Evidence-Based Medicine最新文献_第4页

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

{"title":"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.","authors":"Mario Cazzola, Paola Rogliani","doi":"10.1136/ebmed-2017-110726","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110726","url":null,"abstract":"Commentary on: Horita N, Goto A, Shibata Y, et al . Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev 2017;2:CD012066.\u0000\u0000The Global Initiative for Chronic Obstrictove Lung Disease 2017 report recommends the use of long-acting muscarinic antagonist (LAMA) + long-acting beta-agonist (LABA), or alternatively LABA + inhaled corticosteroid (ICS), in patients with chronic obstructive pulmonary disease (COPD) at risk of exacerbations regardless of the entity of symptoms.1 However, it does not specify whether it is preferable to start with LAMA+LABA rather than LABA+ICS. In fact, no firm conclusions can be drawn from the current literature.\u0000\u0000The aim of this study was to compare the benefits and harms of LAMA+LABA versus LABA+ICS in the treatment of COPD. The authors conducted a meta-analysis of studies published up to June 2016, including individual randomised controlled trials, parallel-group trials and crossover trials …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110726","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35260722","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: 3

Effectiveness of interventions based on implantable devices: meta-analyses or systematic reviews that fail to indicate which device brands were used. 基于植入式设备的干预措施的有效性:未能表明使用了哪些设备品牌的荟萃分析或系统评价。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-29 DOI: 10.1136/ebmed-2017-110802

Andrea Messori, Sabrina Trippoli, Claudio Marinai

引用次数: 1

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":null,"pages":null},"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":null,"pages":null},"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

{"title":"CETP inhibition improves the lipid profile but has no effect on clinical cardiovascular outcomes in high-risk patients.","authors":"Robert S Rosenson","doi":"10.1136/ebmed-2017-110791","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110791","url":null,"abstract":"Commentary on: Lincoff AM, Nicholls SJ, Riesmeyer JS, et al . Evacetrapib and cardiovascular outcomes in high-risk vascular disease. N Engl J Med 2017;376:1933–42.\u0000\u0000High-density lipoprotein (HDL) cholesterol (HDL-C) is a robust predictor of cardiovascular disease (CVD) events; however, research into both rare monogenic HDL disorders and Mendelian randomisation studies of dysfunctional traits associated with HDL-C demonstrate that this biomarker is not involved in the causal pathway for atherosclerosis.1 Small-effect variants in the gene encoding cholesteryl ester transfer protein (CETP) associate with higher HDL-C and lower myocardial infarction rates, whereas large-effect variants associate with reduced survival. CETP loss-of-function variants also associate with low levels of low-density lipoprotein (LDL) cholesterol (LDL-C), which confounds the attribution of the atheroprotective effect of CETP-mediated HDL changes.\u0000\u0000Small molecules that inhibit CETP activity have been previously investigated in two randomised clinical trials of CVD outcomes.2 3 Treatment with torcetrapib, in combination with atorvastatin increased HDL-C …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35449387","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: 6

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: 1

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

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

Routine invasive strategies compared with conservative strategies do not lower the all-cause mortality in patients with non-ST elevation myocardial infarction and unstable angina. 非st段抬高型心肌梗死合并不稳定型心绞痛患者的全因死亡率与常规有创策略相比没有降低。

Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-03 DOI: 10.1136/ebmed-2016-110527

Udho Thadani

引用次数: 0