Evidence-Based Medicine最新文献_第4页

Value of screening for and treating pre-diabetes is reduced by low test accuracy and indirect evidence of impact on patient important outcomes. 筛查和治疗糖尿病前期的价值因检测准确性低和间接证据对患者重要结局的影响而降低。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-07-22 DOI: 10.1136/ebmed-2017-110754

Neri A Alvarez-Villalobos, Rene Rodriguez-Gutierrez, Victor M Montori

引用次数: 0

In stable COPD, long-acting muscarinic antagonist plus long-acting beta-agonists resulted in less exacerbations, pneumonia and larger improvement in FEV _₁ than long-acting beta-agonists plus inhaled corticosteroids. 在稳定型COPD中，长效毒蕈碱拮抗剂加长效β受体激动剂比长效β受体激动剂加吸入皮质类固醇导致更少的加重、肺炎和更大的FEV 1改善。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-11 DOI: 10.1136/ebmed-2017-110726

Mario Cazzola, Paola Rogliani

引用次数: 0

Meta-analysis using individual participant data from randomised trials: opportunities and limitations created by access to raw data. 使用随机试验个体参与者数据的荟萃分析:获取原始数据带来的机会和限制。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-17 DOI: 10.1136/ebmed-2017-110775

Ewelina Rogozińska, Nadine Marlin, Shakila Thangaratinam, Khalid S Khan, Javier Zamora

{"title":"Meta-analysis using individual participant data from randomised trials: opportunities and limitations created by access to raw data.","authors":"Ewelina Rogozińska, Nadine Marlin, Shakila Thangaratinam, Khalid S Khan, Javier Zamora","doi":"10.1136/ebmed-2017-110775","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110775","url":null,"abstract":"Meta-analysis based on individual participant data (IPD), often described as the 'gold standard' for effectiveness evidence synthesis, is increasingly being deployed despite being more resource intensive than collating study-level results. Its professed virtues include the ability to incorporate unreported data and to standardise variables and their definitions across trials. In reality, the unreported data, although present in shared datasets, might still not be usable in the analysis. The characteristics of trial participants and their outcomes may be too diversely captured for harmonisation and too time and resource consuming to standardise. Embarking on an IPD meta-analysis can lead to unanticipated challenges which ought to be handled with pragmatism. The aim of this article is to discuss the opportunities created by access to IPD and the practical limitations placed on such meta-analyses, using an international IPD meta-analysis of trials on the effect of lifestyle interventions in pregnancy as an example. Despite the increasing uptake of IPD meta-analysis, they encounter old problems shared by other research methods. When embarking on IPD meta-analysis, it is essential to evaluate the trade-offs between the ambitions, and what is achievable due to constraints imposed by the condition of collected IPD. Furthermore, incorporation of aggregate data from trials where IPD was not available should be a mandatory sensitivity analysis that makes the evidence synthesis up-to-date.","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":"22 5","pages":"157-162"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35279451","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: 14

USPSTF is unable to recommend for or against lipid screening to identify multifactorial dyslipidaemia in childhood: no recommendation is not without consequences. USPSTF不能推荐或反对脂质筛查以确定儿童多因素血脂异常:没有推荐并非没有后果。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-17 DOI: 10.1136/ebmed-2016-110585

Sarah D de Ferranti, Radley C Sheldrick

{"title":"USPSTF is unable to recommend for or against lipid screening to identify multifactorial dyslipidaemia in childhood: no recommendation is not without consequences.","authors":"Sarah D de Ferranti, Radley C Sheldrick","doi":"10.1136/ebmed-2016-110585","DOIUrl":"https://doi.org/10.1136/ebmed-2016-110585","url":null,"abstract":"Paediatric lipid screening has been recommended for decades to identify youth at increased risk for early atherosclerotic disease but is controversial and not universally adopted. A 2016 review by the US Preventive Services Task Force (USPSTF) found inadequate evidence to recommend for or against lipid screening in childhood. In this Perspective article, we examine this controversial and important topic more broadly. We consider whether the USPSTF framework is asking the right questions, and whether the answers to these questions should be valued equally, whether the USPSTF questions are answerable and by what types of evidence and whether the burden of proof is appropriate. We argue that using a broader framework that includes the magnitude of potential benefits and harms, considering more types of evidence beyond randomised controlled trials, and more fully incorporating patient and parent perspectives could lead to more practical and more widely applicable guidance for practitioners, guide future research priorities and be more inclusive of patient priorities.","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":"22 5","pages":"162-163"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2016-110585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35279454","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

CETP inhibition improves the lipid profile but has no effect on clinical cardiovascular outcomes in high-risk patients. CETP抑制改善了血脂，但对高危患者的临床心血管结局没有影响。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-26 DOI: 10.1136/ebmed-2017-110791

Robert S Rosenson

引用次数: 0

Serial transvaginal cervical length measurements and quantitative vaginal fetal fibronectin concentrations did not predict spontaneous preterm birth in low-risk nulliparous women. 连续经阴道宫颈长度测量和阴道胎儿纤维连接蛋白定量浓度不能预测低风险无产妇女的自发性早产。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-30 DOI: 10.1136/ebmed-2017-110761

Donald Dudley

引用次数: 5

Antenatal corticosteroid administration between 24 hours and 7 days before extremely preterm delivery is associated with the lowest rate of mortality. 在极度早产前24小时至7天期间给予产前皮质类固醇与死亡率最低有关。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-07-17 DOI: 10.1136/ebmed-2017-110742

Colm P Travers, Waldemar A Carlo

引用次数: 0

Over half of the patients who undergo adjustable gastric banding may require revision bariatric surgery. 超过一半接受可调节胃束带的患者可能需要进行改良减肥手术。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-07-29 DOI: 10.1136/ebmed-2017-110753

Christopher de Gara, Vanessa Falk

引用次数: 3

Antibiotic utilisation in very low birth weight infants without sepsis or necrotising enterocolitis is associated with multiple adverse outcomes. 无脓毒症或坏死性小肠结肠炎的极低出生体重婴儿使用抗生素与多种不良后果相关。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-07-12 DOI: 10.1136/ebmed-2017-110756

Jessica L Roberts, Ravi M Patel

引用次数: 2

Early renin-angiotensin system inhibition induced renal deterioration may be a predictor for long-term cardiorenal outcomes. 早期肾素-血管紧张素系统抑制引起的肾脏恶化可能是长期心肾预后的预测因子。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-05 DOI: 10.1136/ebmed-2017-110751

Redi Llubani, Michael Böhm

{"title":"Early renin-angiotensin system inhibition induced renal deterioration may be a predictor for long-term cardiorenal outcomes.","authors":"Redi Llubani, Michael Böhm","doi":"10.1136/ebmed-2017-110751","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110751","url":null,"abstract":"Commentary on: Schmidt M, Mansfield KE, Bhaskaran K, et al . Serum creatinine elevation after renin–angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ 2017;356: j791.\u0000\u0000An increase in serum creatinine level may occur in the first 2 weeks that follow ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) therapy as a consequence of lowering intraglomerular pressure. Such renal impairment at baseline should stabilise within 2–4 weeks assuming normal volume and sodium intake. Renal function might deteriorate further when increasing the dose of diuretics, initiation of non-steroidal anti-inflammatory drugs (NSAIDs) or development of volume depletion from non-diuretic-induced causes such as gastroenteritis.1 Most guidelines recommend monitoring and stopping the treatment, if there is a creatinine increase of 30% or more. Recent studies have shown that ACEI and ARBs may be particularly effective in lowering the incidence of cardiovascular events.2 \u0000\u0000This study examined the incidence of cardiorenal events in ACEI/ARB …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":"22 5","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35386827","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