major complications is higher in laparoscopic than abdominal hysterectomy but quality of life improves with both procedures","authors":"Lee A Learman M.D., Ph.D., F.A.C.O.G. (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.022","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.022","url":null,"abstract":"<div><h3>Question</h3><p>Is the risk of major complications greater following laparoscopic hysterectomy compared with abdominal and vaginal hysterectomy for non-malignant conditions?</p></div><div><h3>Study design</h3><p>Two parallel, multi-centre randomised trials.</p></div><div><h3>Main results</h3><p>More major complications were experienced with laparoscopic hysterectomy compared with abdominal hysterectomy (11.1% vs 6.2%; mean difference 4.9%, 95% CI 0.9% to 9.1%, number needed to harm 20). There was no significant difference in complication rates between laparoscopic and vaginal hysterectomy groups (complication rate 9.5% for both groups).</p><p>Pain scores were higher following abdominal hysterectomy compared with laparoscopic hysterectomy (mean difference 0.4, 95% CI 0.09 to 0.7). There was no detectable difference in the vaginal trial. Quality of life at 12 months improved with all interventions.</p></div><div><h3>Authors’ conclusions</h3><p>Major complications were more common following laparoscopic hysterectomy compared with abdominal hysterectomy. The vaginal trial was inconclusive.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 232-234"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71823706","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}

引用次数: 4

Liver cancer screening in a high-risk population in China fails to reduce mortality 在中国的高危人群中进行肝癌筛查未能降低死亡率

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.003

Sammy Saab MD, MPH (Commentary Author)

{"title":"Liver cancer screening in a high-risk population in China fails to reduce mortality","authors":"Sammy Saab MD, MPH (Commentary Author)","doi":"10.1016/j.ehbc.2004.05.003","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.05.003","url":null,"abstract":"<div><h3>Question</h3><p>Does liver cancer screening reduce mortality from the disease in a high-risk Chinese population?</p></div><div><h3>Study design</h3><p>Cluster randomised controlled trial.</p></div><div><h3>Main results</h3><p>In people at high risk of liver cancer, screening did not significantly reduce the incidence of primary liver cancer or risk of death compared with no screening (see Table 1), despite earlier detection of the disease (see notes).<span><div><div><table><tbody><tr><td>Table 1 Primary liver cancer incidence and mortality rates in a high-risk Chinese population.</td></tr><tr><td></td><td>Screened (<span><math><mtext>N=3712</mtext></math></span>)</td><td>Not screened (<span><math><mtext>N=1869</mtext></math></span>)</td><td><span><math><mtext>p</mtext></math></span> value</td></tr><tr><td>Number of primary liver cancer cases</td><td>257 (7%)</td><td>117 (6%)</td><td></td></tr><tr><td>Incidence rate<sup>†</sup></td><td>1341</td><td>1195</td><td>0.30</td></tr><tr><td>Deaths from primary liver cancer</td><td>218 (6%)</td><td>109 (6%)</td><td></td></tr><tr><td>Mortality rate<sup>†</sup></td><td>1138</td><td>1113</td><td>0.86</td></tr></tbody></table></div></div></span> <sup>†</sup>Per 100,000 person years.</p></div><div><h3>Authors’ conclusions</h3><p>Liver cancer screening in a high-risk population in China does not reduce mortality from the disease.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 4","pages":"Pages 221-223"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71823710","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}

引用次数: 2

Chest pain observation units reduce hospital admission in people with acute chest pain 胸痛观察单位减少了急性胸痛患者的住院率

Evidence-based Healthcare Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.010

Michael A Ross MD, FACEP (Commentary Author)

引用次数: 2