Postoperative adjuvant chemotherapy of gastric cancer: scrutiny into the clinical evidence based on quality assessment of medical literature of randomized controlled trials

2008 ◽  
Vol 63 (5) ◽  
pp. 919-927 ◽  
Author(s):  
Hei-Cheul Jeung ◽  
Sun Young Rha ◽  
Sang Joon Shin ◽  
Joong Bae Ahn ◽  
Jae Kyung Roh ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Clinical Evidence ◽  
Medical Literature ◽  
Controlled Trials ◽  
Evidence Based ◽  
Postoperative Adjuvant Chemotherapy ◽  
Randomized Controlled

Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 15 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Muhammed Rashid ◽  
Madhan Ramesh ◽  
K. Shamshavali ◽  
Amit Dang ◽  
Himanshu Patel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

Trends in randomized controlled trials in ENT: a 30-year review

1997 ◽  
Vol 111 (7) ◽  
pp. 611-613 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony ◽  
A. G. D. Maran
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Randomized Controlled Trials ◽  
Gold Standard ◽  
Controlled Trials ◽  
Evidence Based ◽  
Controlled Clinical Trials ◽  
Medline Search ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

scholarly journals Breast Cancer Research to Support Evidence-Based Medicine in Nigeria: A Review of the Literature

2021 ◽  
pp. 384-390
Author(s):  
Omolara A. Fatiregun ◽  
Temiloluwa Oluokun ◽  
Nwamaka N. Lasebikan ◽  
Emmanuella Nwachukwu ◽  
Abiola A. Ibraheem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Research ◽  
Randomized Controlled Trials ◽  
Evidence Based Medicine ◽  
Treatment Guidelines ◽  
Breast Cancer Research ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Based Medicine

PURPOSE Breast cancer is the most common malignancy in women worldwide. In Nigeria, it accounts for 22.7% of all new cancer cases among women. Evidence-based medicine (EBM) entails using the results from healthcare research to enhance the clinical decision-making process and develop evidence-based treatment guidelines. Level 1 and 2 studies, such as randomized controlled trials, meta-analyses, and systematic reviews of randomized controlled trials, yield more robust types of evidence. This study reviewed the levels of evidence of breast cancer publications in Nigeria. METHODS We conducted an electronic literature search of all studies published on breast cancer in Nigeria from January 1961 to August 2019. We reviewed all the articles found under the search term “Breast Cancer in Nigeria” on medical databases. RESULTS Our search identified 2,242 publications. One thousand two hundred fifty duplicates were removed, and 520 were excluded. A total of 472 articles were considered eligible for this review. Most of these articles were case series or reports (30.7%), qualitative studies (15.7%), followed by cross-sectional studies (13.3%), laboratory studies (12.9%), case-control studies (6.1%), case reports (7%), and cohort (5.7%). CONCLUSION Breast cancer research in Nigeria is yet to produce much evidence of the types considered to best support EBM. The scarcity of data hampers the implementation of EBM in Nigeria. Currently, most treatment guidelines are adapted from those developed in other countries, despite genetic differences among populations and different environmental influencing factors.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

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