1,720,999 research outputs found
Point-of-care testing : where is the evidence? A systematic survey
No full textAbstract Point-of-care testing (POCT) has had rapid technological development and their use is widespread in clinical laboratories to assure reduction of turn-around-time and rapid patient management in some clinical settings where it is important to make quick decisions. Until now the papers published about the POCT have focused on the reliability of the technology used and their analytical accuracy. We aim to perform a systematic survey of the evidence of POCT efficacy focused on clinical outcomes, selecting POCT denoted special analytes characterized by possible high clinical impact. We searched in Medline and Embase. Two independent reviewers assessed the eligibility, extracted study details and assessed the methodological quality of studies. We analyzed 84 studies for five POCT instruments: neonatal bilirubin, procalcitonin, intra-operative parathyroid hormone, troponin and blood gas analysis. Studies were at high risk of bias. Most of the papers (50%) were studies of correlation between the results obtained by using POCT instruments and those obtained by using laboratory instruments. These data showed a satisfactory correlation between methods when similar analytical reactions were used. Only 13% of the studies evaluated the impact of POCT on clinical practice. POCT decreases the time elapsed for making decisions on patient management but the clinical outcomes have never been adequately evaluated. Our work shows that, although POCT has the potential to provide beneficial patient outcome, further studies may be required, especially for defining its real utility on clinical decision making
Most appropriate animal models to study the efficacy of statins: a systematic review
No full textBackground: In animal models and clinical trials, statins are reported as effective in reducing cholesterol levels and lowering the risk of cardiovascular diseases. We have aggregated the findings in animal models - mice, rats and rabbits - using the technique of systematic review and meta-analysis to highlight differences in the efficacy of statins. Materials and methods: We searched Medline and Embase. After examining all eligible articles, we extracted results about total cholesterol and other blood parameters, blood pressure, myocardial infarction and survival. Weighted and standard mean difference random effects meta-analysis was used to measure overall efficacy in prespecified species, strains and subgroups. Results: We included in systematic review 161 animal studies and we analysed 120 studies, accounting for 2432 animals. Statins lowered the total cholesterol across all species, although with large differences in the effect size: -30% in rabbits, -20% in mice and -10% in rats. The reduction was larger in animals fed on a high-cholesterol diet. Statins reduced infarct volume but did not consistently reduce the blood pressure or effect the overall survival. Few studies considered strains at high risk of cardiovascular diseases or hard outcomes. Conclusions: Although statins showed substantial efficacy in animal models, few preclinical data considered conditions mimicking human pathologies for which the drugs are clinically indicated and utilized. The empirical finding that statins are more effective in lowering cholesterol derived from an external source (i.e. diet) conflicts with statin's supposed primary mechanism of action
Gestione del cambiamento attraverso le revisioni sistematiche come strumenti per orientare la pratica clinica: risultati preliminari di una collaborazione tra l'IRCCS Istituto Ortopedico Galeazzi e il Centro Cochrane Italiano (CCI)
No full textIntroduzione
L’Istituto Ortopedico Gaeazzi è un IRCCS polispecialistico di 350 posti letto, prevalentemente ortopedici. La leadership culturale dell’ente nell’ortopedia era tradizionalmente legata al prestigio accumulato nel tempo, alla presenza di scuole di specialità e a chirurghi di fama. La produzione scientifica era caratterizzata dalla pubblicazione di studi quasi-sperimentali (serie di casi), e in misura ridotta, da studi controllati. Oggi questo modello
è messo in discussione, perché sempre di più le scelte clinico terapeutiche necessitano di essere supportate da solide prove scientifiche ottenute attraverso sperimentazioni rigorose.
Obiettivo
Realizzare un programma che preveda la promozione e la produzione di linee-guida scientifiche attraverso la metodologia GRADE (Grading of Recommendations Assessment, Development and Evaluation) e di revisioni sistematiche.
Metodi e risultati
Per facilitare l’uptake di nuove conoscenze metodologiche è stata avviata una collaborazione tra Galeazzi e CCI, affiancando quindi ai clinici figure di supporto metodologico. E’ stato avviato un programma di formazione sviluppato su rilevanti problematiche ortopediche.Infine stato sono esplorati alcuni quesiti clinici, per selezionarne due da trasformare in una revisione sistematica e una linea guida.Il percorso formativo in aula è stato caratterizzato da un’iniziale non ottimale partecipazione. Gli incontri hanno affrontato le metodologie evidence-based e la valutazione critica della letteratura scientifica per prendere decisioni al letto del paziente. L’approccio didattico favoriva la discussione tra pari e
esercitazioni pratiche in piccoli gruppi. L’afflusso di partecipanti è aumentato durante le sessioni e si è concluso con la costituzione di un gruppo attivo e interessato.
Il gruppo ha poi cominciato la stesura di una revisione sistematica della letteratura dal titolo “Definizione dei fattori di rishio di per chirurgia riparativa delle fratture di femore: qual è il tempo d’attesa preoperatorio ottimale?” e avviato la produzione di una linee guida con il sistema GRADE per un uso ottimale delle sacche di sangue dopo interventi di chirurgia
ortopedica maggiore.
Conclusioni
La partecipazione dei clinici ortopedici allo sviluppo di prove di efficacia dovrebbe affiancarsi stabilmente all’attività clinica, con un continuo scambio. Questo dovrebbe
facilitare la diffusione di una cultura evidence-based, con ricadute positive sino ai pazienti. Questi cambiamenti sono lenti e in parte indipendenti dalle attività Galeazzi-Cochrane,
appartengono cioè alla categoria delle modificazioni medico-sociali. Questa collaborazione ha l’ambizione di accelerare questi cambiamenti e aumentare il pay-back in termini di
pubblicazioni, grant e leadership culturale
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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
- …
