Evidence-Based Medicine最新文献_第9页

In patients with intracerebral haemorrhage and concomitant atrial fibrillation, optimal timing of reinitiating anticoagulants may be 7-8 weeks after ICH. 对于脑出血合并心房颤动的患者，重新启动抗凝药物的最佳时间可能是脑出血后7-8周。

Evidence-Based Medicine Pub Date : 2017-06-01 Epub Date: 2017-05-16 DOI: 10.1136/ebmed-2017-110675

Catharina Jm Klijn, Floris Hbm Schreuder

{"title":"In patients with intracerebral haemorrhage and concomitant atrial fibrillation, optimal timing of reinitiating anticoagulants may be 7-8 weeks after ICH.","authors":"Catharina Jm Klijn, Floris Hbm Schreuder","doi":"10.1136/ebmed-2017-110675","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110675","url":null,"abstract":"Commentary on: Pennlert J, et al . Optimal timing of anticoagulant treatment after intracerebral haemorrhage in patients with atrial fibrillation. Stroke 2017: 48 ;314–320.\u0000\u0000In patients with intracerebral haemorrhage (ICH) and a concomitant diagnosis of atrial fibrillation (AF), the clinical dilemma arises whether anticoagulant treatment should be (re)started and when.1 In the absence of results from randomised controlled trials, guidelines provide no firm recommendations. Several observational studies have suggested that reintroduction of oral anticoagulants may be associated with a reduction in thrombotic events and all-cause mortality.2 3 Evidence regarding the optimal timing of reinitiating anticoagulant treatment is even scarcer.\u0000\u0000This was a nationwide observational study of 2619 patients with ICH (mean age 78.0 years) with a concomitant diagnosis of AF identified in the Swedish stroke register, Riksstroke, who survived hospital discharge. Patient characteristics, prescribed drugs after ICH and outcomes were extracted from various national databases. Primary outcome was …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35001941","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

Grading evidence from test accuracy studies: what makes it challenging compared with the grading of effectiveness studies? 测试准确性研究的证据分级:与有效性研究的分级相比，是什么使其具有挑战性?

Evidence-Based Medicine Pub Date : 2017-06-01 DOI: 10.1136/ebmed-2017-110717

Ewelina Rogozińska, Khalid Khan

{"title":"Grading evidence from test accuracy studies: what makes it challenging compared with the grading of effectiveness studies?","authors":"Ewelina Rogozińska, Khalid Khan","doi":"10.1136/ebmed-2017-110717","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110717","url":null,"abstract":"Guideline panels need to process a sizeable amount of information to issue a decision on whether to recommend a health technology or not. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is being frequently applied in guideline development to facilitate this task, typically for the synthesis of effectiveness research. Questions regarding the accuracy of medical tests are ubiquitous, and they temporally precede questions about therapy. However, literature summarising the experience of applying GRADE approach to accuracy evaluations is not as rich as one for effectiveness evidence. Type of study design (cross-sectional), two-dimensional nature of the performance measures (sensitivity and specificity), propensity towards a higher level of between-study heterogeneity, poor reporting of quality features and uncertainty about how best to assess for publication bias among other features make this task challenging. This article presents solutions adopted to addresses above challenges for judicious estimation of the strength of test accuracy evidence used to inform evidence syntheses for guideline development.","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35077021","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

Clinical failure is more common in young children with acute otitis media who receive a short course of antibiotics compared with standard duration. 与标准疗程相比，接受短疗程抗生素治疗的急性中耳炎患儿临床失败更为常见。

Evidence-Based Medicine Pub Date : 2017-06-01 Epub Date: 2017-04-12 DOI: 10.1136/ebmed-2017-110697

Roderick P Venekamp, Anne G M Schilder

{"title":"Clinical failure is more common in young children with acute otitis media who receive a short course of antibiotics compared with standard duration.","authors":"Roderick P Venekamp, Anne G M Schilder","doi":"10.1136/ebmed-2017-110697","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110697","url":null,"abstract":"Commentary on: Hoberman A, Paradise JL, Rockette HE, et al . Shortened antimicrobial treatment for acute otitis media in young children. N Engl J Med 2016;375:2446–56.[OpenUrl][1] \u0000\u0000Acute otitis media (AOM) is a leading cause of doctor consultations and antibiotic prescriptions in young children.1 Strategies to reduce antibiotic prescribing for AOM and thereby the emerging spread of antimicrobial resistance have focused on watchful waiting and delayed prescription, in particular in children over 2 years.2 An alternative strategy to combat antimicrobial resistance is to reduce the duration of antibiotic treatment. So far, the evidence to support this strategy in young children with AOM has been incomplete.3 \u0000\u0000Hoberman and colleagues recruited 520 children from an academic children's hospital and affiliated paediatric practices and a private paediatric research practice in the USA. Children were aged 6–23 months and diagnosed with AOM based on the …\u0000\u0000 [1]: {openurl}?query=rft.jtitle%253DN%2BEngl%2BJ%2BMed%26rft.volume%253D375%26rft.spage%253D56%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34908917","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

Urine concentration should be taken into account when interpreting pyuria in infants. 在解释婴儿脓尿时应考虑尿浓度。

Evidence-Based Medicine Pub Date : 2017-06-01 Epub Date: 2017-05-19 DOI: 10.1136/ebmed-2017-110678

Shouja Alam, Judith van der Voort, Christopher C Butler

{"title":"Urine concentration should be taken into account when interpreting pyuria in infants.","authors":"Shouja Alam, Judith van der Voort, Christopher C Butler","doi":"10.1136/ebmed-2017-110678","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110678","url":null,"abstract":"Commentary on: Chaudhari PP, Monuteaux MC, Bachur RG, et al . Urine concentration and pyuria for identifying UTI in infants. Pediatrics 2016;138:e20162370.\u0000\u0000The relationship between pyuria and true urinary tract infection (UTI) remains controversial. Most studies have assessed pyuria using manual microscopy in centrifuged urine. However, standard practice at most centres now involves automated urinalysis of uncentrifuged urine, thus pyuria in dilute samples may have more significance than pyuria in concentrated urine samples. It may therefore be important to consider the possible impact of urine concentration on the significance of white cell counts (WCC) or leucocyte esterase (LE) assessment.\u0000\u0000This was a retrospective study of routinely collected data from infants aged less than 3 months with suspected UTI, who presented to a busy US emergency department (ED) over 5 years. Automated urinalysis and culture were available for each eligible child. UTI was defined as ≥50 000 colony-forming units (CFU)/mL of a pathogenic organism, and all analysed samples were collected by catheter. Dipstick urinalysis was automated …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35012359","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

Pregabalin is effective in reducing fibromyalgia pain. 普瑞巴林能有效减轻纤维肌痛。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-02-27 DOI: 10.1136/ebmed-2016-110630

Charles Argoff

{"title":"Pregabalin is effective in reducing fibromyalgia pain.","authors":"Charles Argoff","doi":"10.1136/ebmed-2016-110630","DOIUrl":"https://doi.org/10.1136/ebmed-2016-110630","url":null,"abstract":"Commentary on: Derry S, Cording M, Wiffen PJ, et al. Pregabalin for pain in fibromyalgia in adults. Cochrane Database Syst Rev 2016;9:CD011790.\u0000\u0000Anticonvulsants have been widely used in pain management for more than 50 years. Published neuropathic pain treatment guidelines have suggested their use, especially for neuropathic pain.1 The review by Derry et al focuses on the use of one such agent, pregabalin, in the treatment of fibromyalgia, an accepted and validated but heterogeneous condition in which diagnosis is made through history, physical examination and the exclusion of other diseases explaining the key symptoms.\u0000\u0000This was a systematic review of randomised, double-blind trials lasting 8 weeks or longer comparing either pregabalin to placebo or an active treatment for the treatment of pain in fibromyalgia. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were search for randomised controlled trials from inception to 16 March 2016 for this update. Reference lists of retrieved studies and reviews were also searched, and online clinical trial registries. Eight studies were included in this review and …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2016-110630","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34768986","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

Semaglutide is non-inferior to placebo for cardiovascular outcomes in patients with type 2 diabetes. 在2型糖尿病患者的心血管预后方面，Semaglutide不逊于安慰剂。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-03-07 DOI: 10.1136/ebmed-2016-110652

Denise Campbell-Scherer

{"title":"Semaglutide is non-inferior to placebo for cardiovascular outcomes in patients with type 2 diabetes.","authors":"Denise Campbell-Scherer","doi":"10.1136/ebmed-2016-110652","DOIUrl":"https://doi.org/10.1136/ebmed-2016-110652","url":null,"abstract":"Commentary on: Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. NEJM 2016;375:1834–44.[OpenUrl][1]\u0000\u0000Semaglutide is a glucagon-like peptide 1 (GLP-1) analogue under development for the treatment of type 2 diabetes. It is molecularly related to liraglutide but has a longer half-life, requiring once weekly dosing. US Food and Drug Administration (FDA) regulatory guidance requires evidence that new therapies for type 2 diabetes are not associated with an unacceptable increase in cardiovascular risk.1 ,2 This is defined as evidence that compared with placebo the risk ratio estimate has an upper 95% CI of 1.3; the initial preapproval phase may target the 1.8 margin; however, if 1.3 is not achieved then a postmarketing randomised safety trial is required.1 ,2\u0000\u0000This was an industry-sponsored, non-inferiority randomised controlled trial in 3297 patients from 230 sites randomised (1:1:1:1), stratified (cardiovascular disease status, insulin treatment, and glomerular filtration rate at screening), to receive semaglutide (either 0.5 or 1.0 mg subcutaneously, weekly) or placebo. In …\u0000\u0000 [1]: {openurl}?query=rft.jtitle%253DNEJM%26rft.volume%253D375%26rft.spage%253D1834%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2016-110652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34791856","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

Both a stage shift and changes in stage-specific survival have contributed to reductions in breast cancer mortality. 分期转变和分期生存率的变化都有助于降低乳腺癌死亡率。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-02-22 DOI: 10.1136/ebmed-2016-110632

Stephen W Duffy, Ruth Etzioni, Peter Sasieni

引用次数: 0

Survey of instructions for authors on how to report an update of a systematic review: guidance is needed. 关于如何报告系统综述更新的作者说明调查：需要指导。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-01-30 DOI: 10.1136/ebmed-2016-110609

Dawid Pieper, Tim Mathes

{"title":"Survey of instructions for authors on how to report an update of a systematic review: guidance is needed.","authors":"Dawid Pieper, Tim Mathes","doi":"10.1136/ebmed-2016-110609","DOIUrl":"10.1136/ebmed-2016-110609","url":null,"abstract":"Systematic reviews have become the cornerstone of evidence-based healthcare. Approximately half of the systematic reviews are out of date after 5.5 years, and keeping them up to date remains a huge challenge. Despite new guidance on when and how to update systematic reviews, there seems to be a lack of guidance on how to report updates of systematic reviews. Therefore, we decided to systematically analyse instruction for authors in biomedical journals regarding guidance on reporting updates of systematic reviews. We conducted a survey investigating 250 journals. The journal list was derived by a twofold strategy. First, we chose a list of journals that were included in a recently published survey of systematic reviews. This list was augmented by a PubMed search for published updates of systematic reviews. For each journal, we checked the instructions for authors for any content or links related to updating systematic reviews in September 2016. Out of 250 journals, we found only one with guidance clearly related to updates of systematic reviews, namely the BioMed Central journal, Systematic Reviews Nevertheless, concrete guidance on reporting is lacking as it is stated that authors are encouraged to be innovative in how to report and present systematic review updates. This makes clear that there remains a fundamental uncertainty of how authors willing to update a previously published systematic review should act as even the leading journal in evidence syntheses does not have clear guidance. Debate is necessary on how to report updates of systematic reviews.","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10231619","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

Adverse events associated with mood stabiliser treatment should be continuously monitored in patients diagnosed with bipolar affective disorder. 对于确诊为双相情感障碍的患者，应持续监测与情绪稳定剂治疗相关的不良事件。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-03-02 DOI: 10.1136/ebmed-2016-110629

R E Nielsen, R W Licht

引用次数: 0

Thalamotomy using MRI-guided focused ultrasound significantly improves contralateral symptoms and quality of life in essential tremor. mri引导下聚焦超声丘脑切开术可显著改善特发性震颤患者对侧症状和生活质量。

Evidence-Based Medicine Pub Date : 2017-04-01 Epub Date: 2017-02-27 DOI: 10.1136/ebmed-2016-110589

Ludvic Zrinzo

{"title":"Thalamotomy using MRI-guided focused ultrasound significantly improves contralateral symptoms and quality of life in essential tremor.","authors":"Ludvic Zrinzo","doi":"10.1136/ebmed-2016-110589","DOIUrl":"https://doi.org/10.1136/ebmed-2016-110589","url":null,"abstract":"Commentary on : Elias WJ, Lipsman N, Ondo WG, et al. A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor. N Engl J Med 2016;375:730–9.[OpenUrl][1][PubMed][2]\u0000\u0000Propranolol and primidone significantly reduce tremor by around 60% in 50% of patients with essential tremor (ET). When medication is ineffective or causes intolerable side effects, neurosurgical intervention may be considered. Until recently, radiofrequency (RF) ablation or deep brain stimulation (DBS) of the ventralis intermedius (VIM) thalamic nucleus were the main surgical options. Gamma knife thalamotomy avoids a burrhole but delayed effects make intraoperative validation impossible.1 Recent technical advances have enabled transcranial delivery of high-intensity focused ultrasound to create a thalamotomy with MRI guidance and …\u0000\u0000 [1]: {openurl}?query=rft.jtitle%253DN%2BEngl%2BJ%2BMed%26rft.volume%253D375%26rft.spage%253D730%26rft_id%253Dinfo%253Apmid%252F27557301%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx\u0000 [2]: /lookup/external-ref?access_num=27557301&link_type=MED&atom=%2Febmed%2F22%2F2%2F64.atom","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2016-110589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34768985","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