Biomedical subjects

A Gouveia Oliveira

Publications and source records attributed to A Gouveia Oliveira.

5 recordsLinked to original sources

PubMed2006

Design aspects of a distributed clinical trials information system.

BACKGROUND: Clinical trials informatics has evolved through the development of multiple applications addressing distinct parts of the clinical trials cycle. This setting creates difficulties in the transport and sharing of data among applications that serve a common functionality. PURPOSE: We present an alternative approach for the design of clinical trials information systems consisting of loosely coupled components standing on a comprehensive model of the global clinical trial process. METHODS: We describe how such a structure is able to support the development and implementation of complex knowledge-driven modules, such as automated database query systems, reporting systems and intelligent data-analysis tools, and how currently available internet technologies may be used to support the independent development of applications and collaboration between researchers. RESULTS: These principles were applied to the development of a fully functional system that has been in production for eight years in a diversity of pharmaceutical and academic drug trials. Marked time savings in database set-up and statistical reporting have been documented, as well as good reliability in the selection of appropriate statistical methods to clinical trial data analysis. CONCLUSIONS: In order to meet the expected functionality and to avoid the proliferation of databases and software applications, clinical trials information systems need to be based on a generic model of clinical trials and on a distributed architecture.

Clinical Trials as Topic↗

PubMed2005

Intelligent Data Analysis of clinical trials.

We describe the software architecture of DART, an Intelligent Data-Analysis (IDA) tool for clinical trials data. This tool, which is coupled with COATI, a generic clinical trials database, embodies rule-based systems for data extraction and preparation, and algorithm-driven statistical analysis for the creation of fully ICH-compliant study reports.

Algorithms↗

PubMed2005

Data validity and integrity checking in clinical trials information systems.

Data validity and integrity checks in clinical trials (CT) databases have special procedures. We describe a new logic-driven system, coupled with a CT information system, which manages data anomalies found in CT databases. Q-GEM identifies data problems, and issues, emails to study sites, and tracks data discrepancy forms until their final resolution.

Clinical Trials as Topic↗

PubMed2003

Doppler tissue imaging: regional myocardial function in hypertrophic cardiomyopathy and in athlete's heart.

BACKGROUND: The distinction between hypertrophic cardiomyopathy (HCM) and the athlete's (AT) heart is an important clinical problem, and the analysis of regional myocardial function with Doppler tissue imaging may be useful in the differential diagnosis. OBJECTIVE: Our aim was to compare regional function assessed by Doppler tissue imaging in rowers and in a group of patients with HCM. METHODS: In 24 patients with nonobstructive HCM and in 20 competitive rowers with similar age, blood pressure, and heart rate, we analyzed with pulsed Doppler tissue imaging left ventricular (LV) regional function (velocities, time intervals, heterogeneity and asynchrony indices, and meridional gradient) in the longitudinal (8 segments, apical views) and in the radial (2 segments, short-axis view) axis. RESULTS: Compared with AT, patients with HCM showed: (1). systolic function; (a). longitudinal: lower velocities and meridional gradient; longer precontraction period (PCP); and higher PCP/LV contraction time; (b). radial: lower velocities and gradient; longer PCP; and higher PCP/LV contraction time; (2.diastolic function; (a). logitudinal: lower e (early diastolic), a (late diastolic), and e/a velocities; and longer prerelaxation time and time to peak e. The percentage of segments with e/a < 1 was 25% in the HCM group and 0% in the AT heart group; (b). radial: lower e velocity and gradient; lower e/a gradient; and longer medial prerelaxation and basal time to peak e. Most of these differences also occurred in the nonhypertrophied inferior wall of patients with HCM. CONCLUSIONS: There are significant differences between regional LV function of competitive rowers and patients with HCM. These differences (1). occur in systole and diastole; (2). affect velocities and time intervals; (3). are more striking in the long axis, but are also seen in the short axis, and (4). also occur in nonhypertrophied segments, suggesting the usefulness of the technique in the differential diagnosis between the 2 situations, namely in individuals that fall in Maron's "grey zone."

Adolescent↗

PubMedDate not supplied

Current management of hospitalized community acquired pneumonia in Portugal. Consensus statements of an expert panel.

The diagnosis and treatment of Community Acquired Pneumonia (CAP) are controversial issues, without evidence of solid consensus, reflected in the proliferation of Clinical Practice Guidelines proposing a wide range of recommendations. The aim of this study was the clinical validation of five of the most widely recognized Clinical Practice Guidelines (published by the British Thoracic Society, American Thoracic Society, Infectious Diseases Society of America, European Respiratory Society and Portuguese Society of Pulmonology), in line with the real situation in Portugal, as well as an assessment of the role of macrolides in the treatment of CAP. This study adopted the Delphi method to reach consensus from a panel of 20 Portuguese experts in the treatment of CAP, 16 of which participated actively in the study. A questionnaire with all the management options recommended by the five guidelines was distributed to the experts, who reported their degree of agreement with each recommendation on a 9-point Likert scale. The opinions of the specialist panel are reported, as well as the level of consensus and degree of sufficiency of each management option. The results of this study allowed the identification of the management options receiving a high level of acceptance among Portuguese physicians, as well as the estimation of epidemiological parameters, the definition of standards of care and the identification of the most relevant characteristics for the initial selection of antibiotics for empirical therapy. Erythromycin presents disadvantages in almost all characteristics, compared to advanced generation macrolides. Among these, azithromycin meets the panel of experts preferences as to antibiotic tolerability, administration schedule and costs better than clarithromycin.

Anti-Bacterial Agents↗