Integrating Research Data into Clinical Practice

Author(s):  
Kerry E. Meyer ◽  
Patricia A. Abbott ◽  
David Williams
Author(s):  
Elena Sergeevna Ilyina ◽  
Natal’a Valer’evna Filippova ◽  
Yulia Borisovna Barylnik

Pharmacogenetics is a relatively new scientific discipline, which is currently the main tool in personalized medicine. The aim of research in this area is to identify significant genetic markers for the introduction of their accounting in routine clinical practice. Generalization of data on the patient’s phenotype should be the key to predicting the pharmacokinetics and pharmacodynamics of the drug in the body. A personalized approach based on pharmacogenetic research data in psychiatry is extremely relevant due to the high social and budgetary costs of treating mental disorders around the world. Currently, there are data on the pharmacogenetics of most modern antidepressants, however, conducting such studies in patients with depressive disorders in most cases is impossible for implementation in routine clinical practice due to the impossibility of conducting the test in the laboratory of medical organizations and the lack of specialists competent in the clinical interpretation of the results of pharmacogenetic testing.


2019 ◽  
Vol 21 (3) ◽  
pp. 10-15
Author(s):  
Mikhail Yu Fedyanin ◽  
Elizaveta M Polyanskaya ◽  
Alexey A Tryakin ◽  
Ilia A Pokataev ◽  
Sergei A Tjulandin

Aim. To conduct a systematic review and meta-analysis of studies on the effect of starting dose of regorafenib on overall survival (OS) of patients with chemorefractory metastatic colorectal cancer. Materials and methods. We searched for research data in the PubMed. The analysis included all publications till 08.20.2019 which compared OS depending on the starting dose of regorafenib (160 mg or less) in the 1st course of therapy. Meta-analysis was conducted using Review Manager Ver. 5.3. Results. Two studies demonstrated decreased OS at starting dose of less than 160 mg (A. Adenis et al., 2016: risk ratio - RR 1.26, 95% confidence interval - CI 1.01-1.56; A. Aljubran et al., 2019: RR 2.25, 95% CI 0.93-5.43). Two studies showed an improvement in OS with a starting dose of less than 160 mg in the 1st course (T. Bekaii-Saab et al., 2018: RR 0.72, 95% CI 0.47-1,11; J. Gotfrit et al., 2017: RR 0.46, 95% CI 0.17-1.22). In two other studies, there was no effect of a starting dose of regorafenib on OS (K. Yamaguchi et al., 2019: RR 0.95, 95% CI 0.82-1.1; G. Argiles et al., 2019: RR 0,86, 95% CI 0.65-1.13). The meta-analysis did not reveal the effect of starting dose of the drug on OS: RR 0.97, 95% CI 0.78-1.21; p=0.79; I2=64. Conclusions. Reducing the starting dose of regorafenib in the 1st course does not decrease OS and can be recommended for routine clinical practice.


2005 ◽  
Vol 13 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Dhiren Singh

Objective: To review the research data about dementia with Lewy bodies (DLB) and describe those clinical features and investigations that will enhance more accurate diagnosis in day-to-day practice. Methods: A literature search using MEDLINE, Psychlit, Psychinfo and Cochrane databases was performed. Conclusions: The diagnosis of DLB is important now that treatment is available using cognitive enhancers and because of the risk to patients with DLB who are prescribed neuroleptics. The use of consensus criteria, despite their limitations, and judicious use of ancillary investigations, especially neuroimaging and neuropsychological tests, will enhance diagnostic accuracy.


2021 ◽  
pp. 1-9
Author(s):  
Robert E. Harbaugh ◽  
Clinton Devin ◽  
Michelle B. Leavy ◽  
Zoher Ghogawala ◽  
Kristin R. Archer ◽  
...  

OBJECTIVE The development of new treatment approaches for degenerative lumbar spondylolisthesis (DLS) has introduced many questions about comparative effectiveness and long-term outcomes. Patient registries collect robust, longitudinal data that could be combined or aggregated to form a national and potentially international research data infrastructure to address these and other research questions. However, linking data across registries is challenging because registries typically define and capture different outcome measures. Variation in outcome measures occurs in clinical practice and other types of research studies as well, limiting the utility of existing data sources for addressing new research questions. The purpose of this project was to develop a minimum set of patient- and clinician-relevant standardized outcome measures that are feasible for collection in DLS registries and clinical practice. METHODS Nineteen DLS registries, observational studies, and quality improvement efforts were invited to participate and submit outcome measures. A stakeholder panel was organized that included representatives from medical specialty societies, health systems, government agencies, payers, industries, health information technology organizations, and patient advocacy groups. The panel categorized the measures using the Agency for Healthcare Research and Quality’s Outcome Measures Framework (OMF), identified a minimum set of outcome measures, and developed standardized definitions through a consensus-based process. RESULTS The panel identified and harmonized 57 outcome measures into a minimum set of 10 core outcome measure areas and 6 supplemental outcome measure areas. The measures are organized into the OMF categories of survival, clinical response, events of interest, patient-reported outcomes, and resource utilization. CONCLUSIONS This effort identified a minimum set of standardized measures that are relevant to patients and clinicians and appropriate for use in DLS registries, other research efforts, and clinical practice. Collection of these measures across registries and clinical practice is an important step for building research data infrastructure, creating learning healthcare systems, and improving patient management and outcomes in DLS.


1981 ◽  
Vol 26 (3) ◽  
pp. 192-195 ◽  
Author(s):  
Pierre Parenteau ◽  
Yves Lamontagne

Thought-stopping, a simple behavioural technique, can be of help in the treatment of different ruminative processes such as ruminations, phobias of internal stimuli, smoking and sexual deviations. After reviewing the research data, although they claim that more controlled studies are mandatory, the authors believe that thought-stopping can be beneficial in clinical practice under certain conditions. They advise clinicians to use the technique described by Wolpe and Lazarus and they discourage the use of relaxation prior to thought-stopping. Tape-recorded instructions are not recommended in order to maximize the patient-doctor relationship. Finally, if good results are not obtained after a maximum of six sessions of therapy, other forms of treatment should be considered.


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