Scientific basis of the System for Analysis of Validity in Evaluation: The SAVE Metaprotocol.

2021 ◽  
Vol 2 (2) ◽  
pp. 3679-3684
Author(s):  
Antonio Domínguez-Muñoz
Keyword(s):  
Disability Pension ◽  
Scientific Evidence ◽  
Daily Practice ◽  
Scientific Basis ◽  
Third Party ◽  
Significant Advance ◽  
Fraud Triangle ◽  
Clinical Context ◽  
Academic Knowledge ◽  
Flexible Application

There are multiple situations, often related to the administrative or judicial field, in which it is necessary to use a healthy skepticism, to question the validity of an assertion, appealing to the evidence that can prove or disprove it. (Shermer, 2008). From a child custody issue to facing a harsh criminal conviction, to applying for a disability pension or obtaining an indemnity in an insurance context; in all of them, there is the opportunity to use deception for one's own benefit, harming a third party, through fraud. As we know, opportunity, together with prior motivation or incentive and subsequent justification, constitute the classic fraud triangle proposed by Cressey (1961).             This questioning of the validity of the case understood as its accuracy or correspondence with what it pretends to be and independently of its various types, is only possible from a method of analysis based on scientific evidence that benefits from using a system ordered by rules for the investigation - which we know as a protocol (Amezcua, 2000) - as well as a multiple approaches (Campbell and Fiske, 1959) that is proportionate to a conception of the detection and demonstration of deception from the approach of complexity (Cardozo, 2011). If, in addition, such a system was sufficiently flexible to be useful in the daily practice of the various fields in which it may be necessary to use it, it could represent a significant advance in this area.             These, together with those of Behavior Analysis in Ethology, Criminology, and Psychology, are the initial theoretical bases on which the System of Analysis of Validity in Evaluation (SAVE) is designed, establishing four phases in two domains of multiple and orderly but flexible application, to scientifically question the validity of a case and provide it with consistency and even legal value when appropriate. Although SAVE was born in a clinical context (Domínguez-Muñoz et al., 2014) its main area of knowledge is the study of lying and deception, an area in which there is a large bibliography, somewhat dispersed among various disciplines, which must be incorporated as a source of academic knowledge for its use in the applied field (Domínguez-Muñoz et al., 2017).    

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

scholarly journals POS1391 MEASURING SUBCLINICAL INFLAMMATION IN HAND AND FOREFOOT IN PATIENTS WITH ARTHRALGIA USING 1.5T OR 3.0T MRI: DOES FIELD STRENGTH MATTER?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 978.1-978
Author(s):  
D. Krijbolder ◽  
M. Verstappen ◽  
F. Wouters ◽  
L. R. Lard ◽  
P. D. De Buck ◽  
...  
Keyword(s):  
Field Strength ◽  
Scientific Evidence ◽  
Correlation Coefficients ◽  
Daily Practice ◽  
Scientific Data ◽  
Imaging Features ◽  
Subclinical Inflammation ◽  
The Individual ◽  
3.0T Mri ◽  
Inflammation Score

Background:Magnetic resonance imaging (MRI) of small joints sensitively detects inflammation. MRI-detected subclinical inflammation, and tenosynovitis in particular, has been shown predictive for RA development in patients with arthralgia. These scientific data are mostly acquired on 1.0T-1.5T MRI scanners. However, 3.0T MRI is nowadays increasingly used in practice. Evidence on the comparability of these field strengths is scarce and it has never been studied in arthralgia where subclinical inflammation is subtle. Moreover, comparisons never included tenosynovitis, which is, of all imaging features, the strongest predictor for progression to RA.Objectives:To determine if there is a difference between 1.5T and 3.0T MRI in detecting subclinical inflammation in arthralgia patients.Methods:2968 locations (joints, bones or tendon sheaths) in hands and forefeet of 28 arthralgia patients were imaged on both 1.5T and 3.0T MRI. Two independent readers scored for erosions, osteitis, synovitis (according to RAMRIS) and tenosynovitis (as described by Haavaardsholm et al.). Scores were also summed as total inflammation (osteitis, synovitis and tenosynovitis) and total RAMRIS (erosions, osteitis, synovitis and tenosynovitis) scores. Interreader reliability (comparing both readers) and field strength agreement (comparing 1.5T and 3.0T) was assessed with interclass correlation coefficients (ICCs). Next, field strength agreement was assessed after dichotomization into presence or absence of inflammation. Analyses were performed on patient- and location-level.Results:ICCs between readers were excellent (>0.90). Comparing 1.5 and 3.0T revealed excellent ICCs of 0.90 (95% confidence interval 0.78-0.95) for the total inflammation score and 0.90 (0.78-0.95) for the total RAMRIS score. ICCs for individual inflammation features were: tenosynovitis: 0.87 (0.74-0.94), synovitis 0.65 (0.24-0.84) and osteitis 0.96 (0.91-0.98). The field strength agreement on dichotomized scores was 83% for the total inflammation score and 89% for the total RAMRIS score. Of the individual features, agreement for tenosynovitis was the highest (89%). Analyses on location- level showed similar results.Conclusion:Agreement of subclinical inflammation scores on 1.5T and 3.0T were good to excellent, in particular for tenosynovitis. This suggests that scientific evidence on predictive power of MRI in arthralgia patients, obtained on 1.5T, can be generalized to 3.0T when this field strength would be used for diagnostic purposes in daily practice.Disclosure of Interests:None declared

Do we trust scientific evidence? A multicentre retrospective analysis of first IVF/ICSI cycles before and after the OPTIMIST trial

2021 ◽  
Vol 36 (5) ◽  
pp. 1367-1375
Author(s):  
E Papaleo ◽  
A Revelli ◽  
M Costa ◽  
M Bertoli ◽  
S Zaffagnini ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Conflicts Of Interest ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Daily Practice ◽  
Vitro Fertilization ◽  
Starting Dose ◽  
Before And After ◽  
Competing Interest

Abstract STUDY QUESTION Has the practice of individualizing the recombinant-FSH starting dose been superseded after the largest randomized controlled trial (RCT) in assisted reproduction technology (ART), the OPTIMIST trial? SUMMARY ANSWER The OPTIMIST trial has influenced our ART daily practice to a limited degree, but adherence is still generally poor. WHAT IS KNOWN ALREADY Although the ‘one size fits all’ approach has been discouraged for decades by most authors, the OPTIMIST study group demonstrated in a large prospective RCT that, in general, dosage individualization does not improve the prospects for live birth, although it may decrease ovarian hyperstimulation syndrome (OHSS) risk in expected high responders. STUDY DESIGN, SIZE, DURATION Retrospective analysis of all first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles from 1st January 2017 to 31st December 2018, before and after the OPTIMIST publication on November 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Two thousand six hundred and seventy-seven patients, between 18 and 42 years old, undergoing their first IVF-ICSI cycle in seven Italian fertility centres, were included. Patients were allocated to three groups according to their ovarian reserve markers: predicted poor ovarian responders (POR), predicted normo-responders (NR) and expected hyper-responders (HRs). MAIN RESULTS AND THE ROLE OF CHANCE Between 2017 and 2018, there was an overall increase in prescription of the standard 150 IU dose proposed by the OPTIMIST trial and a reduction in the use of a starting dose >300 IU. After subgroup analysis, the decrease in doses >300 IU remained significant in the POR and NR sub-groups. LIMITATIONS, REASONS FOR CAUTION The retrospective nature of the study. Physicians need time to adapt to new scientific evidence and a comparison between 2017 and 2019 may have found a greater impact of the Optimist trial, although other changes over the longer time span might have increased confounding. We cannot be sure that the observed changes can be attributed to knowledge of the OPTIMIST trial. WIDER IMPLICATIONS OF THE FINDINGS Clinicians may be slow to adopt recommendations based on RCTs; more attention should be given to how these are disseminated and promoted. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. E.P. reports grants and personal fees from MSD, grants from Ferring, from IBSA, grants and personal fees from Merck, grants from TEVA, grants from Gedeon Richter, outside the submitted work. E.S. reports grants from Ferring, grants and personal fees from Merck-Serono, grants and personal fees from Theramex, outside the submitted work. All other authors do not have conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

Introduction

ESC CardioMed ◽  
2018 ◽  
pp. 1927-1928
Author(s):  
Giuseppe Boriani
Keyword(s):  
Clinical Skills ◽  
Care Delivery ◽  
Scientific Evidence ◽  
Healthcare Providers ◽  
Cardiac Pacing ◽  
Daily Practice ◽  
Specific Patient ◽  
Current Prevalence ◽  
History Of ◽  
The Impact

The history of pacing for bradycardia started more than 50 years ago and in these five decades the technologically driven evolution of devices and tools has been complemented by the acquisition of important scientific evidence of benefit in specific patient settings. The current prevalence of bradyarrhythmias requiring permanent cardiac pacing therapy is not precisely known, but the progressive ageing of the population makes it necessary to improve knowledge of the impact of bradycardia on patients’ health, as well as to improve the implementation in daily practice of the most appropriate and evidence-based device treatments, with an adequate reorganization of care. Moreover, the impressive technological evolution that occurred in this field, as a result of extensive cooperation between physicians, scientists, engineers, manufacturers, regulatory agencies, and healthcare providers, led to the appearance of new requirements such as improved clinical skills, the need for continuous education on rapidly evolving technology, the assessment of treatment costs, the need for consensus guidelines, and the need for reorganization of care delivery including telemedicine for device follow-up.

Definition of Torture in US Law

2017 ◽  
Author(s):  
Metin Başoğlu
Keyword(s):  
Learned Helplessness ◽  
Scientific Evidence ◽  
Scientific Basis ◽  
Committee Report ◽  
The Us ◽  
Interrogation Techniques ◽  
Us Senate ◽  
Definition Of ◽  
Enhanced Interrogation ◽  
Torture Memos

In the light of the US Senate Intelligence Committee Report on the Central Intelligence Agency’s detention and interrogation program confirming the use of “enhanced interrogation techniques” to induce “learned helplessness” in detainees, this chapter reviews the scientific basis for the US definition of torture and its interpretation in the “Torture Memos.” These memoranda clearly indicate that “enhanced interrogation techniques” are designed for use in combination with specific intent to induce learned helplessness. Abundant research evidence shows that learned helplessness is mental harm that is severe enough to qualify as torture even by US standards. Although the US definition of torture seems to create potential loopholes for impunity, it suffers from certain logical inconsistencies, scientifically unfounded assumptions, and perhaps even “loopholes” that may well render legal cover for use of “enhanced interrogation techniques” difficult, if not impossible—at least not possible in a way that can be justified by logical reasoning or scientific evidence.

Oxford Textbook of Neuromuscular Disorders

2014 ◽  
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Neuromuscular Disorders ◽  
Scientific Basis ◽  
Typical Case ◽  
Clinical Neurology ◽  
Case Histories ◽  
Clinical Context ◽  
Sensory Pathways ◽  
Neuromuscular Conditions

Part of the Oxford Textbooks in Clinical Neurology series, the Oxford Textbook of Neuromuscular Disorders covers the scientific basis, clinical diagnosis, and treatment of neuromuscular disorders with a particular focus on the most clinically relevant disorders. The resource is organized into seven sections, starting with the general approach to the patient with neuromuscular disorders and then focusing on specific neuromuscular conditions affecting the peripheral nervous system from its origins at the spinal cord anterior horn on its outward course to their effector muscles and the inbound sensory pathways. Chapters on specific neuromuscular conditions are illustrated with typical case histories and their presenting features, allowing readers to put rarer conditions into their clinical context more easily.

Legal issues related to drug testing in the clinical laboratory.

1988 ◽  
Vol 34 (3) ◽  
pp. 633-636 ◽  
Author(s):  
R T Chamberlain
Keyword(s):  
Drug Testing ◽  
Clinical Laboratory ◽  
Scientific Evidence ◽  
Legal Issues ◽  
Third Party ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chain Of Custody ◽  
Urine Drug Test ◽  
The Many

Abstract As has been reported many times by the lay press, urine drug testing may pose some unique challenges. The clinical laboratory interested in industrial drug testing (typically known as employee drug testing) should be aware of the many challenges that may be brought on by the fact that the result may be contested in an adversarial proceeding. This is what makes the urine drug test a forensic test. It may be one piece of evidence or the only piece of evidence used in an adversarial proceeding that may decide on punitive or rehabilitative action against an employee. As a result, unique standards for governmental contract laboratories have been proposed from the National Institute on Drug Abuse, and special proficiency testing and accreditation procedures have been promoted by professional societies. These standards illustrate the sensitive nature of the results. Because the results are subject to adversarial proceedings, all parties concerned in the testing process should be aware of the legal issues surrounding urine drug testing. There are constitutional and statutory issues as well as tort issues such as negligence, defamation, invasion of privacy, battery, infliction of emotional distress, and others. Laboratories should be especially aware of these issues, since they may be brought in as a third-party defendant to a suit or brought in as a participant in gathering the evidence. The laboratory should also be aware of other legal ramifications such as chain of custody, expert testimony, and the acceptability of scientific evidence.

Safeguarding Infant Brains: A Multidisciplinary Challenge—Results of a Survey, Update on Current Scientific Evidence, and Recommendations on How to Deal with Possible Anesthetic Drug Neurotoxicity

2017 ◽  
Vol 28 (05) ◽  
pp. 400-405
Author(s):  
John Vlot ◽  
Rene Wijnen ◽  
Frank Weber
Keyword(s):  
Pediatric Surgery ◽  
Scientific Evidence ◽  
Pediatric Anesthesia ◽  
Daily Practice ◽  
Scientific Data ◽  
Shared Responsibility ◽  
Neutral Position ◽  
Anesthetic Drug ◽  
Anesthetic Drugs ◽  
Prospective Longitudinal

Introduction Potential neurotoxicity of anesthetic drugs has been among the most intensively discussed issue in pediatric anesthesia for more than 10 years. It remains unclear how far this discussion has reached the European pediatric surgical community. Our aim was to investigate the thoughts of pediatric surgeons regarding this topic. In addition, we provide an update on the current scientific evidence regarding neurotoxicity together with recommendations for clinical practice. Materials and Methods A web-based survey to assess the thoughts of practicing European pediatric surgeons regarding neurotoxicity and how it may have influenced their daily practice of pediatric surgery was launched via the European Pediatric Surgeons' Association Web site. Results A total of 72 responses could be analyzed. A majority of the respondents were interested in the topic but felt a need to further explore it. Thirty-one respondents have changed their daily practice of pediatric surgery due to potential anesthetic drug toxicity. Eighteen respondents reported to be concerned about neurotoxicity, 29 held a neutral position, and 8 were not concerned. Twenty-seven respondents found it a shared responsibility of the surgeon and the anesthesiologist to deal with the neurotoxicity issue. The majority of respondents found a necessity for further research on anesthetic drug neurotoxicity, assigning the highest priority to prospective longitudinal human studies and the lowest to animal studies. Conclusion The neurotoxicity question has reached the pediatric surgical community. Currently available scientific data do not support the theory of anesthetic drug-induced neurotoxicity in young children. Recent interdisciplinary clinical research focuses on neurodevelopmental outcome after surgery in neonates and infants. The European Safe Anesthesia For Every Tot initiative suggests focusing on proper conduct of anesthesia in children rather than on possible anesthetic drug neurotoxicity.

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