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Biomedical subjects

S Hopewell

Publications and source records attributed to S Hopewell.

5 recordsLinked to original sources

Compression stockings for preventing deep vein thrombosis in airline passengers.

BACKGROUND: Air travel might increase the risk of deep vein thrombosis (DVT). It has been suggested that wearing compression stockings might reduce this risk. OBJECTIVES: To assess the effects of wearing compression stockings versus not wearing them among people travelling on flights lasting at least four hours. SEARCH STRATEGY: We searched the Cochrane Peripheral Vascular Diseases Group's Specialized Register (January 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (in The Cochrane Library, Issue 4, 2005), MEDLINE (January 1966 to November 2005), EMBASE (January 1980 to December 2005) and several other electronic or grey literature sources, detailed in full in the review. The most recent searches were done in January 2006. SELECTION CRITERIA: Randomized trials of compression stockings versus no stockings in passengers on flights lasting at least four hours. Trials in which passengers wore a stocking on one leg but not the other, or those comparing stockings and another intervention were also eligible. DATA COLLECTION AND ANALYSIS: At least two authors independently assessed the quality of each study and extracted data. We sought additional information from trialists. MAIN RESULTS: Ten randomized trials (n = 2856) were included; nine (n = 2821) compared wearing stockings on both legs versus not wearing them, and one (n = 35) compared wearing a stocking on one leg for the outbound flight and on the other leg on the return flight. Of the nine trials, seven included people judged to be at low or medium risk (n = 1548) and two included high risk participants (n = 1273). All flights lasted at least seven hours. Fifty of 2637 participants with follow-up data available in the trials of wearing stockings on both legs had a symptomless DVT; three wore stockings, 47 did not (odds ratio 0.10, 95% confidence interval 0.04 to 0.25, P < 0.00001). There were no symptomless DVTs in three trials. No deaths, pulmonary emboli or symptomatic DVTs were reported. Wearing stockings had a significant impact in reducing oedema (based on six trials). No significant adverse effects were reported. AUTHORS' CONCLUSIONS: Airline passengers similar to those in this review can expect a substantial reduction in the incidence of symptomless DVT and leg oedema if they wear compression stockings. We cannot assess the effect of wearing stockings on death, pulmonary embolus or symptomatic DVT because no such events occurred in these trials. Randomized trials to assess these outcomes would need to include a very large number of people.

Aerospace Medicine↗

Non-steroidal anti-inflammatory drugs for pain in women with endometriosis.

BACKGROUND: Endometriosis is a common gynaecological condition that affects women and can lead to painful symptoms and infertility. It affects women's quality of life greatly, impacting on their careers, everyday activities, sexual and non-sexual relationships, and fertility. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used first-line treatment for endometriosis. OBJECTIVES: To assess the effects of NSAIDs for the management of pain in women with endometriosis compared to placebo, other NSAIDs, other pain management drugs, or no treatment. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register (May 2005) published in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and the reference lists from relevant publications. Experts in the field were also contacted for information about possible studies. SELECTION CRITERIA: We included all randomized controlled trials (RCTs) describing the use of NSAIDs in the treatment of endometriosis in women of all ages. DATA COLLECTION AND ANALYSIS: Two review authors (CA and SH) independently read and extracted data from each of the included studies. Crossover trials were analysed using the inverse variance method in RevMan to calculate the odds ratio for binary outcomes. MAIN RESULTS: Two trials were identified but only one trial, with 24 women, was included in the analysis. Comparing NSAIDs (naproxen) to placebo, there was no evidence of a positive effect on pain relief (odds ratio (OR) 3.27, 95% CI 0.61 to 17.69) in women with endometriosis. There was also inconclusive evidence to indicate whether women taking NSAIDs (naproxen) were less likely to require additional analgesia (OR 0.12, 95% CI 0.01 to 1.29) or experience side effects (OR 0.46, 95% CI 0.09 to 2.47) when compared to placebo. AUTHORS' CONCLUSIONS: There is inconclusive evidence to show whether NSAIDs (naproxen) are effective in managing pain caused by endometriosis. There is no evidence to show whether any individual NSAID is more effective than another. As shown in other Cochrane reviews, women using NSAIDs need to be aware of the possibility that these drugs may cause unintended effects.

Anti-Inflammatory Agents, Non-Steroidal↗

Full publication of trials initially reported as abstracts in the Australian and New Zealand Journal of Medicine 1980-2000.

Abstract Failure to identify all relevant reports of controlled trials is a potential source of bias in systematic reviews of health-care interventions. The present study aims to identify how many reports of trials -initially published as conference abstracts in the Australian and New Zealand Journal of Medicine were subsequently published in full. We identified trial reports by handsearching conference abstracts published in the Journal from 1980 to 2000. We then searched the Cochrane Controlled Trials Register and PubMed to determine how many of these had been subsequently published in full. A total of 962 reports of controlled trials was identified from the conference proceedings of 17 medical societies. Of these, 589 (61%) reports of trials were subsequently published in full, and on average within 1-2 years. Handsearching conference abstracts identified a large number of reports of controlled trials, over one-third of which were unpublished and therefore not easily accessible.

Abstracting and Indexing↗

A comparison of handsearching versus MEDLINE searching to identify reports of randomized controlled trials.

This study aims to compare handsearching to a basic MEDLINE search for the identification of reports of randomized trials in specialized health care journals. Twenty-two specialized health care journals, published in the U.K., were handsearched for all reports of controlled trials (as defined by the Cochrane Collaboration). The reports of trials, which were judged to be definitely randomized, were identified from a random sample of three years per journal and form one element of this study. A MEDLINE search using the publication type terms 'randomized controlled trial' and 'controlled clinical trial' was also performed for the same journal years. The reports of trials retrieved by handsearching were then compared against those retrieved from the MEDLINE search, to identify differences in retrieval between the two techniques. Reports of randomized trials identified by the MEDLINE search but not found by handsearching were individually assessed to see if they met the Cochrane eligibility criteria for a report of a randomized trial. A total of 714 reports of randomized trials were found by using a combination of both handsearching and MEDLINE searching. Of these, 369 (52 per cent) were identified only by handsearching and 32 (4 per cent) were identified only by MEDLINE searching. Of the reports identified only by handsearching, 252 had no MEDLINE record, of which 232 (92 per cent) were meeting abstracts or published in supplements; 117 (25 per cent) of the 462 reports of randomized trials which had a MEDLINE record were missed by the electronic search because they did not have either of the publication type terms 'randomized controlled trial' or 'controlled clinical trial'. This proportion varied depending on when the reports of randomized trials were published (that is, before or after the introduction of the MEDLINE publication type terms above). The highest additional yield from handsearching compared to MEDLINE searching was for reports of randomized trials published prior to 1991 and from handsearching the non-MEDLINE indexed parts of a journal. The results of this study suggest that a combination of MEDLINE and handsearching is required to identify adequately reports of randomized trials.

Information Storage and Retrieval↗

Methodologists and their methods. Do methodologists write up their conference presentations or is it just 15 minutes of fame?

OBJECTIVES: To assess the extent to which abstracts of methodological research, initially presented at meetings on systematic reviews, have gone on to be published as full articles. METHODS: Full publication was assessed in three ways: a search was carried out of The Cochrane Library; a search was conducted using MEDLINE; and a questionnaire was sent to the contact author of each abstract. RESULTS: Approximately half of the abstracts had not been, or were unlikely ever to be, published in full. CONCLUSIONS: The rate of full publication of abstracts related to the methodology of systematic reviews seems similar to that for randomized trials.

Abstracting and Indexing↗