Does ‘insufficient evidence of benefit’ mean ‘sufficient evidence of no benefit’?

1996 ◽  
Vol 2 (2) ◽  
pp. 59
Author(s):  
Andrew Vickers
Keyword(s):  
Sufficient Evidence ◽  
Insufficient Evidence

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

Reasoning and Lapses in James’ The Will to Believe

2012 ◽  
Vol 15 (1) ◽  
pp. 387-399
Author(s):  
Jonathan Adler
Keyword(s):  
Ethics Of Belief ◽  
Insufficient Evidence ◽  
The Will ◽  
The Right ◽  
The Ethics Of Belief

James’ The Will to Believe is the most influential writing in the ethics of belief. In it, James defends the right and rationality to believe on non-evidential grounds. James’ argument is directed against Clifford’s “Evidentialism” presented in The Ethics of Belief in which Clifford concludes that “[i]t is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence”. After an overview of the James-Clifford exchange and James’ argument, I reconstruct his argument in detail. Subsequently, I examine four steps in James’ argument, and try to show that these amount to fallacies – enticing to reason, but not cogent.

The Binding and Viscometric Studies of Ni+2, Co+2 and Mn+2 Ions with Protein by Spectrometric and pH Metric Techniques

2019 ◽  
Vol 9 (2) ◽  
pp. 151-162
Author(s):  
Shveta Acharya ◽  
Arun Kumar Sharma
Keyword(s):  
Metal Ions ◽  
Metal Ion ◽  
Protein Molecule ◽  
Vital Role ◽  
Sufficient Evidence ◽  
Structural Requirement ◽  
Nickel Ions ◽  
Cobalt Ions ◽  
Lower Temperature ◽  
Specific Oxidation

Background: The metal ions play a vital role in a large number of widely differing biological processes. Some of these processes are quite specific in their metal ion requirements. In that only certain metal ions, in specific oxidation states, can full fill the necessary catalytic or structural requirement, while other processes are much less specific. Objective: In this paper we report the binding of Mn (II), Ni (II) and Co (II) with albumin are reported employing spectrophotometric and pH metric method. In order to distinguish between ionic and colloidal linking, the binding of metal by using pH metric and viscometric methods and the result are discussed in terms of electrovalent and coordinate bonding. Methods: The binding of Ni+2, Co+2 and Mn+2 ions have been studied with egg protein at different pH values and temperatures by the spectrometric technique. Results: The binding data were found to be pH and temperature dependent. The intrinsic association constants (k) and the number of binding sites (n) were calculated from Scatchard plots and found to be at the maximum at lower pH and at lower temperatures. Therefore, a lower temperature and lower pH offered more sites in the protein molecule for interaction with these metal ions. Statistical effects seem to be more significant at lower Ni+2, Co+2 and Mn+2 ions concentrations, while at higher concentrations electrostatic effects and heterogeneity of sites are more significant. Conclusion: The pH metric as well as viscometric data provided sufficient evidence about the linking of cobalt, nickel and manganese ions with the nitrogen groups of albumin. From the nature and height of curves in the three cases it may be concluded that nickel ions bound strongly while the cobalt ions bound weakly.

Classical Representations and Uses of the Presocratics

2009 ◽  
Author(s):  
John Palmer
Keyword(s):  
Sufficient Evidence ◽  
Presocratic Philosophy

Anyone interested in the influence of Presocratic thought may be tempted to begin with Plato and Aristotle. There is, however, sufficient evidence of Presocratic influence among the sophists to make it clear that this temptation should be resisted. Some traces of this earlier influence may be found in Plato and Aristotle themselves, and this fact should serve as a reminder that their own involvement with Presocratic philosophy did not take place in a vacuum but will have been conditioned or mediated by previous developments. This article deals with classical thinkers (including Plato and Aristotle) who interpreted, wrote about, and preserved the Presocratics, pointing out that just as one must read the Presocratics through the filters of Plato and Aristotle and their successors and commentators, Plato and Aristotle were influenced by the already burgeoning tradition of historiography that developed in the late fifth and fourth centuries.

scholarly journals Preliminary Pharmacogenetic Study to Explore Putative Dopaminergic Mechanisms of Antidepressant Action

2021 ◽  
Vol 11 (8) ◽  
pp. 731
Author(s):  
Taichi Ochi ◽  
Natalya M. Vyalova ◽  
Innokentiy S. Losenkov ◽  
Diana Z. Paderina ◽  
Ivan V. Pozhidaev ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Sufficient Evidence ◽  
Therapeutic Effects ◽  
Pharmacogenetic Study ◽  
Dopaminergic Mechanisms ◽  
Major Depressive Disorders ◽  
Related Proteins ◽  
Antidepressant Action

Background: There is sufficient evidence that interference of dopaminergic neurotransmission contributes to the therapeutic effects of antidepressants in unipolar and bipolar depression. Methods: Hamilton depression rating scale (HAMD 17) scores of 163 at least moderately ill patients with major depressive disorders were used to establish treatment response. HAMD 17 score status was measured before initiation, after two weeks, and after four weeks of treatment with various antidepressants. The possible association between response and genotype in a total of 14 variants of dopamine neurotransmission-related proteins was investigated. Results: DRD4 rs11246226 CA heterozygous patients were found with a greater improvement of HAMD 17 score when compared to homozygous C patients during 0–2 weeks and 0–4 weeks. Patients with MAOB rs1799836 heterozygous GA and homozygous A also demonstrated improved scores during 2–4 weeks and 0–4 weeks. Conclusions: The results are preliminary due to the limited population size and the small number of variants. Further research into the involvement of habenular dopamine D4 receptors in the antidepressant response is desirable.

scholarly journals The Development of a Personalized Symptom Management Mobile Health Application for Persons Living with HIV in China

2021 ◽  
Vol 11 (5) ◽  
pp. 346
Author(s):  
Shuyu Han ◽  
Yaolin Pei ◽  
Lina Wang ◽  
Yan Hu ◽  
Xiang Qi ◽  
...  
Keyword(s):  
Mobile Health ◽  
Symptom Management ◽  
Medical Staff ◽  
Quantitative Data ◽  
Research Team ◽  
Management Strategies ◽  
Sufficient Evidence ◽  
Relaxation Techniques ◽  
Persons Living With Hiv ◽  
Living With Hiv

Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development process of the symptom management (SM) app and the structure and content of it. Our research team systematically searched for evidence-based resources and summarized up-to-date evidence for symptom management and health education. Our multidisciplinary research team that included physicians, nurses, software engineers, and nursing professors, evaluated the structure and content of the drafted app. Both quantitative data and qualitative results were collected at a group discussion meeting. Quantitative data were scores of sufficient evidence, situational suitability, practicability, cost-effectiveness, and understandability (ranged from one to four) for 119 items of the app contents, including the health tracking module, the self-assessment module, coping strategies for 18 symptoms (80 items), medication management, complementary therapy, diet management, exercise, relaxation techniques, and the obtaining support module. The SM app was comprised of eight modules and provided several personalized symptom management functions, including assessing symptoms and receiving different symptom management strategies, tracking health indicators, and communicating with medical staff. The SM app was a promising and flexible tool for HIV symptom management. It provided PLWH with personalized symptom management strategies and facilitated the case management for medical staff. Future studies are needed to further test the app’s usability among PLWH users and its effects on symptom management.

scholarly journals Characterization and Treatment Goals of Patients on Long-Acting Injectable vs Oral Antipsychotics: Results from a Patient/Caregiver/Psychiatrist Survey

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 154-154
Author(s):  
Heather M. Fitzgerald ◽  
Jason Shepherd ◽  
Hollie Bailey ◽  
Mia Berry ◽  
Jack Wright ◽  
...  
Keyword(s):  
Real World ◽  
Sufficient Evidence ◽  
Treatment Goals ◽  
Full Time ◽  
Medication Regimen ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Course Of Illness ◽  
Current Medication ◽  
Long Acting

AbstractBackgroundPatient preferences in schizophrenia (SCZ), including identification of key goals and outcomes for treatment and relative importance of certain treatment goals to patients, have been assessed by several studies. However, there continues to be a lack of sufficient evidence on US patient attitudes and perceptions towards treatment goals and pharmacotherapy options in SCZ, especially taking into context long-acting injectable antipsychotics (LAIs) in this disease area. This lack of evidence is further pronounced in caregivers of individuals with SCZ. The objective of this analysis was to characterize patients with SCZ on LAIs vs patients on oral antipsychotics (OAPs) and evaluate the treatment goals of patients in each group.MethodsThis was a real-world, cross-sectional survey of US psychiatrists, patients =18 years old with a diagnosis of SCZ, and caregivers. Data was collected using the Disease Specific Programme (DSP) methodology, which has been previously published. Psychiatrists (n=120) completed detailed record forms for next 8 consecutive outpatients and 2 inpatients matching inclusion criteria, including non-interventional clinical and subjective assessments. The same patients and their caregivers, if present, were invited by their psychiatrist to voluntarily complete a separate survey.ResultsOf 1135 patients on treatment where the physician provided survey data; 251 were on an LAI, and 884 were on an OAP. Mean (SD) time to SCZ diagnosis for those on an LAI was 10.3 (12.0) years vs 7.8 (10.5) years for those on OAPs. More patients in the LAI vs OAP group were being treated as an inpatient (27.1% vs 15.7%, respectively; p<0.0001). Patients on an LAI reported being on their current medication regimen for less time (mean 1.7 years) vs those on OAPs (mean 2.5 years) (p=0.0093). More patients on LAIs were unemployed due to disability vs those on OAPs (56.1% vs 39.5%, respectively), and less patients on LAIs were able to work part-time or full-time (21.1% or 4.1%) vs those on OAPs (23.2% or 11.4%). More patients on an LAI had a caregiver vs those on OAPs (37.3% vs 26.1%, respectively; p=0.0011). Regarding the most important treatment goals reported by patients, both groups reported similar preferences for decrease in disease symptoms (62% on LAI vs 65% on OAPs) and thinking more clearly (53% on LAI vs 46% on OAPs); however, a numerically higher proportion of LAI patients reported that the current medication helped decrease hospitalizations due to relapse vs those on OAPs (38% vs 32%, respectively).DiscussionGiven the characteristics of patients participating in this real-world survey, those on LAIs exhibited qualities which indicate a higher severity of illness vs those on OAPs. Results suggest that treatment with LAIs is still mainly being provided to patients later in the disease course and/or who have adherence problems, despite a growing body of evidence of utility in younger patients earlier in the course of illness.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. and Lundbeck LLC

scholarly journals Comment on “Circadian rhythms in the absence of the clock gene Bmal1”

Science ◽  
2021 ◽  
Vol 372 (6539) ◽  
pp. eabe9230 ◽  
Author(s):  
Elan Ness-Cohn ◽  
Ravi Allada ◽  
Rosemary Braun
Keyword(s):  
Circadian Rhythms ◽  
Clock Gene ◽  
Insufficient Evidence ◽  
The Core ◽  
Clock Component ◽  
Mouse Tissues ◽  
Associated Data

Ray et al. (Reports, 14 February 2020, p. 800) report apparent transcriptional circadian rhythms in mouse tissues lacking the core clock component BMAL1. To better understand these surprising results, we reanalyzed the associated data. We were unable to reproduce the original findings, nor could we identify reliably cycling genes. We conclude that there is insufficient evidence to support circadian transcriptional rhythms in the absence of Bmal1.

Sign in / Sign up

Export Citation Format

Share Document