Indirect evidence update

2021 ◽  
pp. 185-224
Author(s):  
Richard Gray
Keyword(s):  
Indirect Evidence

Efficacy of Crisis Intervention

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Thomas Reisch ◽  
Petra Schlatter ◽  
Wolfgang Tschacher
Keyword(s):  
Crisis Intervention ◽  
Intervention Program ◽  
Suicide Ideation ◽  
Indirect Evidence ◽  
Well Being ◽  
Term Therapy ◽  
Contributing Factors ◽  
Step Therapy ◽  
Long Term Therapy ◽  
The Impact

This study assesses the efficacy of the treatment approach implemented in the Bern Crisis Intervention Program, where particular emphasis is placed on the remediation of suicide ideation and suicidal behavior, and depression, fear, and phobia are generally considered to be contributing factors. Four questionnaires addressing psychopathology, emotional well-being, social anxiety, and personality were administered prior to and after the treatment of 51 patients over a period of 2 to 3 weeks. The reduction of symptoms contributing to suicidal ideation and behavior was interpreted as indirect evidence of an antisuicidal effect of the program. Significant improvements were found in the psychopathology ratings, with depression and anxiety showing the largest reductions. The impact on personality and social phobia, however, was only moderate, and on average patients still exhibited symptoms after attending the program. This residual symptomatology points to the necessity of introducing a two-step therapy approach of intensive intervention targeted at the precipitating causes of the crisis, augmented by long-term therapy to treat underlying problems.

Prevalence of Factor V Leiden Mutation in Non-European Populations

1997 ◽  
Vol 77 (02) ◽  
pp. 329-331 ◽  
Author(s):  
Guglielmina Pepe ◽  
Olga Rickards ◽  
Olga Camacho Vanegas ◽  
Tamara Brunelli ◽  
Anna Maria Gori ◽  
...  
Keyword(s):  
Factor V Leiden ◽  
Indirect Evidence ◽  
Factor V ◽  
Factor V Leiden Mutation ◽  
The World ◽  
Fv Leiden ◽  
Sub Saharan ◽  
Low Prevalence ◽  
European Populations ◽  
Apparently Healthy

SummaryA difference in the prevalence of venous thromboembolism (TE) in major human groups has been described and an uneven distribution of FV Leiden mutation over the world has recently been reported.We investigated FV Leiden mutation in 584 apparently healthy sub#jects mostly from populations different from those previously investi#gated: 170 Europeans (Spanish, Italians), 101 sub-saharan Africans (Fon, Bariba, Berba, Dendi), 115 Asians (Indonesians, Chinese, Tharus), 57 Amerindians (Cayapa), 84 Afroamericans (Rio Cayapa, Viche), and 57 Ethiopians (Amhara, Oromo).The mutation was detected in only 1/115 Asian (Tharu) and in 5/170 Europeans (4 Italians, 1 Spanish).These data confirm that in non-Europeans the prevalence of FV mutation is at least 7 times lower than in Europeans and provide indirect evidence of a low prevalence not only of the FV Leiden gene but also of other genes leading to more severe thrombophilia. Finally, findings from the literature together with those pertaining to this study clearly show a marked heterogeneity among Europeans.

Blood Viscosity and Platelet Aggregation in Male and Female Patients with Transient Ischaemic Attacks (TIA)

1979 ◽  
Author(s):  
G. Palareti ◽  
M. Poggi ◽  
G. Fortunato ◽  
S. Coccheri
Keyword(s):  
Platelet Aggregation ◽  
Blood Viscosity ◽  
Indirect Evidence ◽  
Vascular Lesions ◽  
Transient Ischaemic Attacks ◽  
Group A ◽  
Circulating Platelet Aggregates ◽  
Male Patients ◽  
Group B ◽  
Almost All

A series of 40 patients with TIA (25 males and 15 females) was thoroughly investigated by means of angiography and computerized tomography, and divided into a group (A) of 15 “sine materia”, and a group (B) of 25 with direct or indirect evidence of vascular occlusive or stenotic changes. Blood viscosity at 230 sec-1 37° was cp 4.2 ± 0.3 in the controls, cp 4.7 ± 0.7 in all patients (p < 0.05) cp 4.98 ± 0.7 in all male patients (p < 0.01 versus male controls), and cp 4.75 ± 0.8 in group B (p < 0.02). Haematocrit and Fibrinogen were also significantly increased in all male patients and in group B. Circulating platelet aggregates (CPA) were increased in 40% of the patients. Almost all patients with elevated CPA were males, with a slight prevalence in group B. Changes in blood viscosity parameters and in platelet aggregation in TIA patients were therefore related both to evidence of vascular lesions, and to sex, since they were found to prevail in male patients of both groups.

MONITORING RESULTS OF SAZAN (CYPRINUS CARPIO CARPIO LINNAEUS, 1758) POPULATION IN THE EASTERN PART OF THE TAGANROG BAY AND THE DON RIVER DELTA

2020 ◽  
Author(s):  
P.A. Balykin ◽  
◽  
A.V. Startsev ◽  
G.E. Guskov ◽  
A.S. Grin ◽  
...  
Keyword(s):  
Age Groups ◽  
Indirect Evidence ◽  
Parasite Fauna ◽  
River Delta ◽  
Weight Growth ◽  
Younger Age ◽  
Cyprinus Carpio Carpio ◽  
Don River ◽  
Taganrog Bay ◽  
Biological State

The materials for 2003-2018 on the biological state of sazan of the eastern part of the Taganrog Bay and the Don River delta were summarized. It has been shown that the catches of sazan in the study area consisted of more than half of the fish of younger age groups, the length of which was less than the commercial measure. The ratio of linear and weight growth of sazan is shifting towards a decrease in the mass of one-dimensional specimen, which is indirect evidence of the deterioration of the natural living conditions of semi-migratory fish. In 2019, the carp parasite fauna was represented by 7 species related to monogenes - 2 species, cestodes - 3 species, nematodes - 1 species, crustaceans - 1. The state of the sazan population needs further research.

Is Brain-Derived Neurotrophic Factor: A Common Link Between Neurodegenerative Disorders and Cancer?

2019 ◽  
Vol 16 (4) ◽  
pp. 344-352
Author(s):  
Radhika Khosla ◽  
Avijit Banik ◽  
Sushant Kaushal ◽  
Priya Battu ◽  
Deepti Gupta ◽  
...  
Keyword(s):  
Neurodegenerative Disorders ◽  
Neurotrophic Factor ◽  
Animal Studies ◽  
Neurodegenerative Disorder ◽  
Indirect Evidence ◽  
Brain Derived Neurotrophic Factor ◽  
Common Disease ◽  
Inverse Association ◽  
Bdnf Expression ◽  
Strong Inverse Association

Background: Cancer is a common disease caused by the excessive proliferation of cells, and neurodegenerative diseases are the disorders caused due to the degeneration of neurons. Both can be considered as diseases caused by the dysregulation of cell cycle events. A recent data suggests that there is a strong inverse association between cancer and neurodegenerative disorders. There is indirect evidence to postulate Brain-derived Neurotrophic Factor (BDNF) as a potential molecular link in this association. Discussion: The BDNF levels are found to be downregulated in many neurodegenerative disorders and are found to be upregulated in various kinds of cancers. The lower level of BDNF in Alzheimer’s and Parkinson’s disease has been found to be related to cognitive and other neuropsychological impairments, whereas, its higher levels are associated with the tumour growth and metastasis and poor survival rate in the cancer patients. Conclusion: In this review, we propose that variance in BDNF levels is critical in determining the course of cellular pathophysiology and the development of cancer or neurodegenerative disorder. We further propose that an alternative therapeutic strategy that can modulate BDNF expression, can rescue or prevent above said pathophysiological course. Larger studies that examine this link through animal studies are imperative to understand the putative biochemical and molecular link to wellness and disease.

scholarly journals Conditional power of antidepressant network meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Holper
Keyword(s):  
Meta Analysis ◽  
Indirect Evidence ◽  
Dropout Rate ◽  
Conclusive Evidence ◽  
Effect Sizes ◽  
Current Evidence ◽  
Hamilton Depression Scale ◽  
Conditional Power ◽  
Sample Sizes ◽  
Antidepressant Treatments

Abstract Background Conditional power of network meta-analysis (NMA) can support the planning of randomized controlled trials (RCTs) assessing medical interventions. Conditional power is the probability that updating existing inconclusive evidence in NMA with additional trial(s) will result in conclusive evidence, given assumptions regarding trial design, anticipated effect sizes, or event probabilities. Methods The present work aimed to estimate conditional power for potential future trials on antidepressant treatments. Existing evidence was based on a published network of 502 RCTs conducted between 1979-2018 assessing acute antidepressant treatment in major depressive disorder (MDD). Primary outcomes were efficacy in terms of the symptom change on the Hamilton Depression Scale (HAMD) and tolerability in terms of the dropout rate due to adverse events. The network compares 21 antidepressants consisting of 231 relative treatment comparisons, 164 (efficacy) and 127 (tolerability) of which are currently assumed to have inconclusive evidence. Results Required sample sizes to achieve new conclusive evidence with at least 80% conditional power were estimated to range between N = 894 - 4190 (efficacy) and N = 521 - 1246 (tolerability). Otherwise, sample sizes ranging between N = 49 - 485 (efficacy) and N = 40 - 320 (tolerability) may require stopping for futility based on a boundary at 20% conditional power. Optimizing trial designs by considering multiple trials that contribute both direct and indirect evidence, anticipating alternative effect sizes or alternative event probabilities, may increase conditional power but required sample sizes remain high. Antidepressants having the greatest conditional power associated with smallest required sample sizes were identified as those on which current evidence is low, i.e., clomipramine, levomilnacipran, milnacipran, nefazodone, and vilazodone, with respect to both outcomes. Conclusions The present results suggest that conditional power to achieve new conclusive evidence in ongoing or future trials on antidepressant treatments is low. Limiting the use of the presented conditional power analysis are primarily due to the estimated large sample sizes which would be required in future trials as well as due to the well-known small effect sizes in antidepressant treatments. These findings may inform researchers and decision-makers regarding the clinical relevance and justification of research in ongoing or future antidepressant RCTs in MDD.

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