Evidence-based Healthcare最新文献

{"title":"Do For-profit health plans restrict access to high-cost procedures?","authors":"A. Trujillo","doi":"10.1016/J.EHBC.2004.03.021","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.03.021","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"135 1","pages":"116-118"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79575875","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":"Universal screening does not reduce the prevalence of visual impairment in older people","authors":"R. Enzenauer","doi":"10.1016/J.EHBC.2004.03.009","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.03.009","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"16 1","pages":"150-152"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73661370","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":"Treatment of unilateral visual impairment in preschool children modestly improves visual acuity","authors":"Maria S Castanes","doi":"10.1016/J.EHBC.2004.03.002","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.03.002","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"1217 1","pages":"174-175"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76055841","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":"Major bleeding episodes occur in people receiving anticoagulant therapy for venous thromboembolism","authors":"Christoph Pechlaner MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.004","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.004","url":null,"abstract":"<div><h3>Question</h3><p>What is the clinical impact of bleeding in people taking anticoagulants for venous thromboembolism?</p></div><div><h3>Study design</h3><p>Systematic review with meta-analysis.</p></div><div><h3>Main results</h3><p>Thirty-three studies met inclusion criteria (29 randomised controlled trials, 4 prospective cohort studies; 10,757 people). Major bleeding occurred in <span><math><mtext>276</mtext><mtext>10,757</mtext></math></span> (2.6%) of people receiving anticoagulant therapy for venous thromboembolism (see Table 1). Intracranial bleeding accounted for <span><math><mtext>24</mtext><mtext>276</mtext></math></span> (8.7%) of all major bleeding episodes with fatalities occurring in <span><math><mtext>11</mtext><mtext>24</mtext></math></span> (45.8%) of these episodes.<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Clinical impact of bleeding in people receiving anticoagulant therapy for venous thromboembolism.</td></tr><tr><td></td><td>Absolute risk (%)</td><td>Absolute risk for fatal episodes (%)</td><td>Rate of bleeding per 100 patient-years (95% CI)</td></tr><tr><td>Entire anticoagulation period</td><td></td><td></td><td></td></tr><tr><td>Major bleeding episodes</td><td>276/10,757 (2.6%)</td><td>37/276 (13.4%)</td><td>7.22 (7.19 to 7.24)</td></tr><tr><td>Intracranial bleeding episodes</td><td>24/8717 (0.3%)</td><td>11/24 (45.8%)</td><td>1.15 (1.14 to 1.16)</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Major bleeding associated with anticoagulant therapy has considerable clinical consequences that will need to be weighed against therapeutic benefits in people with venous thromboembolism.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 171-173"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829102","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":"Addition of artesunate to standard antimalarial drugs reduces treatment failure","authors":"Timothy ME Davis (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.020","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.020","url":null,"abstract":"<div><h3>Question</h3><p><span>What is the effect of adding artesunate to existing drug regimens for people with acute uncomplicated </span><em>Plasmodium falciparum</em> malaria?</p></div><div><h3>Study design</h3><p>Systematic review with meta-analysis.</p></div><div><h3>Main results</h3><p>16 trials met inclusion criteria. Standard antimalarial drugs in the trials varied (sulfadoxine–pyrimethamine: 7 RCTs; amodiaquine<span><span>: 3 RCTs; chloroquine: 3 RCTs; mefloquine: 3 RCTs). Adding artesunate for 3 days to standard antimalarial drugs significantly reduced 14 and 28 day's failure rates compared with standard drugs alone (15 RCTs; OR for failure by 14 day 0.20, 95% CI 0.17 to 0.25; OR for failure by 28 days 0.23, 95% CI 0.19 to 0.28). Addition of artesunate for 1 day was not as effective as 3 days, but still significantly reduced failure rates compared with standard drugs alone (6 RCTs; OR for failure by 14 days 0.61, 95% CI 0.48 to 0.77; OR for failure by 28 days 0.68, 95% CI 0.53 to 0.89). The </span>incidence of side effects was similar in both groups.</span></p></div><div><h3>Authors’ conclusions</h3><p>Adding artesunate to a standard antimalarial drug regimen for 3 days leads to a consistent decrease in treatment failure at 14 days, irrespective of the standard antimalarial drug used.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 156-158"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829109","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":"Length of hospital stay for elderly people is substantially higher in the NHS compared with Kaiser Permanente and US Medicare programmes","authors":"David P Sklar MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.016","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.016","url":null,"abstract":"<div><h3>Question</h3><p>Does utilization of hospital beds by people aged over 65 years differ in the NHS in England, Kaiser Permanente in California and Medicare in California and the USA?</p></div><div><h3>Study Design</h3><p>Retrospective cohort study.</p></div><div><h3>Main results</h3><p>For all 11 causes of hospital admissions, standardised length of hospital stay for people aged &gt;65 years was highest in the NHS (3.5 times as long as Kaiser, twice as long as Medicare California, and nearly 50% higher than Medicare in the United States). Standardised hospital admission rates for 11 leading causes of hospital admissions in people aged &gt;65 years are generally highest for Medicare recipients in the United States and California, followed by the NHS in England and then Kaiser Permanente in California (see Table 1). However, there are important limitations to the reliability of these findings (see notes).</p></div><div><h3>Authors’ conclusions</h3><p>For 11 leading causes of acute hospital admissions in people aged &gt;65 years, the NHS has generally lower hospital admission rates and longer hospital stays compared with Medicare recipients in the United States and California, and Kaiser Permanente in California.<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Number of hospital admissions (per 100,000 population) and length of stay (days) in people aged &gt;65 years, standardised for English population data.</td></tr><tr><td>Clinical Diagnosis</td><td>NHS</td><td>Kaiser</td><td>Medicare California</td><td>Medicare United States</td></tr><tr><td></td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td></tr><tr><td>Stroke</td><td>823</td><td>27.08</td><td>788</td><td>4.26</td><td>1155</td><td>5.84</td><td>1183</td><td>6.53</td></tr><tr><td>Chronic obstructive pulmonary disease</td><td>699</td><td>9.87</td><td>558</td><td>3.79</td><td>1067</td><td>5.35</td><td>1256</td><td>5.37</td></tr><tr><td>Bronchitis or asthma</td><td>531</td><td>11.73</td><td>141</td><td>3.09</td><td>225</td><td>4.22</td><td>310</td><td>4.41</td></tr><tr><td>Coronary bypass</td><td>144</td><td>13.27</td><td>97</td><td>9.60</td><td>296</td><td>8.63</td><td>321</td><td>9.98</td></tr><tr><td>Acute myocardial infarction</td><td>550</td><td>9.39</td><td>893</td><td>4.35</td><td>675</td><td>5.14</td><td>923</td><td>5.46</td></tr><tr><td>Heart failure/shock</td><td>556</td><td>12.42</td><td>1118</td><td>3.70</td><td>1893</td><td>5.28</td><td>2272</td><td>5.37</td></tr><tr><td>Angina pectoris</td><td>783</td><td>5.88</td><td>152</td><td>2.21</td><td>176</td><td>2.58</td><td>203</td><td>2.56</td></tr><tr><td>Hip replacement</td><td>342</td><td>12.60</td><td>256</td><td>4.54</td><td>602</td><td>5.41</td><td>644</td><td>5.46</td></tr><tr><td>Knee replacement</td><td>344</td><td>11.32</td><td>367</td><td>4.17</td><td>479</td><td>4.54</td><td>557</td><td>4.40</td></tr><tr><td>Hip fracture</td><td","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 113-115"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71828665","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":"Cannabinoids do not reduce objective measurements in muscle spasticity, but people with multiple sclerosis perceive some benefit","authors":"Franjo Grotenhermen MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.014","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.014","url":null,"abstract":"<div><h3>Question</h3><p>Do cannabinoids have a beneficial effect on muscle spasticity and other symptoms associated with multiple sclerosis?</p></div><div><h3>Study Design</h3><p>Double-blind randomised placebo controlled trial.</p></div><div><h3>Main Results</h3><p>At 15 weeks, neither cannabis extract nor Δ⁹-tetrahydrocannabinol (THC) reduced muscle spasticity, compared with placebo (mean difference in Ashworth score: cannabis extract vs. placebo 0.32, 95% CI −1.04 to 1.67; THC vs. placebo 0.94, 95% CI −0.44 to 2.31). Participants taking cannabinoids reported improvements in mobility, pain, sleep quality, spasms and spasticity, but not irritability, depression, tiredness, tremor or energy (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Results of primary and secondary outcomes.</td></tr><tr><td></td><td>Cannabis extract</td><td>THC</td><td>Placebo</td><td>P value (baseline to follow-up)</td></tr><tr><td><em>Primary and objective outcomes</em></td></tr><tr><td>Mean change from baseline in Ashworth scores</td><td>1.24</td><td>1.86</td><td>0.92</td><td>0.4</td></tr><tr><td>Reduction in median time taken to walk 10<!--> <!-->m (95% CI)</td><td>4% (0 to 10)</td><td>12% (6 to 21)</td><td>4% (−2 to 7)</td><td>0.015</td></tr><tr><td><em>Secondary, subjective outcomes: percentage of participants whose symptoms improved relative to baseline</em></td></tr><tr><td>Pain</td><td>46%</td><td>50%</td><td>30%</td><td>0.002</td></tr><tr><td>Spasticity</td><td>52%</td><td>51%</td><td>37%</td><td>0.010</td></tr><tr><td>Spasms</td><td>53%</td><td>49%</td><td>39%</td><td>0.038</td></tr><tr><td>Sleep</td><td>50%</td><td>47%</td><td>36%</td><td>0.025</td></tr><tr><td>Tiredness</td><td>28%</td><td>22%</td><td>22%</td><td>0.068</td></tr><tr><td>Shake/tremor</td><td>38%</td><td>41%</td><td>33%</td><td>0.398</td></tr><tr><td>Energy</td><td>33%</td><td>35%</td><td>24%</td><td>0.140</td></tr><tr><td>Irritability</td><td>39%</td><td>33%</td><td>26%</td><td>0.619</td></tr><tr><td>Depression</td><td>36%</td><td>29%</td><td>28%</td><td>0.298</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ Conclusions</h3><p>Although cannabinoids are not beneficial for treating spasticity measured by the Ashworth score, they are useful for treating other symptoms of multiple sclerosis.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 159-161"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829101","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":"Magnesium sulphate given before birth does not significantly reduce death or cerebral palsy in premature babies, but may improve motor dysfunction","authors":"Alistair Jan Gunn MBChB, FRACP, PhD,&nbsp;Laura Bennet PhD (Commentary Authors)","doi":"10.1016/j.ehbc.2004.03.003","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.003","url":null,"abstract":"<div><h3>Question</h3><p>Does giving magnesium sulphate to the mother during labour reduce the risk of cerebral palsy or death in premature babies?</p></div><div><h3>Study design</h3><p>Double blind randomised controlled trial.</p></div><div><h3>Main results</h3><p>Magnesium sulphate lowered, but did not significantly reduce, the risk of death or cerebral palsy compared with placebo (see Table 1). Magnesium sulphate significantly reduced the risk of substantial motor dysfunction compared with placebo. There were no major adverse effects in the mother, although minor adverse events were more frequent with magnesium sulphate compared with placebo (RR 2.74, 95% CI 1.81 to 4.15).<span><div><div><table><tbody><tr><td><strong>Table 1</strong>. Death, cerebral palsy and motor dysfunction of infants at 2 years of age.</td></tr><tr><td></td><td>Magnesium sulphate (n=629)</td><td>Placebo N=626</td><td>RR magnesium sulphate vs placebo (95% CI)</td></tr><tr><td>Total deaths, <em>n</em> (%)</td><td>87 (14)</td><td>107 (17)</td><td>0.83 (0.64 to 1.09)</td></tr><tr><td>Cerebral palsy, <em>n</em> (%)</td><td>36 (7)</td><td>42 (8)</td><td>0.83 (0.54 to 1.27)</td></tr><tr><td>Substantial gross motor dysfunction, <em>n</em> (%)</td><td>18 (3)</td><td>34 (7)</td><td>0.51 (0.29 to 0.91)</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Magnesium sulphate provides some protection against nerve damage in premature babies and should be investigated in future trials.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 162-164"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829484","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":"Patient satisfaction questionnaires equally acceptable to patients","authors":"Stephen J. Aragon, M. C. Edwards","doi":"10.1016/J.EHBC.2004.03.007","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.03.007","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"39 1","pages":"125-127"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83580637","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":"Survival of people with out-of-hospital cardiac arrest is not improved by equipping first responders with an automated external defibrillator☆","authors":"J. Finn, I. Jacobs","doi":"10.1016/J.EHBC.2004.03.012","DOIUrl":"https://doi.org/10.1016/J.EHBC.2004.03.012","url":null,"abstract":"","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"14 1","pages":"139-141"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79536855","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}