scholarly journals A Birds-Eye (Re)View of Acid-Suppression Drugs, COVID-19, and the Highly Variable Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Cameron Mura ◽  
Saskia Preissner ◽  
Robert Preissner ◽  
Philip E. Bourne
Keyword(s):  
Systematic Approach ◽  
Retrospective Studies ◽  
Methodological Issue ◽  
Acid Suppression ◽  
Evidence Based ◽  
Real World Evidence ◽  
Potential Benefits ◽  
Observational Cohort ◽  
The One ◽  
Meta Analyses

This Perspective examines a recent surge of information regarding the potential benefits of acid-suppression drugs in the context of COVID-19, with a particular eye on the great variability (and, thus, confusion) that has arisen across the reported findings, at least as regards the popular antacid famotidine. The degree of inconsistency and discordance reflects contradictory conclusions from independent, clinical-based studies that took roughly similar approaches, in terms of both experimental design (retrospective, observational, cohort-based, etc.) and statistical analysis workflows (propensity-score matching and stratification into sub-cohorts, etc.). The contradictions and potential confusion have ramifications for clinicians faced with choosing therapeutically optimal courses of intervention: e.g., do any potential benefits of famotidine suggest its use in a particular COVID-19 case? (If so, what administration route, dosage regimen, duration, etc. are likely optimal?) As succinctly put this March in Freedberg et al. (2021), “…several retrospective studies show relationships between famotidine and outcomes in COVID-19 and several do not.” Beyond the pressing issue of possible therapeutic indications, the conflicting data and conclusions related to famotidine must be resolved before its inclusion/integration in ontological and knowledge graph (KG)–based frameworks, which in turn are useful for drug discovery and repurposing. As a broader methodological issue, note that reconciling inconsistencies would bolster the validity of meta-analyses which draw upon the relevant data-sources. And, perhaps most broadly, developing a system for treating inconsistencies would stand to improve the qualities of both 1) real world evidence-based studies (retrospective), on the one hand, and 2) placebo-controlled, randomized multi-center clinical trials (prospective), on the other hand. In other words, a systematic approach to reconciling the two types of studies would inherently improve the quality and utility of each type of study individually.

The Use of Evidence-Based Practice Among Japanese Vocational Rehabilitation Professionals

2014 ◽  
Vol 58 (2) ◽  
pp. 70-79 ◽  
Author(s):  
Jun Yaeda ◽  
Kanako Iwanaga ◽  
Mayu Fujikawa ◽  
Fong Chan ◽  
Jill Bezyak
Keyword(s):  
Vocational Rehabilitation ◽  
Evidence Based Practice ◽  
Perceived Barriers ◽  
Evidence Based ◽  
Rehabilitation Professionals ◽  
Empirically Supported ◽  
Research Designs ◽  
Potential Benefits ◽  
Meta Analyses ◽  
Empirically Supported Interventions

The current study surveyed 94 Japanese vocational rehabilitation (VR) professionals to determine their perceived self-efficacy, perceived benefits, perceived barriers, and readiness to use evidence-based practice (EBP). VR counselors in Japan generally see the potential benefits of using EBP to improve psychosocial and employment outcomes of people with disabilities. However, responses related to knowledge and skills were mixed with higher confidence reported in the ability to understand basic concepts of rehabilitation research designs, methods, and statistics but less confidence in the use of research databases to find empirically supported interventions and in their ability to understand the best evidence information from systematic reviews/meta-analyses. Perceived barriers to EBP were identified, including lack of support for the use of EBP from colleagues and senior management in the agency and not having supervisors who are experienced in EBP. As expected, Japanese VR counselors also reported EBP was not effectively used in VR service delivery practices. Implications for practice, education, and professional development are discussed

The Complex Dynamic Evolution of Cultural Vibrancy in the Region of Halland, Sweden

2019 ◽  
Vol 43 (3) ◽  
pp. 159-202
Author(s):  
Paolo Massimo Buscema ◽  
Guido Ferilli ◽  
Christer Gustafsson ◽  
Pier Luigi Sacco
Keyword(s):  
Systematic Approach ◽  
Policy Design ◽  
Regional Scale ◽  
Computational Approach ◽  
Dynamic Evolution ◽  
Evidence Based ◽  
Complex Dynamic ◽  
The One ◽  
First Time ◽  
Public Decision

This article examines the implicit space grammar of the cultural vibrancy of the region of Halland in Southwest Sweden. By using a new computational approach, we implement for the first time a methodology that allows us, on the one side, to extrapolate the complex dynamic evolution of the region’s cultural geography and, on the other side, to diagnose the structural causes of its eventual decay. The results provide a basis for a more systematic approach to evidence-based policy design at the regional scale, and for a more participatory, bottom-up public decision-making in the cultural and other policy spheres.

Evidence-based management of arrhythmogenic right ventricular cardiomyopathy in pregnancy

2020 ◽  
Author(s):  
Jagjit Khosla ◽  
Reshma Golamari ◽  
Alice Cai ◽  
Jamal Benson ◽  
Wilbert S Aronow ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Retrospective Studies ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Genetic Disorder ◽  
Ventricular Myocardium ◽  
Evidence Based ◽  
Ventricular Cardiomyopathy ◽  
Genes Encoding ◽  
In Pregnancy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disorder resulting in fibrofatty replacement of the myocardium. Genetic mutations in genes encoding for desmosome proteins result in a ventricular myocardium prone to arrhythmias and heart failure. Although ARVC is known for a few decades, most of the outcomes in pregnancy are reported recently. Pregnancy leads to significant physiological changes with excess mechanical stress on the myocardium. All the retrospective studies suggest that pregnancy is well tolerated in these patients despite the high risk of arrhythmias and heart failure. Our review focuses on the most up-to-date evidence on the management of ARVC patients during the antepartum and postpartum period.

scholarly journals A161 PREVALENCE OF FINANCIAL CONFLICTS OF INTEREST (FCOI) AMONG PROPENSITY-SCORE MATCHED RETROSPECTIVE STUDIES EVALUATING BIOLOGIC THERAPEUTICS FOR IBD

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-170
Author(s):  
K Elsolh ◽  
D Tham ◽  
M A Scaffidi ◽  
R Bansal ◽  
J Li ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Retrospective Studies ◽  
Conflicts Of Interest ◽  
Cochrane Library ◽  
High Burden ◽  
Real World Evidence ◽  
Full Text Retrieval ◽  
Financial Conflicts Of Interest ◽  
Matched Comparison

Abstract Background Inflammatory Bowel Disease (IBD) studies have commonly relied on real-world evidence to evaluate different therapies. An emerging idea has been the use of propensity score matching as a statistical method to account for baseline characteristics in IBD patients. In retrospective studies, propensity score matching of patients helps reduce treatment assignment bias and mimic the effects of randomization. Recently, propensity-score matching has become an important tool in IBD studies comparing biologic therapeutics. Biologic medications are among the highest-grossing drugs worldwide, and their pharmaceutical producers make considerable payments to physicians to market them. In spite of this, there is a lack of evidence examining the role of undue industry influence among propensity-score matched comparative studies evaluating biologic therapeutics for IBD. Aims Given the documented association between IBD biologics and FCOI, we hypothesize a high burden of FCOI in propensity-score matched studies. The aim of this study was to evaluate the prevalence of disclosed & undisclosed financial conflicts of Interest (FCOI) in propensity-score matched comparison studies evaluating biologics for IBD. Methods We developed & ran a librarian-reviewed systematic search on EMBASE, MEDLINE, and Cochrane Library databases for all propensity-score matched retrospective studies comparing biologics for the treatment of IBD. Full-text retrieval & screening was performed on all studies in duplicate. 16 articles were identified. Industry payments to authors were only considered FCOI if they were made by a company producing a biologic that was included in the comparison study. Disclosed FCOI were identified by authors’ interests disclosures in full-texts. Any undisclosed FCOI among US authors were identified using the Centre for Medicare and Medicaid Services (CMS) Open Payments Database, which collects industry payments to physicians. Results Based on a preliminary analysis of 16 studies, there was at least one author with a relevant FCOI in 14 (88%) of the 16 studies. 14 studies (88%) had at least one disclosed FCOI, while 6 studies (37.5%) had at least one undisclosed FCOI. Among studies with disclosed FCOI, a mean of 40.2% (SD = 23.4%) of authors/study reported FCOI. Among studies with undisclosed FCOI, a mean of 18.8% (SD = 7.0%) of authors/study reported FCOI. The total dollar value of FCOIs was $1,974,328.3. The median conflict dollar value was $5,576.6 (IQR: $321.6 to $36,394.9). Conclusions We found a high burden of undisclosed FCOI (37.5%) among authors of propensity-score matched studies evaluating IBD biologics. Given the potential for undue industry influence stemming from such payments, authors should ensure better transparency with industry relationships. Funding Agencies None

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

PP205 The Use Of Real-World Evidence To Support National Institute For Health And Care Excellence Medical Technology Submissions

2021 ◽  
Vol 37 (S1) ◽  
pp. 26-26
Author(s):  
Scott Gibson ◽  
Sita Saunders ◽  
Maximilian Blüher ◽  
Amanda Hansson Hedblom ◽  
Rafael Torrejon Torres ◽  
...  
Keyword(s):  
Decision Making ◽  
Real World ◽  
Trial Design ◽  
Clinical Evidence ◽  
Patient Characteristics ◽  
The United Kingdom ◽  
Real World Evidence ◽  
Guidance Documents ◽  
Meta Analyses ◽  
Positive Recommendation

IntroductionAlthough randomized controlled trials (RCTs) are recognized as providing the highest level of clinical evidence, few medical device RCTs are available due to underfunding or inherent challenges associated with trial design. This study examines the extent to which real-world evidence (RWE) supports the recommendations made by the National Institute for Health and Care Excellence Medical Technologies Evaluation Programme (MTEP).MethodsAll MTEP guidance documents published online prior to October 2020 were reviewed. The “case for adoption” recommendation, type of clinical data, and clinical critiques for each MTEP submission were extracted and categorized. RWE was defined as studies with neither blinding nor prospective selection or control of patient characteristics.ResultsOf the MTEP submissions reviewed, 34 of 45 (76%) received a positive recommendation. Independent of outcome, all submissions included RWE, but only 19 (42%) utilized RCT evidence (15 were recommended and four were not). Meta-analyses of RWE were used whenever possible. The most common clinical critiques in unsuccessful submissions were the following: (i) not generalizable to the United Kingdom National Health Service (NHS); (ii) low quality; (iii) likelihood of bias; (iv) trial design faults; (v) uncertain benefit; and (vi) evidence unrelated to scope.ConclusionsThis study suggests that while the use of RCTs has not always led to a positive recommendation, RWE can be valuable in decision-making. Evidence that is generalizable to the NHS, is related to the scope, and shows clear indication of benefit is more likely to positively influence MTEP decision-making.

Zur Entstehung und Entwicklung des begriffes „Konzept“ in der kognitiven Semantik

2021 ◽  
pp. 251-259
Author(s):  
Nedas Jurgaitis ◽  
Keyword(s):  
Middle Ages ◽  
Cognitive Linguistics ◽  
Word Meaning ◽  
Cognitive Semantics ◽  
Subjective Perception ◽  
Scientific Discussion ◽  
European Languages ◽  
The One ◽  
Meta Analyses ◽  
Linguistic Units

The present article deals with the genesis of the notion “concept” in German cognitive semantics. The aim of the study is to present the origin and development of the notion “concept” from a diachronic perspective. The genesis of the notion “concept” in linguistics, particularly cognitive semantics, is an object of discussion. It reveals a connection between ancient ideas about word meaning and trends in modern linguistics. The roots of the notion can be traced back to ancient Greek philosophy – the concept debuts as a primal notion of mental experiences in Aristotle’s writings. However, the controversial translation of ancient works leaves room for scientific discussion regarding the prototype of the notion. In the Middle Ages, the word concept originated in European languages from Latin, later establishing itself in scientific discourse through the influence of Neo-Scholasticism, Frege’s conception of logic and the semiotic triangle, as well as the principle of the arbitrariness of linguistic signs. Finally, the notion concept gains importance in the transition from objective to the subjective perception of the meaning of linguistic units (the shift from structuralism to cognitivism) and becomes under the influence of cognitive psychology, the central term in cognitive linguistics in the 1970s and 1980s. The unconventional use of the notion in linguistic studies, on the one hand, makes meta-analyses of the semantics of certain concepts more difficult; on the other hand, it favours disciplinary and methodological diversity in today’s linguistic research.

Update on hypnotherapy for psychiatrists

2021 ◽  
pp. 1-7
Author(s):  
Natalie A. Chan ◽  
Zhisong Zhang ◽  
Guoxing Yin ◽  
Zhimeng Li ◽  
Roger C. Ho
Keyword(s):  
Psychiatric Disorders ◽  
Practice Guidelines ◽  
Review Article ◽  
Outcome Studies ◽  
Evidence Based ◽  
High Quality ◽  
Long Time ◽  
Meta Analyses ◽  
Evidence Based Therapy

SUMMARY Although hypnosis has played a part in psychotherapy for a long time, it is not yet seen as an evidence-based therapy and is absent from many practice guidelines when it comes to the treatment of psychiatric disorders. At present, the applications and methods of hypnotherapy are poorly understood and other methods of psychotherapy tend to be favoured. This review article aims to introduce the role of hypnotherapy and its application for certain common psychiatric presentations, as well as examine its efficacy by summarising recent evidence from high-quality outcome studies and meta-analyses.

scholarly journals Telementoring of Surgeons: A Systematic Review

2018 ◽  
Vol 26 (1) ◽  
pp. 95-111 ◽  
Author(s):  
Simon Erridge ◽  
Derek K. T. Yeung ◽  
Hitendra R. H. Patel ◽  
Sanjay Purkayastha
Keyword(s):  
Systematic Review ◽  
Study Quality ◽  
Review Of The Literature ◽  
Exact Role ◽  
Technological Advances ◽  
Training Modality ◽  
Potential Benefits ◽  
Video And Audio ◽  
Meta Analyses ◽  
Efficacy Profile

Background. Telementoring is a technique that has shown potential as a surgical training aid. Previous studies have suggested that telementoring is a safe training modality. This review aimed to review both the technological capabilities of reported telementoring systems as well as its potential benefits as a mentoring modality. Methods. A systematic review of the literature, up to July 2017, was carried out in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study quality was assessed using the Oxford Levels of Evidence proforma. Data were extracted regarding technical capabilities, bandwidth, latency, and costs. Additionally, the primary aim and key results were extracted from each study and analyzed. Results. A total of 66 studies were identified for inclusion. In all, 48% of studies were conducted in general surgery; 22 (33%), 24 (36%), and 20 (30%) of studies reported telementoring that occurred within the same hospital, outside the hospital, and outside the country, respectively. Sixty-four (98%) of studies employed video and audio and 38 (58%) used telestration. Twelve separate studies directly compared telementoring against on-site mentoring. Seven (58%) showed no difference in outcomes between telementoring and on-site mentoring. No study found telementoring to result in poorer postoperative outcomes. Conclusions. The results of this review suggest that telementoring has a similar safety and efficacy profile as on-site mentoring. Future analysis to determine the potential benefits and pitfalls to surgical education through telementoring are required to determine the exact role it shall play in the future. Technological advances to improve remote connectivity would also aid the uptake of telementoring on a larger scale.

scholarly journals Evidence-Based Chinese Medicine for Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Jie Wang ◽  
Xingjiang Xiong
Keyword(s):  
Chinese Medicine ◽  
Tai Chi ◽  
Clinical Evidence ◽  
Poor Quality ◽  
Evidence Based ◽  
Hypertensive Patients ◽  
Primary Endpoints ◽  
Potential Benefits ◽  
Public Health Challenge

Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go.

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