Evidence-Based Medicine最新文献

Ten essential papers for the practice of evidence-based medicine. 循证医学实践的十篇重要论文。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-23 DOI: 10.1136/ebmed-2017-110854

David Nunan, Jack O'Sullivan, Carl Heneghan, Annette Pluddemann, Jeffrey Aronson, Kamal Mahtani

引用次数: 10

Long-acting reversible contraception acceptability and satisfaction is high among adolescents. 青少年对长效可逆避孕的接受度和满意度较高。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-09-18 DOI: 10.1136/ebmed-2017-110768

David Hubacher

引用次数: 3

Intensive glucose control in patients with diabetes prevents onset and progression of microalbuminuria, but effects on end-stage kidney disease are still uncertain. 糖尿病患者强化血糖控制可预防微量白蛋白尿的发生和进展，但对终末期肾病的影响仍不确定。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-02 DOI: 10.1136/ebmed-2017-110806

Clement Lo, Sophia Zoungas

{"title":"Intensive glucose control in patients with diabetes prevents onset and progression of microalbuminuria, but effects on end-stage kidney disease are still uncertain.","authors":"Clement Lo, Sophia Zoungas","doi":"10.1136/ebmed-2017-110806","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110806","url":null,"abstract":"Commentary on: Ruospo M, Saglimbe VM, Palmer SC, et al . Glucose targets for preventing diabetic kidney disease and its progression. Cochrane Database Syst Rev 2017;6:CD010137.\u0000\u0000Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD). Randomised controlled trials (RCTs) suggest that intensive glycaemic control reduces progression of albuminuria, but effects on later DKD stages and cardiovascular outcomes are less clear. This systematic review evaluated the benefits and harms of intensive versus standard glycaemic control on the onset and progression of DKD and mortality.\u0000\u0000This meta-analysis of published tabular data included RCTs assigning patients with diabetes (type 1 or 2) with and without kidney disease to intensive (glycated haemoglobin (HbA1c) <7% or fasting blood glucose (FBG) <6.6 mmol/L) or standard glycaemic control (HbA1c ≥7% or FBG ≥6.6 mmol/L). Primary outcomes were doubling of serum creatinine, ESKD, and death or non-fatal myocardial infarction or stroke. Secondary outcomes included measures of albuminuria, serum creatinine, measures of glomerular …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35219004","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

Protocolised early goal-directed therapy in patients with sepsis/septic shock does not result in improved survival compared with usual care with less invasive resuscitation strategies. 在脓毒症/脓毒性休克患者中，与采用微创复苏策略的常规护理相比，协议化的早期目标导向治疗并不能提高生存率。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-10-22 DOI: 10.1136/ebmed-2017-110805

Joel Meyer, Manu Shankar-Hari

引用次数: 1

Routine prophylaxis is not necessary to prevent renal scarring in children with urinary tract infection. 常规预防对于预防尿路感染儿童肾脏瘢痕形成是不必要的。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-10-22 DOI: 10.1136/ebmed-2017-110784

Tej K Mattoo, Ron Thomas

引用次数: 3

What evidence affects clinical practice? An analysis of Evidence-Based Medicine commentaries. 什么证据影响临床实践?循证医学评论分析。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-17 DOI: 10.1136/ebmed-2017-110856

Charles Coombs, Igho Onakpoya, Kamal Mahtani, Jeffrey Aronson, Jack O'Sullivan, Annette Pluddemann, Carl Heneghan

{"title":"What evidence affects clinical practice? An analysis of Evidence-Based Medicine commentaries.","authors":"Charles Coombs, Igho Onakpoya, Kamal Mahtani, Jeffrey Aronson, Jack O'Sullivan, Annette Pluddemann, Carl Heneghan","doi":"10.1136/ebmed-2017-110856","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110856","url":null,"abstract":"Evidence-Based Medicine (EBM) published by BMJ aims to alert clinicians to significant advances in healthcare by selecting original and systematic review articles, from 100 candidate journals, whose results are likely to be both reliable and useful.1 We select articles if they concern topics relevant to internal medicine, general and family practice, surgery, emergency and critical care, psychiatry, paediatrics or obstetrics and gynaecology. Articles are summarised in value-added abstracts and commented on by clinical experts in the field.\u0000\u0000To better understand the impact our choices may have on clinical practice, we audited 1 year’s worth of the journal’s commentaries, asking what journals we select from, what types of studies we choose and whether we identify articles likely to change practice.\u0000\u0000To do this, we surveyed EBM commentaries published between December 2016 and September 2017 and extracted the following information: study type, original journal, setting and type of intervention. We used the commentaries from clinical experts …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110856","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35563793","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

Supplementary antimicrobials for patients with HIV and <100 CD4 cells/µL are associated with improved survival. 对艾滋病毒感染者和<100 CD4细胞/µL的患者补充抗菌素可提高生存率。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-13 DOI: 10.1136/ebmed-2017-110843

George W Rutherford, Elvin Geng

引用次数: 0

Ocrelizumab appears to reduce relapse and disability in multiple sclerosis but quality of evidence is moderate. Ocrelizumab似乎可以减少多发性硬化症的复发和残疾，但证据质量是中等的。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-08 DOI: 10.1136/ebmed-2017-110721

Graziella Filippini

{"title":"Ocrelizumab appears to reduce relapse and disability in multiple sclerosis but quality of evidence is moderate.","authors":"Graziella Filippini","doi":"10.1136/ebmed-2017-110721","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110721","url":null,"abstract":"Commentary on : Hauser SL, Bar-Or A, Comi G, et al . Ocrelizumab versus interferon Beta-1a in relapsing multiple sclerosis. N Engl J Med 2017;376:221–34. Montalban X, Hauser SL, Kappos L, et al . Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376:209–20.\u0000\u0000Multiple sclerosis (MS) is a chronic, immune-mediated disorder of the central nervous system, and one of the most common causes of disability in young people, with an annual incidence ranging from 2 to 10 cases/100 000 persons/year. The disease is classified as either relapsing-remitting MS (RRMS) or primary progressive MS (PPMS) based on the initial disease course.1 People with RRMS have recurrent episodes of neurological deficit (relapses) followed by periods of remission and over time an accumulation of residual deficits and a slow progression of fixed disability supervene in about 80% of them (secondary progressive MS). Approximately, 15% of people with PPMS have a slowly progressive course from onset. PPMS presents at an older age (mean age at onset 40 years) than does RRMS. Preventing progressive disability is the key therapeutic goal for MS. Several pathological processes occur in MS, including engagement of the immune system, T cell-mediated and B cell-mediated mechanisms, demyelination, inflammatory injury of axons and glia, postinflammatory gliosis and neurodegeneration. Several disease-modifying drugs (DMDs) are available for RRMS; however, their relative benefit in delaying disability worsening remains unclear due to the limited …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35585233","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

Journal Clubs: 1. Origins. 期刊俱乐部:1;的起源。

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-17 DOI: 10.1136/ebmed-2017-110860

Jeffrey K Aronson

引用次数: 6

What data sources do ophthalmologists trust? 眼科医生信任哪些数据来源?

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-10-17 DOI: 10.1136/ebmed-2017-110757

William C Stewart, Jeanette A Stewart, Lindsay A Nelson

{"title":"What data sources do ophthalmologists trust?","authors":"William C Stewart, Jeanette A Stewart, Lindsay A Nelson","doi":"10.1136/ebmed-2017-110757","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110757","url":null,"abstract":"<p><p>To survey ophthalmologists regarding sources they trust when incorporating new medical knowledge into their practice. The survey was distributed primarily to US-based ophthalmologists. Questions were derived based on the lead author's research experience from congresses and discussions and from mentions in the medical literature. In total, 77 physicians completed the survey of 1886 sent (4% response rate). Regarding study design, physicians preferred a well-controlled, randomised, double-masked trial (99%) with multicentred investigational site across a wide geographical area (80%). Authorship of a research article was most desired from a well-known key opinion leader (KOL) (75%) or any KOL leader at a university (75%). The most selected journal type was a subspecialty publication (86%) and second a multispecialty high impact journal (77%). Study sponsorship was most desired from the NIH or other government agencies (71%) or a university (71%). Doctors preferred clinical opinions from an ophthalmic medical society (75%). For the source of new clinical data, physicians indicated an unsponsored peer-reviewed journal article (77%) or a lecture at a large ophthalmic congress (74%) as the preferred source. Ophthalmologists generally desire sponsors, study designs and opinions that appear free of bias on which to base their clinical practice decisions.</p>","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35523612","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