1,721,122 research outputs found
Early palliative and supportive care in hematology wards.
No full textEarly palliative and supportive care in hematology ward
Health status, resource consumption, and costs of dysthymic patients in Italian primary care
No full textAims - To describe the health status, resource consumption and costs of patients with dysthymic disorder in the Italian primary care setting. Methods - A total of 79 general practitioners (GPs) participated the study. Diagnosis was based on each GP's clinical assessment. At entry the Mini-International Neuropsychiatric Interview (MINI) was used as a supporting diagnostic aid. Health status was measured with the SF-36 questionnaire. Resource consumption and costs regarded the six months before enrolment. Results - Out of 598 patients enrolled by GPs according to their clinical assessment, 503 fulfilled the MINI criteria and 95 did not. The latter had a better perception of their health than the former. Resource consumption was similar in the two groups; and the total per patient six-month costs did not differ significantly. Conclusions - The study confirms there may be a gap between standardised criteria for defining dysthymia and everyday clinical practice. All dysthymic patients diagnosed by GPs might be considered together from a health policy perspective
Propensity score for the analysis of observatonal data. An introduction and an illustrative examle
No full textThe principal aim of analysis of any sample of data is to draw causal inferences about the effects of different exposures, such as decisions, actions, medical treatments, or other interventions on relevant outcomes. Data may be the result of several kinds of study designs and approaches, either experimental or observational. In experimental, comparative intervention studies, randomization of patients guarantees that the groups are comparable before the exposure to the treatments and random assignment assures that the choice for a given treatment is not due to the decision by treating physicians and also allows a correct application of statistical tests. In observational studies when randomization is not used for practical or ethical reasons, treatments are decided by physicians (or by patients, or by both) in the context of the best clinical practice and, thus, groups are not comparable and differences in outcomes may reflect either effects caused by the treatment choices or differences in prognosis before treatment. When differences between groups are observed or expected, different kinds of adjustments are used to statistically adjust for the unbalance, using variables describing the condition of patients before treatment. Usually, potential predictive and/or prognostic variables are used together to adjust for confounding by constructing multivariable models. This approach is most of the time able to reduce the effect of confounders or effect modifiers on relevant outcomes, but it makes it difficult for investigators and for final users of the results to assess the adequacy of the approach, the role and impact of each class of variables, and, eventually, the clinical meaning of the results. In 1983, Rosenbaum and Rubin proposed a new method, named Propensity Score, to balance the variables related to the choice of the exposure (treatments) in order to reconstruct a situation similar to random assignment. Since then, there has been an explosion of examples of the use of this approach in the literature. This report introduces the method, uses an empirical example to illustrate its use, and eventually discusses the pros and cons of the method using the authors’ experience and some hints extracted from recent commentaries
Quello che i pazienti dicono e non dicono: paradossi teorici ed empirici nelle rilevazioni sulla soddisfazione dei pazienti
No full textFactors associated with poor health-related quality of life in patients with cirrhosis. A study based on Short Form 36 and the Nottingham Health Profile questionnaires
No full textIs EQ-5D a valid measure of HRQoL in patients with movement disorders?
No full textIn a pilot study, we assessed the desriptive part of the EQ-5D system in rehabilitation patients with severe moving disorders and compered it with FIM and SF-36 in a sample of 60 patients. The internal validity of the EQ-5D was good. However, most patients considered "moving on a wheelchair" as a good way of "getting about". The findings show possible problem of misinterpretation in the levels of mobility dimension
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Liquid dynamic medicine and N-of-1 clinical trials: A change of perspective in oncology research
Full text linkThe increasing use of genomics to define the pattern of actionable mutations and to test and validate new therapies for individual cancer patients, and the growing application of liquid biopsy to dynamically track tumor evolution and to adapt molecularly targeted therapy according to the emergence of tumor clonal variants is shaping modern medical oncology., In order to better describe this new therapeutic paradigm we propose the term "Liquid dynamic medicine" in the place of "Personalized or Precision medicine". Clinical validation of the "Liquid dynamic medicine" approach is best captured by N-of-1 trials where each patient acts as tester and control of truly personalized therapies. © 2017 The Author(s)
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