Major intraoperative complications during video-assisted thoracoscopic anatomical lung resections: an intention-to-treat analysis

Objective. This systematic review aimed to assess the efficacy of manual therapies for headache relief. Method. A systematic search in MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Science databases was conducted for randomized and quasi-randomized trials, with no restrictions for language or year of publication. The descriptors were ‘Headache’, ‘Headache disorders’ and ‘Musculoskeletal manipulations’, in addition to the keyword ‘Manual therapy’ and its equivalents in Portuguese. We included studies that compared massage, chiropractic manipulation, osteopathic manipulation and other spinal manipulation to groups with no intervention, other physiotherapeutic modalities or to a sham group. Results. Seven of the 567 articles initially screened were selected, including patients with tension type headache, cervicogenic headache or migraine. It was not possible to assess the magnitude of the treatment effect on the findings of this review. The main limitations were the absence of randomization and adequate allocation concealment, the lack of blinded evaluators and intention-to-treat analysis and inadequate statistical analysis. Conclusions. We were unable to determine the size of the treatment effect due to the selective description of findings. Owing to the high risk of bias in the articles included, the available evidence regarding the efficacy of manual therapies for headache relief is insufficient.

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The Treatment Effect of Liver Transplantation versus Liver Resection for HCC: A Review and Future Perspectives

Cancers ◽

10.3390/cancers13153730 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3730

Author(s):

Berend R. Beumer ◽

Roeland F. de Wilde ◽

Herold J. Metselaar ◽

Robert A. de Man ◽

Wojciech G. Polak ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Liver Resection ◽

Early Stage ◽

Disease Free Survival ◽

Milan Criteria ◽

Term Survival ◽

Equal Distribution ◽

Intention To Treat ◽

Treat Analysis

For patients presenting with hepatocellular carcinoma within the Milan criteria, either liver resection or liver transplantation can be performed. However, to what extent either of these treatment options is superior in terms of long-term survival is unknown. Obviously, the comparison of these treatments is complicated by several selection processes. In this article, we comprehensively review the current literature with a focus on factors accounting for selection bias. Thus far, studies that did not perform an intention-to-treat analysis conclude that liver transplantation is superior to liver resection for early-stage hepatocellular carcinoma. In contrast, studies performing an intention-to-treat analysis state that survival is comparable between both modalities. Furthermore, all studies demonstrate that disease-free survival is longer after liver transplantation compared to liver resection. With respect to the latter, implications of recurrences for survival are rarely discussed. Heterogeneous treatment effects and logical inconsistencies indicate that studies with a higher level of evidence are needed to determine if liver transplantation offers a survival benefit over liver resection. However, randomised controlled trials, as the golden standard, are believed to be infeasible. Therefore, we suggest an alternative research design from the causal inference literature. The rationale for a regression discontinuity design that exploits the natural experiment created by the widely adopted Milan criteria will be discussed. In this type of study, the analysis is focused on liver transplantation patients just within the Milan criteria and liver resection patients just outside, hereby ensuring equal distribution of confounders.

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Krebstherapie – 68Ga-PSMA-PET/CT beim rezidivierten Prostatakarzinom richtungweisend und kosteneffektiv

Gesundheitsökonomie & Qualitätsmanagement ◽

10.1055/a-1244-6542 ◽

2020 ◽

Vol 25 (04) ◽

pp. 184-185

Author(s):

Susanne Krome

Keyword(s):

Prostate Cancer ◽

Cancer Recurrence ◽

Intention To Treat ◽

Biochemisches Rezidiv ◽

Choline Pet ◽

Psma Pet ◽

Pet Ct ◽

Prostate Cancer Recurrence ◽

Treat Analysis

Schwenck J et al. Intention-to-Treat Analysis of 68Ga-PSMA and 11C-Choline PET/CT Versus CT for Prostate Cancer Recurrence After Surgery. J Nucl Med 2019; 60: 1359–1365 15–40 % der Patienten mit einem Prostatakarzinom erleiden postoperativ ein biochemisches Rezidiv. In der retrospektiven Analyse beeinflussten die Bildgebungsverfahren die Häufigkeit einer richtigen Therapiewahl. Die Autoren empfehlen die 68Ga-PSMA-PET/CT, die die höchste Genauigkeit aufwies. Unter Berücksichtigung der Kosten für inadäquate Behandlungen entstünden keine ökonomischen Nachteile.

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Impact of narrow margin and R1 resection for hepatocellular carcinoma on the salvage liver transplantation strategy. An intention-to-treat analysis

HPB ◽

10.1016/j.hpb.2019.02.001 ◽

2019 ◽

Vol 21 (10) ◽

pp. 1295-1302 ◽

Cited By ~ 3

Author(s):

Chetana Lim ◽

Chady Salloum ◽

Eylon Lahat ◽

Dobromir Sotirov ◽

Rony Eshkenazy ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Intention To Treat ◽

R1 Resection ◽

Salvage Liver Transplantation ◽

Treat Analysis

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Possibilities of video-assisted mini-thoracotomy for lobular lung resections

Clinical and Experimental Surgery. Petrovsky journal ◽

10.33029/2308-1198-2021-9-3-112-117 ◽

2021 ◽

Vol 9 (3) ◽

pp. 112-117

Author(s):

D.N. Pilkevich ◽

◽

M.A. Chekasina ◽

S.S. Anufrieva ◽

◽

...

Keyword(s):

Video Assisted ◽

Lung Resections ◽

Mini Thoracotomy

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Intention-to-treat analysis: Are we managing dropouts and missing data properly in research on orthodontic treatment? A systematic review

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2018.08.013 ◽

2019 ◽

Vol 155 (1) ◽

pp. 19-27.e3 ◽

Cited By ~ 1

Author(s):

Klaus Barretto dos Santos Lopes Batista ◽

Badri Thiruvenkatachari ◽

Kevin O'Brien

Keyword(s):

Systematic Review ◽

Missing Data ◽

Orthodontic Treatment ◽

Intention To Treat ◽

Treat Analysis

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Outcomes with Biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs) in Older Patients Treated for Rheumatoid Arthritis

Canadian Geriatrics Journal ◽

10.5770/cgj.23.393 ◽

2020 ◽

Vol 23 (2) ◽

pp. 184-189

Author(s):

Ripa Akter ◽

Walter P. Maksymowych ◽

M. Liam Martin ◽

David B. Hogan

Keyword(s):

Rheumatoid Arthritis ◽

Older Patients ◽

Treatment Effectiveness ◽

Remission Rate ◽

Age Groups ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Intention To Treat ◽

Disease Modifying ◽

Treat Analysis

Background Biological disease-modifying antirheumatic drugs (bDMARDs) are recommended for rheumatoid arthritis (RA), but older patients reportedly experience more adverse events (AEs) and show variable treatment response. The objective of this study was to evaluate AEs and effectiveness of bDMARDs in a cohort of older patients. Methods AE and treatment effectiveness (based on DAS28 scores) data from a prospective provincial pharmacovigilance program for the years 2006–2009 in patients 55–64, 65–74, and 75+ years of age were compared. An intention to treat analysis with chisquare and unpaired t-testing for significance was performed. Results There were a total of 333 patients (156 were aged 55–64, 125 were 65–74, 52 were 75+). Those 75+ had higher disease activity and worse functional status at baseline. Among those 75+, AEs with bDMARDs were more common and likely to lead to discontinuation of therapy, be graded as severe, and classified as infectious (p < .05). Remission rate among those 75+ was significantly higher than patients 65–74. Etanercept was the most commonly used drug in all age groups. Conclusion Patients 75+ treated with bDMARDs are at a significantly greater risk of AEs, including infectious ones. The higher remission found in the oldest age group warrants further study.

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Treatment and Cost -outcomes of a simplified antiretroviral treatment strategy for hepatitis C among HCV and HIV co-infected patients in Ukraine

10.1101/2021.03.19.21253780 ◽

2021 ◽

Author(s):

Sergie Antoniak ◽

Charles Chasela ◽

Julie Morgan Freiman ◽

Yulia Stopolianska ◽

Tetiana Barnard ◽

...

Keyword(s):

Treatment Program ◽

Treatment Strategy ◽

Average Cost ◽

Indirect Costs ◽

Virologic Response ◽

Load Testing ◽

Genotype 3 ◽

Intention To Treat ◽

Program Costs ◽

Treat Analysis

Background: We conducted a demonstration project of an integrated HIV and viral hepatitis testing and treatment strategy using generic ledipasvir/sofosbuvir (LDV/SOF). Methods: Eligible HCV viraemic adults from two clinics in Kyiv were treated with LDV/SOF +/- weight-based ribavirin for 12 weeks. Clinical assessments were performed at screening and week 24 and as needed; treatment was dispensed every 4 weeks. The primary outcome was sustained virologic response (SVR)12 weeks after treatment. Program costs in 2018 USD were estimated per patient treated using observed resource utilization, local unit, and antiretroviral therapy (ART) costs over the 24-week period. Results: 868 participants initiated on treatment, 87% (755) were PWID and 55.5% (482) were HIV co-infected. The common genotypes were 1 (74.1%) and 3 (22%) and SVR was achieved in 831/868 (95.7%) by intention-to-treat analysis. The average cost per patient treated was $680, assuming generic LDV/SOF and ribavirin pricing and standard quantitative HCV viral load testing. Medications comprised 38% of the average cost/patient, laboratory tests 26%, events (clinic visits, counselling) 10%, and indirect costs 26%. ART accounted for 60% of all drug costs, with HCV medications just 40%. Conclusion: Generic LDV/SOF +/- ribavirin provided produced exceptionally good outcomes including amongst patients with genotype 3 HCV and PWID at an average cost of <$700/patient year, including ART for those with HIV. Under the assumptions of generic drug pricing but higher laboratory costs, an average cost of $750/patient is likely a reasonable estimate for this intervention in Ukraine, excluding costs for scaling or maintaining the treatment program.

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