Are excellent systematic reviews of clinical trials useful for patient care?

2008 ◽  
Vol 4 (6) ◽  
pp. 294-295 ◽  
Author(s):  
Theodore Pincus ◽  
Yusuf Yazici ◽  
Tuulikki Sokka
Keyword(s):  
Clinical Trials ◽  
Patient Care ◽  
Systematic Reviews

Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

2019 ◽  
Vol 25 (15) ◽  
pp. 1783-1790 ◽  
Author(s):  
Rosario Pastor ◽  
Josep A. Tur
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Statistical Tests ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

scholarly journals Clinical Trials Registries For Systematic Reviews – An Alternative Source For Unpublished Data

2015 ◽  
Vol 18 (3) ◽  
pp. A12 ◽  
Author(s):  
N.J. Halfpenny ◽  
J.C. Thompson ◽  
J.M. Quigley ◽  
D.A. Scott
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Alternative Source

scholarly journals Random-effects meta-analysis for systematic reviews of phase I clinical trials: Rare events and missing data

2016 ◽  
Vol 8 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Mi-Ok Kim ◽  
Xia Wang ◽  
Chunyan Liu ◽  
Kathleen Dorris ◽  
Maryam Fouladi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Missing Data ◽  
Phase I ◽  
Random Effects ◽  
Systematic Reviews ◽  
Rare Events ◽  
Meta Analysis ◽  
Phase I Clinical Trials

scholarly journals Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023464 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Care ◽  
Systematic Reviews ◽  
Social Care ◽  
Interdisciplinary Teams ◽  
Cochrane Library ◽  
Early Assessment ◽  
Health And Social Care ◽  
The Impact

IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.

Clinical Trials and P Values

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 189-189
Author(s):  
JOHN D. LANTOS
Keyword(s):  
Clinical Trials ◽  
Patient Care ◽  
Randomized Trials ◽  
Therapeutic Interventions ◽  
P Values ◽  
Clinical Interventions

In Reply.— Here is the question: Are randomized trials so superior to other knowledge-generating techniques that we should not consider a fact to have been established unless it has been established by such a trial? If so, then the use of clinical interventions which have not been studied using randomized trials is wrong. if not, then we need to determine how such trials should be combined with other techniques, and how results of different techniques should be interpreted to lead to the best possible patient care, the incorporation of new therapeutic interventions into practice, and the timely discarding of techniques which are no longer sufficiently efficacious.

Patient care and clinical trials in gynecological oncology: Implications of the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5564-5564
Author(s):  
Sara Nasser ◽  
Christina Fotopoulou ◽  
Murat Guktekin ◽  
Desislava Dimitrova ◽  
Philippe Morice ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medical Care ◽  
Patient Care ◽  
Healthcare Professionals ◽  
Clinical Pathways ◽  
Trial Participation ◽  
Early Stage Disease ◽  
Gynecological Oncology ◽  
Cardiopulmonary Support ◽  
The Impact

5564 Background: This is a prospective international Survey to evaluate the impact of the COVID-19 Pandemic on the management of patients with gynecological malignancies from the multidisciplinary physicians' perspective, with particular focus on clincial infrastructures, and trial participation. Methods: The anonymous online survey consisted of 53 COVID-related questions. It was sent to all healthcare professionals in gynaecological oncology centres across Europe and the Pan-Arabian region from April 2020 to October 2020. All healthcare professionals treating women with gynecological cancers were able to participate in the survey. Results: A total of 243 answers were collected from 30 different countries. The majority (73%) of participants were gynecological oncologists from university hospitals(71%) with at least an Intensive care unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years(range 0-12 weeks). Cases that were prioritised for surgical intervention across all tumors (Ovarian, Endometrium, Cervical) were early stage disease (74%), primary situation (61%), and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumor types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. 45% stated the pandemic has negatively impacted the financial structure and support for clinical trials. 79% do not routinely screen patients included in trials for SARS CoV2. Overall, approx. 20% of clinicians did not feel well informed regarding clinical pathways for COVID-19 patients throughout the pandemic. The majority preferred regular updates and training via Webinars (75%), followed by tumorboards and interdisciplinary conferences (45%). 30% of clinicians stated that they are currently experiencing difficulties in providing adequate medical care due to staff shortage. Conclusions: Despite well-established guidelines for patient care and performing clinical trials in gynecological oncology, the COVID-19 pandemic has impacted clinical research, and financial structures. Longer waiting times for operative interventions, less support for clinical trials and concerns regarding provision of adequate medical care and triaging patients are very real. This survey underlines the necessity for building robust emergency algorithms tailored to gynecological oncology patients in the future.

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