PubMed · 8564530
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1996. Information please.. https://doi.org/10.1038/nsb0296-105
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Clinical and biochemical data were collected prospectively from 8032 jaundiced patients to form a database as part of a EU-supported project on computer-aided diagnosis. Patients were recruited prospectively from centres in all EU-countries and some other countries as well. Five hundred and twenty-eight jaundiced patients were collected from four centres in Denmark. Alcoholic cirrhosis, acute alcoholic liver disease and malignancy of the pancreas or the biliary tract were more common in the Danish data base: 49% of cases in Denmark as compared to 30% of cases in the international database. Viral hepatitis was underrepresented in Denmark, 16% as compared to 23% in the international group. A crude Bayesian diagnostic programme on the total database with 17 diagnostic groups achieved 63% accuracy. For the 528 Danish cases the diagnostic accuracy was 64% when the European data base was used, whereas it increased to 81% when only the Danish data base was taken as basis for the calculations. In conclusion, we found a drop in diagnostic accuracy for the Danish patients when using the large European data base instead of the national one.
BACKGROUND: Published reports of complication rates, such as erectile dysfunction, associated with treatments for prostate carcinoma are often used to guide patient decision-making and develop clinical guidelines. Unfortunately, the published data are largely comprised of case series from single institutions. Meta-analysis is a methodology for combining findings from several studies to produce a better result. METHODS: A comprehensive literature review and subsequent meta-analysis of the rates of erectile dysfunction associated with external beam radiotherapy and radical prostatectomy was conducted. A simple logistic regression model was used to combine the data from 40 articles that met selection criteria. RESULTS: The probability of maintaining erectile functioning after radiotherapy is 0.69. The probability after surgery is 0.42. This difference is significant. Analysis of the effects of variables such as patient age and stage of disease on erectile functioning could not be performed due to inconsistencies across studies and the limited number of studies reporting such variables. CONCLUSIONS: The published data indicate that men with normal erectile functioning are more likely to retain this function after radiotherapy than after surgery. Attention is drawn to the weaknesses in the reviewed studies in the hope that the clinical trials of emerging treatments, such as cryotherapy, brachytherapy, three-dimensional conformal radiotherapy, and neoadjuvant hormones can be strengthened to reflect more accurately the rate of treatment-associated erectile dysfunction.
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