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181701. The Columbia Registry of Information and Utilization Management Trials. Full Text available with Trip Pro

The Columbia Registry of Information and Utilization Management Trials. T systematically locate, register, and abstract information used in comparing effects of various information services (computerized and noncomputerized) and utilization management interventions on the process and outcome of patient care.Manual and electronic database searches located reports that met three main criteria: 1) randomized controlled trial; 2) information or utilization management intervention in the study group (...) , length of stay, immunization rate, and mortality rate. Standardized formal tools were developed for the separation and abstraction of practical information and methodologic details from the collected trial reports.The registry provides a new source of information for meta-analyses, traditional reviews, and executive summaries of quality improvement of health services. The streamlined knowledge engineering process of quality evaluation and abstraction of critical information can generate helpful

1996 Journal of the American Medical Informatics Association : JAMIA

181702. Does hormone replacement therapy increase the risk of breast cancer? (Abstract)

Does hormone replacement therapy increase the risk of breast cancer? The data contained in the literature about breast cancer risk and hormone replacement therapy is reviewed. Many studies with different methodologies have been published. Analysis of classical papers or of meta-analysis do not support the view that short-term use of hormone replacement therapy significantly increases the risk of breast cancer. In some clinical situations such as family history of breast cancer, high dose

1995 European journal of obstetrics, gynecology, and reproductive biology

181703. [Aspirin dosage for prevention of cerebral infarct: arguments for low dosage]. (Abstract)

[Aspirin dosage for prevention of cerebral infarct: arguments for low dosage]. Acetylsalicylic acid (ASS) is one of the best examined substances used in secondary prevention after TIA and stroke. Since different strategies and measurement variables were used in numerous randomised, double-blind, placebo-controlled studies (one end-variable, such as non-fatal stroke, myocardium infarction and vascular mortality, or combined end-variables, such as TIA, stroke and death), meta-analysis

1995 Der Nervenarzt

181704. Effects of lipid-lowering therapy on total and coronary mortality. (Abstract)

Survival Study. The meta-analysis of randomized cholesterol-lowering trials also indicates that no excess of all-cause mortality is present when the degree of cholesterol reduction and treatment modality is adjusted. It is probable that the excess mortality from noncardiovascular causes found in unadjusted analyses is due to specific effects of hormones and fibrate drug treatments to reduce cholesterol. It is concluded that the lipid hypothesis is confirmed more solidly than ever before.

1995 Current opinion in lipidology

181705. The use of a 51Cr technique to detect gastrointestinal microbleeding associated with nonsteroidal antiinflammatory drugs. (Abstract)

The use of a 51Cr technique to detect gastrointestinal microbleeding associated with nonsteroidal antiinflammatory drugs. Of techniques used to evaluate gastrointestinal (GI) bleeding, use of radiochromium (51Cr)-tagged erythrocytes is the most quantitative and scientifically acceptable method. The value of this technique as well as systematic errors possible with its use are discussed. The medical literature concerning 51Cr evaluation of GI microbleeding with naproxen therapy is critically (...) reviewed. We suggest that future studies using this technique be parallel, randomized, double-blind, and include a 1-week placebo baseline phase for all subjects. Treatment with nonsteroidal antiinflammatory drugs (NSAIDs) should last 3 to 4 weeks. A parallel group of subjects should receive placebo throughout the study. For valid statistical analyses, randomization must achieve baseline comparability of weight, height, age, and sex in the treatment groups. Data transformations may be necessary

1988 Seminars in arthritis and rheumatism

181706. [Treatment with statins: further data from the Heart Protection Study]. (Abstract)

[Treatment with statins: further data from the Heart Protection Study]. Statins have been shown to reduce cardiovascular disease in subjects with coronary heart disease, in men with high cholesterol levels and in men and postmenopausal women with low high-density lipoprotein cholesterol levels. In meta-analysis, reduction in events is associated with reduction in serum low-density lipoprotein (LDL) cholesterol levels, however, some studies have proposed a threshold level for the effect.A (...) clinician and a statistician reviewed the Heart Protection Study in the context of previous similar studies.High-risk men and women (n = 20,536) aged 40-80 years with coronary heart disease, peripheral artery disease or diabetes and a cholesterol level of at least 3.5 mmol/l were randomised to simvastatin 40 mg or placebo. After 5.5 years, the incidence of nonfatal myocardial infarction or coronary death was reduced from 11.8% in the placebo group to 8.7% in the simvastatin group, and a similar

2002 Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række

181707. Inhaled versus systemic corticosteroids for the treatment of chronic lung disease in ventilated very low birth weight preterm infants. (Abstract)

inhaled versus systemic corticosteroid therapy (irrespective of the dose and duration of therapy) starting after the first two weeks of life in ventilator dependent very low birth weight preterm neonates.Data were extracted regarding clinical outcomes including CLD at 28 days or 36 weeks corrected gestational age (CGA), mortality, combined outcome of death or CLD at 28 days or 36 weeks CGA, other pulmonary outcomes and adverse effects. All data were analyzed using RevMan 4.1. When appropriate, meta (...) -analysis was performed using relative risk (RR), risk difference (RD), and weighted mean difference (WMD) along with their 95% confidence intervals (CI). If RD was statistically significant, number needed to treat (NNT) was calculated.Five trials comparing inhaled versus systemic corticosteroids in the treatment of CLD were identified. Two trials were excluded as both included non ventilator dependent patients. One trial is awaiting assessment and clarification of published data. Two trials qualified

2003 Cochrane database of systematic reviews (Online)

181708. Rilmenidine and vigilance. Review of clinical studies. (Abstract)

Rilmenidine and vigilance. Review of clinical studies. In this study, the possible effects of rilmenidine on vigilance are evaluated. Sedation is the most disturbing side effect of alpha 2-agonists, especially during the first weeks of treatment. The level of vigilance was first determined by assessing drowsiness using visual analogue scales and/or by several psychometric tests in four pharmacoclinical studies in healthy subjects or in hypertensive patients: three studies with single (...) significantly greater than with rilmenidine, at equihypotensive doses. Daytime drowsiness was systematically assessed and graded by inciting questioning at each visit in five clinical studies. Ambulatory hypertensive patients were treated with rilmenidine (1 mg per day or 1 mg twice a day). These studies were controlled versus placebo (one study for two weeks, 120 patients; and one study for one month, 126 patients), hydrochlorothiazide (six weeks, 56 patients), clonidine (six weeks, 333 patients

1989 The American journal of medicine

181709. Use of a physician-directed questionnaire to define a consensus about management of breast cancer: implications for assessing costs and benefits of treatment. (Abstract)

the absence of improvement in overall survival in large, mature, controlled randomized trials (and in a meta-analysis). We suggest that further research be undertaken into factors that influence decision making by oncologists when they consider the administration of adjuvant chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

1992 Journal of the National Cancer Institute. Monographs

181710. Update on immunotherapy for recurrent pregnancy loss. (Abstract)

and heterogeneity by the populations studied as well as cointervention by the placebo. A meta-analysis has been proposed to investigate these explanations. Because the trials have largely used husband's leukocytes for immunization, alternative forms of immunotherapy have been sought. Two treatments that have been proposed but have not completed testing a randomized, placebo-controlled trials are intravenous immunoglobulin (IVIG) and immunization with seminal plasma. A safe and efficacious method is needed

1992 American journal of reproductive immunology (New York, N.Y. : 1989) Controlled trial quality: uncertain

181711. Drainage after thyroidectomy: a randomized clinical trial. (Abstract)

Drainage after thyroidectomy: a randomized clinical trial. A randomized clinical trial of surgical drainage in thyroid surgery was performed on 97 patients. Morbidity was not significantly different between both groups. The length of hospital stay was shorter in the undrained group. However, this RCT is not an indication of the value of drainage after thyroid surgery because the series is too small. Using a meta-analysis of the RCTs reported it is possible to show that to drain is not useful.

1992 International surgery Controlled trial quality: uncertain

181712. Regional and systemic therapies for advanced colorectal carcinoma: randomized clinical trial results. (Abstract)

-aspartic acid did not enhance the activity of the weekly infusional 5-FU. Oral leucovorin provided no advantage over IV dosing. There was a significant difference in survival for patients with nonmeasurable disease (16.9 months) compared to those with measurable disease (12.6 months, P = .001). The Advanced Colorectal Cancer Meta-analysis Project demonstrated a response advantage for patients receiving 5-FU plus leucovorin (23%) compared to those receiving bolus 5-FU (11%, P = 10(-7); however (...) , there was no survival advantage of 5-FU plus leucovorin over 5-FU alone (P = 0.57). The Meta-Analysis Group in Cancer showed that continuous-infusion 5-FU resulted in a statistically significantly higher response rate than bolus 5-FU (22% vs 14%, P = .0002). Overall survival also favored continuous-infusion 5-FU (P = .04). Continuous-infusion 5-FU was less toxic than bolus treatment. Data from six select randomized trials comparing hepatic intra-arterial infusion of FUDR to systemic therapy demonstrated

1998 Oncology (Williston Park, N.Y.)

181713. Failure of an ACE inhibitor to improve exercise tolerance. A randomized study of trandolapril. Trandolapril study group. (Abstract)

Failure of an ACE inhibitor to improve exercise tolerance. A randomized study of trandolapril. Trandolapril study group. There has been conflicting evidence of the effect of angiotensin-converting enzyme (ACE) inhibitors on exercise tolerance. Meta-analysis of published results has suggested that a beneficial effect of ACE inhibitors is demonstrated if a trial design is adequate.Multicentre International Trial.In a double-blind, randomized, multicentre trial, 292 patients with moderate (New

1998 European heart journal Controlled trial quality: uncertain

181714. Informed consent for clinical trials: in search of the "best" method. (Abstract)

Informed consent for clinical trials: in search of the "best" method. To review the literature on comparisons between different methods of obtaining informed consent for clinical trials.Eight hundred and twelve articles were traced, in the process of conducting a systematic review of the ethics of clinical trials, by searching a number of sources: bibliographic databases (Medline, Psychlit and BIDS science and social science indices), hand searches, personal contacts, an original collection (...) and a systematic follow-up of reference lists. Fourteen research reports were found which provided comparative data on different methods of obtaining informed consent. Eleven of these used a randomised design. Studies were classified according to three outcome measures (anxiety, consent rate and understanding).The results of the various studies suggest that giving people more information and more time to reflect tends to be associated with a lower consent rate. There seems to be an optimal level of information

1998 Social Science & Medicine

181715. A randomized trial of in vitro fertilization versus conventional treatment for infertility. (Abstract)

. To reject the null hypothesis of no treatment effect, a larger sample size or a meta-analysis to combine the results of similar trials is required.

1993 Fertility and sterility Controlled trial quality: uncertain

181716. Randomized clinical trials on medical treatment of glaucoma. Are they appropriate to guide clinical practice? (Abstract)

Randomized clinical trials on medical treatment of glaucoma. Are they appropriate to guide clinical practice? A systematic quantitative and qualitative overview of published randomized clinical trials was undertaken to assess the yield of medical treatment on the outcome of patients with primary open angle glaucoma. Reports of 102 randomized clinical trials were published between 1975 and 1991, totalling about 5000 patients. Only 16% (16/102) of the trials were, however, properly designed (ie (...) failed to show a significant protective effect of active treatment (odds ratio, 0.75; 95% CI, 0.42 to 1.35). All of the remaining 86 randomized clinical trials looked at the effectiveness of one drug vs another in lowering intraocular pressure and were thus of no use in the overview. Practicing ophthalmologists should be aware that the effectiveness of pressure-lowering agents in the treatment of primary open angle glaucoma is still to be determined and that the vast majority of published trials

1993 Archives of ophthalmology

181717. Antithrombotic therapy in acute ischaemic stroke: an overview of the completed randomised trials. Full Text available with Trip Pro

Antithrombotic therapy in acute ischaemic stroke: an overview of the completed randomised trials. A formal statistical overview of all truly randomised trials was undertaken to determine whether antithrombotic therapy is effective and safe in the early treatment of patients with acute stroke. There were 15 completed randomised controlled trials of the value of early antithrombotic treatment in patients with acute stroke. The regimes tested in acute presumed or confirmed ischaemic stroke were (...) was associated with a highly significant 81% (SD 8, 2p < 0.00001) reduction in deep venous thrombosis detected by I125 fibrinogen scanning or venogram. Only three trials systematically identified pulmonary emboli, which occurred in 6/106 (5.7%) allocated control vs 3/132 (2.3%) allocated heparin, a non-significant 58% reduction (SD 45.7, 2p > 0.1). There were relatively few deaths in the trials in patients with presumed ischaemic stroke: 94/485 (19.4%) among patients allocated to the control group vs 79/497

1993 Journal of neurology, neurosurgery, and psychiatry Controlled trial quality: uncertain

181718. Reexamining the quality of life of hypertensive patients. A new self-structured measure. (Abstract)

Reexamining the quality of life of hypertensive patients. A new self-structured measure. This study included the introduction of a new, qualitative, self-structured measure of quality of life (QOL) after meta-analysis had shown that prestructured quantitative measures yielded insignificant results. This study compared the pre- and post-treatment evaluations of 268 men with mild hypertension, aged 40 to 65 years, who were randomly allocated to three treatment groups (methyldopa, isradipine

1993 American journal of hypertension Controlled trial quality: uncertain

181719. Sibutramine and fat distribution: is there a role for pharmacotherapy in abdominal/visceral fat reduction? (Abstract)

inhibitor, on weight reduction and changes in fat distribution. A meta-analysis of four long-term, placebo-controlled, double-blind studies showed significantly greater mean decreases in waist circumference in sibutramine-treated subjects compared with placebo (P < 0.001). Similar results were seen for WHR, with 15 mg sibutramine daily producing a significant reduction of 0.02 compared with placebo (P < 0.02). Changes in fat distribution have been examined using computerised tomography (CT) scans

1998 International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity Controlled trial quality: uncertain

181720. Calcium supplementation in nulliparous women for the prevention of pregnancy-induced hypertension, preeclampsia and preterm birth: an Australian randomized trial. FRACOG and the ACT Study Group. (Abstract)

systematic review of the 9 randomized trials of calcium supplementation in pregnancy shows a significant reduction in the risk of hypertension and preeclampsia although no effect on preterm birth. Calcium supplementation during pregnancy reduced the risk of preeclampsia and preterm birth in this nulliparous population. The available evidence for systematic review of all the randomized trials of calcium supplementation shows benefit in reducing the risk of hypertension and preeclampsia.

1999 The Australian & New Zealand journal of obstetrics & gynaecology Controlled trial quality: predicted high

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