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259221. Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for Recurrent Anterior instability of the shoulder: a meta-analysis. (PubMed)

Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for Recurrent Anterior instability of the shoulder: a meta-analysis. In published comparative studies, it remains unknown if arthroscopic techniques for performing Bankart repair for anterior shoulder instability equal the success of open repair.The current literature supports a lower rate of recurrent instability after open Bankart repair compared to arthroscopic repair with bioabsorbable tacks

2004 American Journal of Sports Medicine

259222. Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta-analysis of long-term omeprazole trials. (PubMed)

Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta-analysis of long-term omeprazole trials. This meta-analysis investigated factors that may affect the risk of relapse of oesophagitis, and evaluated the predictive value of symptoms for the presence of relapse during long-term treatment.Individual data from 1154 patients included in five independently conducted, randomized, long-term clinical trials of the efficacy of different (...) dosage regimens of omeprazole, standard ranitidine treatment and placebo for the prevention of relapse of oesophagitis were pooled for this meta-analysis. The therapeutic regimens studied were omeprazole 20 mg o.m. (OME20) in 366 patients, omeprazole 10 mg o.m. (OME10) in 225 patients, omeprazole 20 mg weekends (OMEW) in 235 patients, ranitidine 150 mg b.d. (RAN) in 179 patients, or placebo (PLA) in 149 patients.OME20 maintained 82.4% (95% CI: 78.2-86.6%) of patients in endoscopic remission over

1997 Alimentary pharmacology & therapeutics

259223. Rectal corticosteroids versus alternative treatments in ulcerative colitis: a meta-analysis. (PubMed)

Rectal corticosteroids versus alternative treatments in ulcerative colitis: a meta-analysis. Clear strategies to optimise the use of corticosteroids in ulcerative colitis are lacking.A meta-analysis was undertaken to examine critically the role of rectal corticosteroids in the management of active distal ulcerative colitis.All reported randomised controlled trials were retrieved by searching the Medline and EMBASE databases and the bibliographies of relevant studies. Trials which met inclusion

Full Text available with Trip Pro

1997 Gut

259224. Economic implications of hepatic arterial infusion chemotherapy in treatment of nonresectable colorectal liver metastases. Meta-Analysis Group in Cancer. (PubMed)

Economic implications of hepatic arterial infusion chemotherapy in treatment of nonresectable colorectal liver metastases. Meta-Analysis Group in Cancer. Approximately 20% of patients with colorectal cancer die of metastases confined to the liver. A meta-analysis recently performed by our group confirmed that in these patients hepatic arterial infusion of 5-fluoro-2'-deoxyuridine, compared with intravenous chemotherapy with fluoropyrimidines or supportive care (including symptom palliation when (...) necessary), improved tumor response.Because of the high cost of hepatic arterial infusion, we undertook a cost-effectiveness analysis that related the cost of such therapy to its medical efficacy.The patient population was drawn from the seven randomized clinical trials included in the meta-analysis and included individual data on 654 patients. Of these seven trials, five compared hepatic arterial infusion and intravenous chemotherapy and two compared hepatic arterial infusion and a control group

1997 Journal of the National Cancer Institute.

259225. Efficacy of pentosan polysulfate in the treatment of interstitial cystitis: a meta-analysis. (PubMed)

Efficacy of pentosan polysulfate in the treatment of interstitial cystitis: a meta-analysis. To determine the efficacy of pentosan polysulfate (Elmiron) compared to placebo in the treatment of interstitial cystitis.The data sources used were MEDLINE, Excerpta Medica, and International Pharmaceutical Abstracts databases, and the manufacturer. Bibliographies of articles obtained were reviewed. The keywords used were pentosanpolysulfate, pentosanpolysulfate sodium, and pentosan. Inclusion criteria

1997 Urology

259226. The use of antibiotics to prevent serious sequelae in children at risk for occult bacteremia: a meta-analysis. (PubMed)

The use of antibiotics to prevent serious sequelae in children at risk for occult bacteremia: a meta-analysis. To determine whether antibiotics prevent serious bacterial infections in children at risk for occult bacteremia.Meta-analysis of randomized controlled trials involving children aged 3 months to 36 months without a focus of infection and randomized into 2 treatment groups: 1) no antibiotic vs antibiotic or 2) IM ceftriaxone vs oral antibiotic.The use of either an oral antibiotic or IM

1997 Academic Emergency Medicine

259227. Strengths and limitations of meta-analysis: larger studies may be more reliable. (PubMed)

Strengths and limitations of meta-analysis: larger studies may be more reliable. Meta-analysis of randomized controlled trials combines information from independent studies that address a similar question to provide more reliable estimates of treatment effects. At the present time, the methodology and usefulness of meta-analysis is under scrutiny. In the first part of this paper, we summarize the limitations of meta-analysis and make suggestions for improvements. In the second part, we (...) illustrate strengths and limitations using examples of meta-analyses and subsequent large trials that address the same question. We develop the hypothesis that the size of the meta-analysis may be a useful measure of reliability. Small meta-analyses (i.e., those with less than 200 outcome events) may only be useful for summarizing the available information and generating hypotheses for future research. The results of small meta-analyses should be regarded with caution, even if the p value shows extreme

1997 Controlled clinical trials

259228. Risk of serious adverse events in hypertensive patients receiving isradipine: a meta-analysis. (PubMed)

Risk of serious adverse events in hypertensive patients receiving isradipine: a meta-analysis. A meta-analysis was performed to compare the risk of serious adverse events associated with the use of all formulations of isradipine, when used as monotherapy in hypertension, to active drug or placebo controls. Eligible studies totalled 65 published and unpublished randomised controlled trials involving 9903 subjects and 10,675 treatment exposures: 4492 to isradipine, 1473 to isradipine sustained

1997 Journal of human hypertension

259229. Investigating underlying risk as a source of heterogeneity in meta-analysis. (PubMed)

Investigating underlying risk as a source of heterogeneity in meta-analysis. In a meta-analysis of clinical trials, an important issue is whether the treatment benefit varies according to the underlying risk of the patients in the different trials. The usual naive analyses employed to investigate this question use either the observed risk of events in the control groups, or the average risk in the control and treatment groups, as a measure of underlying risk. These analyses are flawed and can (...) produce seriously misleading results. We show how their biases depend on three components of variability, the within-trial and between-trial variances of the control group risks, and the between-trial variance of the treatment effects. We propose a Bayesian solution to the problem which can be carried out using the BUGS implementation of Gibbs sampling. The analysis is illustrated for a meta-analysis of bleeding and mortality data in trials of sclerotherapy for patients with cirrhosis, and the results

1997 Statistics in medicine

259230. A meta-analysis of trials evaluating patient education and counseling for three groups of preventive health behaviors. (PubMed)

A meta-analysis of trials evaluating patient education and counseling for three groups of preventive health behaviors. To examine the overall effectiveness of patient education and counseling on preventive health behaviors and to examine the effects of various approaches for modifying specific types of behaviors.Computerized databases (Medline, Healthline, Dissertation Abstracts, and Psychological Abstracts), bibliographies 1971-1994. Search terms (patient education, patient compliance

1997 Patient education and counseling

259231. Single agent versus combination chemotherapy in patients with advanced nonsmall cell lung carcinoma: a meta-analysis of response, toxicity, and survival. (PubMed)

Single agent versus combination chemotherapy in patients with advanced nonsmall cell lung carcinoma: a meta-analysis of response, toxicity, and survival. This meta-analysis was conducted to compare the effects of single agent versus combination chemotherapy on response rate, toxicity, and survival of patients with advanced nonsmall cell lung carcinoma (NSCLC).The authors reviewed randomized clinical trials published in the medical literature and the reference lists of relevant articles (...) . Objective response rate, survival at 6 and 12 months, and the incidence of treatment-related death were compared among all patients receiving single agent chemotherapy and those receiving combination chemotherapy. A subgroup analysis for all outcomes was conducted for 10 trials published between 1989 and 1996 that used a platinum analogue or vinorelbine as the single agent arm.The authors identified 38 potentially eligible trials, 25 of which (with a total of 5156 patients) were included in the meta

1998 Cancer

259232. Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A meta-analysis. The International Study of Perioperative Transfusion. (PubMed)

Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A meta-analysis. The International Study of Perioperative Transfusion. The objective of this study was to systematically review the literature and to statistically summarize the evidence evaluating acute normovolemic hemodilution (ANH). Prospective, randomized, controlled trials of ANH that reported either the proportion of patients exposed to allogeneic blood or the units of allogeneic blood transfused were (...) included. All types and languages of publication were eligible. Of 1573 identified publications, 24 trials (containing a total of 1218 patients) were included in the meta-analysis. When all trials were pooled, ANH reduced the likelihood of exposure to allogeneic blood (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.15, 0.62) and the total units of allogeneic blood transfused (weighted mean difference [WMD] -2.22 U, 95% CI -3.57, -0.86). However, there was marked heterogeneity of the results

1998 Anesthesia and analgesia

259233. DST studies in psychotic depression: a meta-analysis. (PubMed)

DST studies in psychotic depression: a meta-analysis. Although hypersecretion of cortisol has frequently been reported in psychotic depression, the findings have been mixed. The authors performed a meta-analysis of the existing studies to determine the significance of differences in nonsuppression of cortisol across studies.Fourteen studies that compared dexamethasone suppression test (DST) results in psychotic and nonpsychotic patients were examined, and a Mantel-Haenszel meta-analysis

1997 American Journal of Psychiatry

259234. A meta-analysis of zinc salts lozenges and the common cold. (PubMed)

A meta-analysis of zinc salts lozenges and the common cold. In the United States, the common cold has been estimated to cost more than $3.5 billion a year. Despite several randomized clinical trials, the effect of treating colds with zinc salts lozenges remains uncertain because of conflicting results.To conduct a meta-analysis of published randomized clinical trials on the use of zinc salts lozenges in colds using a random effects model.Eight clinical trials of treating adults with zinc salts

1997 Archives of internal medicine

259235. Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis. (PubMed)

Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis. Pancreatic enzyme therapy is widely used in the treatment of pain in chronic pancreatitis. The aim of our study was to perform a meta-analysis to determine whether pancreatic enzyme supplementation significantly decreases abdominal pain in patients with chronic pancreatitis.From a MEDLINE search, we identified, evaluated, and subjected to a meta-analysis, six randomized, double-blind (...) , placebo-controlled trials. Important features of data extraction included the method of subject inclusion, definition of disease, enzyme preparation, response to pancreatic enzyme therapy versus placebo, and modality for measuring response.In the meta-analysis, the pooled estimate of the percentage of patients per study who preferred enzymes relative to placebo was 52% (95% confidence interval, 45-60%). A test of homogeneity indicated that there was no statistically significant heterogeneity across

1997 The American journal of gastroenterology

259236. The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. (PubMed)

The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. A systematic review was conducted to evaluate the effectiveness of intrauterine insemination (IUI) with or without ovarian stimulation using gonadotrophin in the treatment of persistent infertility. Relevant randomized controlled trials were identified by a diverse strategy including a hand search of 43 core journals from 1966 to the present. Two approaches to meta (...) -analysis were used to summarize data. First, using a standard Mantel-Haenszel approach, eight trials comparing FSH/IUI with FSH/timed intercourse for unexplained infertility were combined. The common odds ratio for pregnancy was 2.37 [95% confidence interval (CI), 1.43, 3.90], suggesting a significant improvement with IUI following ovulation induction in this patient group. Although the data were statistically homogeneous, clinically important heterogeneity was present. Second, across all diagnostic

1997 Human reproduction (Oxford, England)

259237. Effects of antihistamines in adult asthma: a meta-analysis of clinical trials. (PubMed)

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials. A meta-analysis of clinical trials of antihistamines was performed to assess the risk-benefit ratio of this therapeutic class in asthma. Double-blind randomized placebo-controlled trials assessing lung function changes under repeated use of antihistamine in adult asthma were selected, and the quality of studies was scored. Morning peak expiratory flow rate (PEFR) was the primary outcome: an effect size was computed (...) for each study, with a 95% confidence interval (95% CI), and a mean effect size was computed, combining all studies. Effect sizes were also determined for secondary outcomes: evening PEFR, forced expiratory volume in one second (FEV1) and daily use of inhaled beta-agonists. Nineteen studies were included in the meta-analysis. Mean quality score of studies was 59.4%; asthma was generally uncontrolled at study inclusion. Altogether, 582 antihistamine-treated and 557 placebo-treated asthma patients were

1997 The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology

259238. Preparing and interpreting meta-analysis in clinical research. (PubMed)

Preparing and interpreting meta-analysis in clinical research. Meta-analysis is a procedure to systematically research and collect published and (ideally) unpublished randomized clinical trials (RCTs) of treatments and quantitatively summarise their results, in order to obtain an objective assessment of efficacy. Collaboration between statisticians and clinical experts in the field of pathology addressed by the treatment is needed for performing reliable meta-analyses. "Typical" meta-analysis (...) can be refined as "cumulative" meta-analysis, where the pooled assessment of treatment effect is repeated every time a new trial is added to a set of trials, and by meta-analysis "on individual patient data", i.e. using information on each patient included in every trial. Due to the emergence of Evidence-Based Medicine (EBM), the role of meta-analysis is expanding. EBM is a way of practising medicine by integrating individual clinical expertise with the most reliable evidence from the medical

1997 Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia

259239. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis. (PubMed)

Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis. We conducted a meta-analysis to determine the effect of consumption of psyllium-enriched cereal products on blood total cholesterol (TC), LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) levels and to estimate the magnitude of the effect among 404 adults with mild to moderate hypercholesterolemia (TC of 5.17-7.8 mmol/L) who consumed (...) a low fat diet. Studies of psyllium cereals were identified by a computerized search of MEDLINE and Current Contents and by contacting United States-based food companies involved in psyllium research. Published and unpublished studies were reviewed by one author and considered eligible for inclusion in the meta-analysis if they were conducted in humans, were randomized, controlled experiments, and included a control group that ate cereal providing

1997 The Journal of nutrition

259240. Effect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis. (PubMed)

Effect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis. To critically appraise and summarize the trials examining the addition of noninvasive positive pressure ventilation to standard therapy on hospital mortality and need for endotracheal intubation in patients admitted with acute respiratory failure.We searched MEDLINE (1966 to September 1995) and key references were searched forward using the Scientific Citation

1997 Critical care medicine

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