448 research outputs found
Ken je beperkingen en schrijf ze op: Zelfkritisch kijken naar je eigen werk
No full textDoor verslag te doen van je eigen zwaktes kun je volgens Gerben ter Riet een bijdrage leveren aan de ‘georganiseerde scepsis’ van de onderzoeksgemeenschap. ‘Voor mij persoonlijk geldt dat ik de gebreken in het onderzoek van anderen veel beter zie dan die in onderzoek waarvan ik de bedenker en projectleider ben.
Apathy and depressive symptoms in older people and incident myocardial infarction, stroke, and mortality: A systematic review and meta-analysis of individual participant data
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Templated from ALIBI II: Acknowledging Limitations in Biomedical Research Papers
No full textEffect of peer review on self-acknowledgment of study limitations and linguistic hedgin
Are tests for predicting pre-eclampsia good enough to make screening viable? A review of reviews and critical appraisal
No full textArticle first published online: 31 DEC 2010The aim of this article is to review the accuracy of tests purported to be predictive of pre-eclampsia, a major cause of maternal and perinatal mortality and morbidity worldwide. A review of systematic reviews was done. A total of 219 studies were evaluated for the accuracy of 27 tests for predicting pre-eclampsia. Study quality assessment and data abstraction were performed using piloted proformas. Bivariate meta-analyses were used to synthesize data. Levels of sensitivity and specificity were measured. There were deficiencies in many areas of methodology including blinding, test description, and reference standard adequacy. No test had a high level of both sensitivity and specificity of greater than 90%. Where multiple studies were available, only BMI > 34, alpha-fetoprotein, fibronectin (cellular and total), and uterine artery Doppler (bilateral notching) measurements reached specificity above 90%. Only Doppler (any/unilateral notching, resistance index, and combinations) measurements were over 60% sensitive. Studies were of variable quality and most tests performed poorly. Further research should focus on tests which offer much higher levels of sensitivity than tests currently available. High sensitivity is a more useful attribute in early detection of pre-eclampsia than specificity because consideration of benefits, harms and costs indicates a much greater preference for minimizing false negatives than false positives, although the ideal would be to avoid both.Jeltsje S. Cnossen, Gerben ter Riet, Ben Willem Mol, Joris A. van der Post, Mariska M. Leeflang, Catherine A. Meads, Chris Hyde and Khalid S. Kha
A Randomized Clinical Trial of Ultrasound in the Treatment of Pressure Ulcers
No full textA randomized clinical trial of ultrasound in the treatment of pressure ulcers. ter Riet G, Kessels AG, Knipschild P. Department of Epidemiology, Maastricht University, The Netherlands. BACKGROUND AND PURPOSE: The purpose of this study was to assess the effects of ultrasound (US) therapy in the treatment of pressure ulcers as an adjunct to standardized treatment. SUBJECTS: Eighty-eight patients from 11 nursing homes and one hospital participated. Subjects were randomly assigned to either a US group (n = 45) or a sham US group (n = 43). METHODS: This was a multicenter placebo-controlled randomized trial. Wound survival, healing rates of wound surfaces, and changes on a clinical rating scale were measured over 12 weeks. RESULTS: Comparison of the 12-week cumulative incidences of wound closure showed that 40% (18/45) of ulcers in the US group and 44% (19/43) of ulcers in the sham US group were closed. An analysis in which between-group baseline differences and the days of wound closures were accounted for showed that the wound closure probability per unit of time (ie, closure rate) was almost equal in the two treatment groups (Cox proportional-hazards ratio of 1.08). Mean absolute healing rates were 0.18 and 0.31 cm2/wk in the US and sham US groups, respectively. Relative healing rates and healing speeds were similar in the two treatment groups. A panel scored slides of the ulcers with a report mark between 1 (bad) and 10 (excellent). The improvement was 0.71 and 0.46 points per week in the US and sham US groups, respectively. CONCLUSION AND DISCUSSION: These data do not support the idea that US speeds up the healing of pressure ulcers
Effect of guideline based computerised decision support on decision making of multidisciplinary teams: cluster randomised trial in cardiac rehabilitation (vol 338, b1440, 2009)
No full textVoorspellen van kwaliteit van leven van COPD-patiënten
No full textHet proefschrift van Siebeling betreft een internationaal prospectief cohortonderzoek met eerstelijns-COPD-patiënten. Het primaire doel is het ontwikkelen van predictiemodellen voor ziektegerelateerde kwaliteit van leven (KvL) en het secundaire doel betreft exacerbaties en sterfte. Deze modellen moeten bruikbaar zijn voor huisartsen en mogen dus alleen predictoren bevatten die beschikbaar zijn in de huisartsenpraktijk. Er zijn verschillende modellen om de sterftekans bij COPD-patiënten te voorspellen. Vanuit het perspectief van de patiënt is het voorspellen van het ziektebeloop in termen van KvL en exacerbaties waarschijnlijk belangrijker. Daarnaast zijn bestaande modellen veelal niet toepasbaar in de huisartsenpraktijk. Voor het instellen van het juiste behandelplan voor de individuele patiënt kan het voor huisartsen nuttig zijn als ze een inschatting kunnen maken van het te verwachten beloop van deze klinisch belangrijke uitkomstmaten. Voorgaande COPD-gerelateerde KvL blijkt de sterkste voorspeller van toekomstige KvL. Bij patiënten informeren naar kortademigheid, vermoeidheid, emotionele beperkingen en de manier waarop ze met COPD omgaan levert belangrijke informatie op over toekomstige KvL en is in iedere huisartsenpraktijk toepasbaa
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