scholarly journals Comparative studies of dual bronchodilation in COPD

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Mario Cazzola ◽  
Maria Gabriella Matera ◽  
Paola Rogliani ◽  
Luigino Calzetta
Keyword(s):  
Comparative Analysis ◽  
Comparative Effectiveness ◽  
Fixed Dose ◽  
Effectiveness Research ◽  
Clinical Use ◽  
Equivalent Amount ◽  
Dual Bronchodilation ◽  
Clinical Benefits ◽  
Proper Comparison ◽  
Meta Analyses

Dual bronchodilation therapy is becoming the cornerstone for the treatment of COPD because the clinical benefits of LABA/LAMA fixed-dose combinations (FDCs) are now extensively established. Therefore, it not surprising that a number of LAMA/LABA combinations in a single inhaler have now been approved for clinical use as treatments for patients with COPD. Regrettably, very few head-to-head studies between all of the available LABA/LAMA FDCs have been carried out. This makes choosing the most appropriate FDC difficult. Comparative effectiveness research that also uses conventional meta-analyses to compare different care strategies can help generate useful information. A bidimensional comparative analysis across LAMA/LABA FDCs has suggested constant superiority for tiotropium/olodaterol. However, considering that there is not an equivalent amount of evidence on efficacy outcomes for all LAMA/LABA FDCs, a proper comparison between the different LAMA/LABA FDCs cannot be made yet, and the information available is still rather inconsistent.

scholarly journals Comparative Effectiveness Research: Using Systematic Reviews and Meta-Analyses to Synthesize Empirical Evidence

2011 ◽  
Vol 25 (3) ◽  
pp. 191-209 ◽  
Author(s):  
Maria C. Katapodi ◽  
Laurel L. Northouse
Keyword(s):  
Systematic Reviews ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Meta Analysis ◽  
Research Question ◽  
Alternative Methods ◽  
Evidence Based ◽  
Effectiveness Research ◽  
Meta Analyses ◽  
Research Studies

The increased demand for evidence-based health care practices calls for comparative effectiveness research (CER), namely the generation and synthesis of research evidence to compare the benefits and harms of alternative methods of care. A significant contribution of CER is the systematic identification and synthesis of available research studies on a specific topic. The purpose of this article is to provide an overview of methodological issues pertaining to systematic reviews and meta-analyses to be used by investigators with the purpose of conducting CER. A systematic review or meta-analysis is guided by a research protocol, which includes (a) the research question, (b) inclusion and exclusion criteria with respect to the target population and studies, © guidelines for obtaining relevant studies, (d) methods for data extraction and coding, (e) methods for data synthesis, and (f ) guidelines for reporting results and assessing for bias. This article presents an algorithm for generating evidence-based knowledge by systematically identifying, retrieving, and synthesizing large bodies of research studies. Recommendations for evaluating the strength of evidence, interpreting findings, and discussing clinical applicability are offered.

scholarly journals Using meta-analyses for comparative effectiveness research

2012 ◽  
Vol 60 (4) ◽  
pp. 182-190 ◽  
Author(s):  
Vicki S. Conn ◽  
Todd M. Ruppar ◽  
Lorraine J. Phillips ◽  
Jo-Ana D. Chase
Keyword(s):  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Effectiveness Research ◽  
Meta Analyses

Is Atherothromboaspiration a Possible Solution for the Prevention of No-Reflow Phenomenon in Acute Coronary Syndromes? Single Centre Experience and Review of the Literature

2019 ◽  
Vol 17 (2) ◽  
pp. 164-179
Author(s):  
Antonis S. Manolis
Keyword(s):  
Coronary Intervention ◽  
Covered Stent ◽  
Current Status ◽  
Extensive Literature ◽  
Review Of The Literature ◽  
Single Centre ◽  
Total N ◽  
No Reflow ◽  
Clinical Benefits ◽  
Meta Analyses

Background: Intracoronary thrombus in acute Myocardial Infarction (MI) confers higher rates of no-reflow with attendant adverse consequences. Earlier Randomized-Controlled-Trials (RCTs) of routine thromboaspiration during Percutaneous Coronary Intervention (PCI) indicated a clinical benefit, but more recent RCTs were negative. However, data of selective use of this adjunctive approach remain scarce. </P><P> Objective: The aim of this single-centre prospective study was to report the results of selective thromboaspiration during PCI in patients with intracoronary thrombi, and also to provide an extensive literature review on current status of thromboaspiration. </P><P> Methods: The study included 90 patients (77 men; aged 59.3±12.7 years) presenting with acute MI (STElevation MI (STEMI) in 74, non-STEMI in 16) who had intracoronary thrombi and were submitted to thromboaspiration. </P><P> Results: Total (n=67) or subtotal (n=18) vessel occlusions were present in 85 (94%) patients. Thromboaspiration and subsequent PCI were successful in 89/90 (98.9%) patients, with coronary stenting in 86 (96.6%). In 4 patients with residual thrombus, a mesh-covered stent was implanted. IIb/IIIa-inhibitors were administered in 57 (63.3%) patients. No-reflow occurred in only 1 (1.1%) patient. The postprocedural course was uneventful. Review of the literature revealed several early observational and RCTs and meta-analyses favouring manual, not mechanical, thrombectomy. However, newer RCTs and meta-analyses significantly curtailed the initial enthusiasm for the clinical benefits of routine use of thromboaspiration. </P><P> Conclusion: Selective thromboaspiration for angiographically visible thrombi in MI patients undergoing PCI, as an adjunct to mechanical reperfusion and to IIb/IIIa-inhibitors, may be an option since this manoeuvre may improve procedural and clinical outcome.

scholarly journals Botulinum Toxin: An Update on Pharmacology and Newer Products in Development

Toxins ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 58
Author(s):  
Supriyo Choudhury ◽  
Mark R. Baker ◽  
Suparna Chatterjee ◽  
Hrishikesh Kumar
Keyword(s):  
Botulinum Toxin ◽  
Clinical Use ◽  
First Line ◽  
High Demand ◽  
Short Term ◽  
Medical Specialties ◽  
Naturally Occurring ◽  
Pharmacokinetic Properties ◽  
Clinical Benefits ◽  
First Line Treatment

Since its introduction as a treatment for strabismus, botulinum toxin (BoNT) has had a phenomenal journey and is now recommended as first-line treatment for focal dystonia, despite short-term clinical benefits and the risks of adverse effects. To cater for the high demand across various medical specialties, at least six US Food and Drug Administration (FDA)-approved formulations of BoNT are currently available for diverse labelled indications. The toxo-pharmacological properties of these formulations are not uniform and thus should not be used interchangeably. Synthetic BoNTs and BoNTs from non-clostridial sources are not far from clinical use. Moreover, the study of mutations in naturally occurring toxins has led to modulation in the toxo-pharmacokinetic properties of BoNTs, including the duration and potency. We present an overview of the toxo-pharmacology of conventional and novel BoNT preparations, including those awaiting imminent translation from the laboratory to the clinic.

A Standard Set of Outcome Measures for the Comprehensive Appraisal of Cleft Care

2017 ◽  
Vol 54 (5) ◽  
pp. 540-554 ◽  
Author(s):  
Alexander C. Allori ◽  
Thomas Kelley ◽  
John G. Meara ◽  
Asteria Albert ◽  
Krishnamurthy Bonanthaya ◽  
...  
Keyword(s):  
Health Care ◽  
Outcome Measures ◽  
Comparative Effectiveness ◽  
Cleft Lip ◽  
Effectiveness Research ◽  
Data Standards ◽  
Prospective Data ◽  
Treatment Protocols ◽  
Multidisciplinary Working ◽  
Standard Set

Care of the patient with cleft lip and/or palate remains complex. Prior attempts at aggregating data to study the effectiveness of specific interventions or overall treatment protocols have been hindered by a lack of data standards. There exists a critical need to better define the outcomes- particularly those that matter most to patients and their families-and to standardize the methods by which these outcomes will be measured. This report summarizes the recommendations of an international, multidisciplinary working group with regard to which outcomes a typical cleft team could track, how those outcomes could be measured and recorded, and what strategies may be employed to sustainably implement a system for prospective data collection. It is only by agreeing on a common, standard set of outcome measures for the comprehensive appraisal of cleft care that intercenter comparisons can become possible. This is important for quality-improvement endeavors, comparative effectiveness research, and value-based health-care reform.

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