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PubMedDate not supplied

Variability of the Harris-Benedict equation in recently published textbooks.

The Harris-Benedict equation, as cited in a selection of textbooks of medicine, surgery, and nutrition, was compared with the original monograph published by the Carnegie Foundation. A significant amount of variation was found in published versions of this equation. Of 24 published versions, eight were sufficiently variant to produce errors of 7% to 55% in calculations of nutrition requirements. The error is usually in the constant term for one of the two Harris-Benedict equations. Either the constant term for men is increased to a value approximately the same as for women, or the constant term for women is reduced to be approximately equal to that for men. The primary reason appears to be the lack of availability in medical libraries of the original Carnegie Foundation publication by Harris and Benedict.

Energy Intake↗
PubMed2005

Managing febrile infants: impact of literature recommendations published during a physician's residency.

The authors hypothesized that sepsis workup recommendations are associated with practice recommendations published during the physician's residency. The first published recommendations suggesting sepsis workups for nontoxic, young, febrile infants appeared in pediatric journals from 1975-1980 and in family practice journals from 1981-1987. Data are from the Community Tracking Study (3,272 pediatricians and 2,432 family physicians). "Percentage of sepsis workups recommended" was defined by response to a vignette about the percentage of well-appearing 6-week-old children with a fever of 101 degrees F for whom the physician would recommend a sepsis workup. Multivariable regression with piecewise linear functions evaluated workup recommendations by timing of literature recommendations during residency. Pediatricians recommended sepsis workups 81.6% of the time and family physicians 67.7% (p < .001). Increased recommendations occurred among pediatricians who completed residency from 1975-1980 (p < .05) and among family physicians who completed residency from 1981-1987 (p < .005), when specialty-specific journals published recommendations for sepsis workups for febrile infants. The association between publication of sepsis workup recommendations during a physician's residency and increased sepsis workup recommendations suggests an unrecognized and enduring impact of such publications.

Diagnostic Tests, Routine↗
PubMedDate not supplied

A survey of clinicians' opinions regarding the value of published decision analyses as sources of clinically useful information.

Published decision analyses avoid many of the practical problems thought to be contributing to the slow acceptance of clinical decision analysis. To assess clinicians' opinions regarding the usefulness of published decision analyses, 46 physicians at a large community teaching hospital judged how useful 13 proposed interventions would be in helping them make better clinical decisions. Although 48% of the respondents indicated that they clearly understood decision analysis, easy access to a published decision analysis was the lowest-ranked intervention, with 28% of the respondents indicating that it would be helpful. In contrast, 87% indicated that easy access to the latest review article, the highest-rated intervention, would be helpful. This finding suggests that the proposed practical barriers to the acceptance of clinical decision analysis are relatively unimportant. The success of efforts to foster clinical decision analysis will depend on the identification of the key factors impeding its acceptance by clinicians and the development of effective techniques to overcome them.

Attitude of Health Personnel↗
PubMed2004

Selective serotonin reuptake inhibitor and venlafaxine use in children and adolescents with major depressive disorder: a systematic review of published randomized controlled trials.

OBJECTIVE: This review critiques published randomized placebo-controlled trials pertaining to the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and venlafaxine in the treatment of major depressive disorder in children and adolescents. METHOD: Medline was searched for articles meeting defined inclusion criteria. The following key terms were used: depressive disorders, antidepressive agents, fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine, venlafaxine, child, and adolescent. RESULTS: Six articles met inclusion criteria. Only 2 studies claim efficacy by significant results in primary outcomes; both have since been contested in further analysis. Not one study adequately examines safety, particularly with respect to whether a link exists between antidepressant use and induction of suicidal ideation or attempts. CONCLUSION: Published studies on SSRI or venlafaxine use in children and adolescents are inconclusive with respect to safety and efficacy, owing to inappropriate claims of efficacy, lack of improvement in global functioning scores, nonstandardized data collection regarding adverse effects, exclusion of suicidal subjects in the recruitment process, grouping of children and adolescents together, small sample sizes, conflict of interest posed by pharmaceutical company sponsorship, and publishing bias. Future investigators should consider these factors when developing study designs.

Adolescent↗
PubMed1999

The treatment of attention-deficit hyperactivity disorder: an annotated bibliography and critical appraisal of published systematic reviews and metaanalyses.

CONTEXT: The Agency for Health Care Policy and Research charged the McMaster Evidence-based Practice Center with conducting a comprehensive systematic review of the literature on the treatment of attention-deficit hyperactivity disorder (ADHD), with input from various groups of stakeholders. One strategy used to avoid duplication of work included a critical appraisal of existing systematic reviews and metaanalyses. OBJECTIVE: To identify and appraise published metaanalyses and systematic reviews on the treatment of ADHD and to produce an annotated bibliography. DATA SOURCES: Medline, Cumulative Index in Nursing and Allied Health (CINAHL), Healthstar, Psycinfo, and Embase were searched to September 1998; the Cochrane Database (1998 issue 3), selected Internet sites, and the files of investigators were also reviewed. STUDY SELECTION: Review articles described as systematic reviews or metaanalyses or including a Methods section were identified independently by 3 reviewers. DATA EXTRACTION: Two reviewers extracted, by consensus, relevant information on the name, methodological quality, ADHD-related aspects (comorbid disorders, family characteristics) of those reviews; data on the population, study setting, interventions, and outcomes evaluated by the reviews were also retrieved. RESULTS: Thirteen reviews, published from 1982 to 1998, were included. Eight included metaanalysis and 5 a qualitative review. Nonpharmacological treatments were mentioned in 6 reviews and combination therapies in 3. One review focused on the treatment of adults. Forty-seven drugs and 20 adverse effects were mentioned. Most reviews had major methodological flaws. CONCLUSIONS: Most published systematic reviews and metaanalyses on the treatment of ADHD have limited value for guiding clinical, policy, and research decisions. A rigorous, systematic review following established methodological criteria is warranted.

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Exploring the use of qualitative methods in published health services and management research.

There is interest in promoting greater use of qualitative methods in health care research. However, little is known about the volume or characteristics of published studies that use qualitative methods. This article explores these issues through a systematic review of 3 years (1995-1997) of articles classified as research in nine core health services research and management journals. The findings show that only about one in seven published research articles used qualitative methods. Two of the nine journals reviewed contributed 45 percent of the total number of articles using qualitative methods. Four journals contributed a combined 2 percent of this total number. The primary purposes in using these methods are description and articulating stakeholder perspectives. There is no standard number of pages devoted by journals to these studies or evidence that they require more journal space on average than quantitative studies. Most of the studies reviewed presented little or no information on methodology. These findings clarify future areas of emphasis for both editors and researchers wishing to promote the use of qualitative methodology in published health care research.

Data Collection↗
PubMedDate not supplied

Meta-analysis of published studies of work-related carpal tunnel syndrome.

The published information about work-related carpal tunnel syndrome (CTS) was surveyed to identify risk estimates and possible biases influencing the risk estimates. Seventeen studies from the English-language literature were identified and study characteristics were coded for univariate and regression analysis. Country of publication, study population, force, and repetitive motion were significant predictors or risk, with R(2) = 0.57, adjusted R(2) = 0.43, Cp = 5.79, and AIC = 19.6 using the best-subset method of variable selection. Using the forward-variable selection method, country, study population, study type, and repetitive motion were significant predictors, with R(2) = 0.57, Cp = 6.24, p = 0.033. Excess risks of work-related CTS were consistent in the studies reviewed. Studies published in the United States reported higher risk estimates than did those published elsewhere. Some industrial populations were found to have higher risk estimates than others. Cross-sectional designs were the most common epidemiologic approach, but are not without methodologic concerns.

Analysis of Variance↗
PubMed2004

Reported use of data monitoring committees in the main published reports of randomized controlled trials: a cross-sectional study.

BACKGROUND: We describe a review of published main reports of randomized controlled trials (RCTs), in order to measure the frequency of reported use of data monitoring committees (DMCs) and factors associated with reported DMC use. METHODS: Twenty-four higher impact general and specialist medical journals were handsearched for main reports of RCTs in order to provide a cross-sectional sample of trials published in the year 2000. Additionally, the same general medical journals were handsearched for 1990 to allow a comparison across time. RESULTS: Of 662 RCTs published in 2000, 120 (18%) explicitly reported using a DMC, while 107 (16%) reported planned interim analyses. Overall, about a quarter (24%) reported at least one of these. A higher proportion of trials reported using a DMC in 2000 than 1 990 (70/282, 25% versus 21/204, 10%) in the general medical journals. Logistic regression models suggested the more important variables associated with increased reported DMC use were: later year of publication, publication in general medical journal, survival-based endpoint, multicentre trial, increasing number of patients recruited, at least one arm involving a placebo, at least one arm involving a drug, factorial design and USA involvement in the trial. CONCLUSIONS: In 2000, about a quarter of main RCT reports mention use of a DMC. Actual use of DMCs is likely to be somewhat greater. Reporting use of a DMC was more likely for larger and longer trials among other factors. We believe the factors affecting reported use affect actual use. It is recommended that when a DMC oversees a trial, brief details should be explicitly included in the main trial paper. Standard nomenclature for DMCs is recommended.

Clinical Trials Data Monitoring Committees↗
PubMed2006

Determining urinary calcium/creatinine cut-offs for the paediatric population using published data.

BACKGROUND: The purpose of this study was to determine a cut-off above which a result is considered abnormal for 'spot' calcium-to-creatinine ratio (Ca/Cr) in urine in the paediatric age group. While the cut-offs are not well established, there are many published reports of urine Ca/Cr excretion ratio in the literature. Rather than undertaking a difficult, time-consuming, expensive, and ultimately redundant study, an analysis of these published works was undertaken to determine urine Ca/Cr cut-offs for the laboratory. METHODS: Fourteen studies reporting urine Ca/Cr ratio available in the literature were reviewed. Each study was abstracted for several characteristics. The data were plotted and the line of best fit describing the data was determined. Using the function describing the line, cut-offs by pertinent age were recalculated. These cut-offs were then compared to the original data and to in-house data. RESULTS: The function describing the line of best fit was y=-0.3175 ln(x) +1.46 (y=Ca/Cr in mmol/mmol and x=age in years), r2=0.85. After consultation with the paediatric nephrologists and comparison with our in-house data, cut-offs for age groups of <1, 1-<2, 2-<5, 5-<10, and 10-18 years in mmol/mmol of 1.50, 1.25, 1.00, 0.70, and 0.60, respectively, were derived. CONCLUSIONS: Using data from 14 published studies, suitable spot urine Ca/Cr cut-offs from birth to 18 years of age were determined.

Adolescent↗
PubMed1987

Second chronological supplement to the Carcinogenic Potency Database: standardized results of animal bioassays published through December 1984 and by the National Toxicology Program through May 1986.

This paper is the second chronological supplement to the Carcinogenic Potency Database, published earlier in this journal (1,2,4). We report here results of carcinogenesis bioassays published in the general literature between January 1983 and December 1984, and in Technical Reports of the National Cancer Institute/National Toxicology Program between January 1983 and May 1986. This supplement includes results of 525 long-term, chronic experiments of 199 test compounds, and reports the same information about each experiment in the same plot format as the earlier papers: e.g., the species and strain of test animal, the route and duration of compound administration, dose level and other aspects of experimental protocol, histopathology and tumor incidence, TD50 (carcinogenic potency) and its statistical significance, dose response, author's opinion about carcinogenicity, and literature citation. We refer the reader to the 1984 publications for a description of the numerical index of carcinogenic potency (TD50), a guide to the plot of the database, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. The three plots of the database are to be used together, since results of experiments published in earlier plots are not repeated. Taken together, the three plots include results for more than 3500 experiments on 975 chemicals. Appendix 14 is an index to all chemicals in the database and indicates which plot(s) each chemical appears in.

Animals↗
PubMed1993

The fifth plot of the Carcinogenic Potency Database: results of animal bioassays published in the general literature through 1988 and by the National Toxicology Program through 1989.

This paper is the fifth plot of the Carcinogenic Potency Database (CPDB) that first appeared in this journal in 1984 (1-5). We report here results of carcinogenesis bioassays published in the general literature between January 1987 and December 1988, and in technical reports of the National Toxicology Program between July 1987 and December 1989. This supplement includes results of 412 long-term, chronic experiments of 147 test compounds and reports the same information about each experiment in the same plot format as the earlier papers: the species and strain of test animal, the route and duration of compound administration, dose level and other aspects of experimental protocol, histopathology and tumor incidence, TD50 (carcinogenic potency) and its statistical significance, dose response, author's opinion about carcinogenicity, and literature citation. We refer the reader to the 1984 publications (1,5,6) for a guide to the plot of the database, a complete description of the numerical index of carcinogenic potency, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. The five plots of the database are to be used together, as results of individual experiments that were published earlier are not repeated. In all, the five plots include results of 4487 experiments on 1136 chemicals. Several analyses based on the CPDB that were published earlier are described briefly, and updated results based on all five plots are given for the following earlier analyses: the most potent TD50 value by species, reproducibility of bioassay results, positivity rates, and prediction between species.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data.

OBJECTIVE: The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. METHODS: Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the "related links" option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. RESULTS: Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. CONCLUSIONS: Studies do not demonstrate a link between thimerosal-containing vaccines and ASD, and the pharmacokinetics of ethylmercury make such an association less likely. Epidemiologic studies that support a link demonstrated significant design flaws that invalidate their conclusions. Evidence does not support a change in the standard of practice with regard to administration of thimerosal-containing vaccines in areas of the world where they are used.

Autistic Disorder↗
PubMed2005

Pharmacological management of overactive bladder : a systematic and critical review of published economic evaluations.

Overactive bladder is a common condition, with recent findings estimating the prevalence in adults at about 15%. Symptoms, including urinary urgency, high voiding frequency and urge incontinence, have been shown to decrease patients' quality of life. Given its high prevalence, the economic burden of overactive bladder is also substantial, with a recent estimate placing the annual cost in the US at 9.1 billion US dollars (year 2000 values). The objective of this review is to provide a critical appraisal of published economic evaluations of pharmacological and non-pharmacological treatments for overactive bladder. Published economic evaluations of treatments for overactive bladder have focused entirely on pharmacological treatments -- mainly on the two most commonly used drugs, oxybutynin and tolterodine, each of which is available in immediate- and extended-release formulations. Ten economic evaluations (more than half are cost-effectiveness studies) have been published. Modelling with decision trees or Markov models has been the predominant method. Evaluations comparing drug therapy with no treatment have concluded that drug therapy is cost effective. Analyses comparing the formulations of oxybutynin and tolterodine have produced highly inconsistent results, largely due to the sources of data employed for effectiveness and treatment discontinuation rates. There are no evaluations of drugs relative to non-pharmacological treatment, and there are other significant gaps in the economic evaluations of treatment to date. These include gaps resulting from a lack of reliable data on the performance of these drugs in real-world settings, particularly data on long-term persistence with treatment. A more definitive pharmacoeconomic comparison of oxybutynin and tolterodine formulations, incorporating all available clinical data, and other treatment options would help direct treatment.

Benzhydryl Compounds↗
PubMed2004

A meta-analysis of the published research on the affective, cognitive, and behavioral effects of corporal punishment.

The present study is a meta-analysis of the published research on the effects of corporal punishment on affective, cognitive, and behavioral outcomes. The authors included 70 studies published between 1961 and 2000 and involving 47,751 people. Most of the studies were published between 1990 and 2000 (i.e., 53 or 68%) and were conducted in the United States (65 or 83.3%). Each of the dependent variables was coded, and effect sizes (ds) were computed. Average unweighted and weighted ds for each of the outcome variables were .35 and .20 for affective outcomes, .33 and .06 for cognitive outcomes, and .25 and .21 for behavioral outcomes, respectively. The analyses suggested small negative behavioral and emotional effects of corporal punishment and almost no effect of such punishment on cognition. Analyses of several potentially moderating variables, such as gender or socioeconomic status, and the frequency or age of first experience of corporal punishment, the relationship of the person administering the discipline, and the technique of the discipline all had no affect on effect size outcome. There was insufficient data about a number of the moderator variables to conduct meaningful analyses. The results of the present meta-analysis suggest that exposure to corporal punishment does not substantially increase the risk to youth of developing affective, cognitive, or behavioral pathologies.

Affect↗
PubMed1998

The therapy of amblyopia: an analysis of the results of amblyopia therapy utilizing the pooled data of published studies.

CONTEXT: Although the treatment of amblyopia with occlusion has changed little over the past 3 centuries, there is little agreement about which regimes are most effective and for what reasons. OBJECTIVE: To determine the outcome of occlusion therapy in patients with anisometropic, strabismic, and strabismic-anisometropic amblyopia employing the raw data from 961 patients reported in 23 studies published between 1965 and 1994. DESIGN: Analysis of the published literature on amblyopia therapy results during the above interval, utilizing primary data obtained from the authors of these articles or tables published in the articles detailing individual patient outcomes. PARTICIPANTS: 961 amblyopic patients, participants in 23 studies, undergoing patching therapy for amblyopia from 1965 to 1994 with anisometropia, strabismus, or anisometropia-strabismus. MAIN OUTCOMES: In the pooled data set, success of occlusion therapy was defined as visual acuity of 20/40 at the end of treatment. RESULTS: Success by the 20/40 criteria was achieved in 512 of 689 (74.3%) patients. By category, 312 of 402 (77.6%) were successful in strabismic amblyopia, 44 of 75 (58.7%) in strabismic-anisometropic amblyopia, and 72 of 108 (66.7%) in anisometropic amblyopia. Success was not related to the duration of occlusion therapy, type of occlusion used, accompanying refractive error, patient's sex, or eye. Univariate analyses showed that success was related to the age at which therapy was initiated; the type of amblyopia; the depth of visual loss before treatment for the anisometropic patients and the strabismic patients, but not for the anisometropic-strabismic patients; and the difference in spherical equivalents between eyes, for the anisometropic patients. Logistic/linear regression revealed that 3 were independent predictors of a successful outcome of amblyopia therapy. CONCLUSIONS: Factors that appear most closely related to a successful outcome are age, type of amblyopia, and depth of visual loss before treatment. These may be related to factors, as yet undetermined in the pathogenesis of amblyopia. With present emphasis on the value of screening and prevention and the development of new screening tools, such a look at the results of amblyopia therapy in a large population seems indicated.

Adolescent↗
PubMedDate not supplied

[The first medical textbooks published after the founding of the Medical School in Belgrade].

After the founding of the University Medical School in Belgrade in 1920 the most urgent necessity was to write the first textbooks for theoretical medical studies. However, the first published textbook was that for forensic medicine (one of the last subjects in the study of medicine). This was the textbook "Forensic Medicine" written by military physician and internist Svetozar Peshitsh (1880-1936) in Belgrade in 1921. Next year the "Technique of Autopsy" was published. The author was Milovan Milovanovitsh (1893-1948), forensic physician. In 1923 there were published two medical textbooks for students of medicine: "Fundamental Basis for Human Anatomy" written by Russian physician Ilja Shapshal (1878-1949) and "Histological Techniques" written by the founder of histology at the Medical School in Belgrade, Aleksandar Dj. Kostitsh (1893-1983).

History, 19th Century↗
PubMed2003

Clinical research in family medicine: quantity and quality of published articles.

BACKGROUND AND OBJECTIVES: Publication of clinical research in peer-reviewed journals is an important measure of scholarly productivity. This study determined the quantity and quality of original clinical research published by family physicians. METHODS: We surveyed clinical research papers published in the year 2000 in four leading family medicine research journals and research originating in a family practice institution but published in 16 non-family medicine journals. All were selected on the basis of relevance to family physicians and "impact factor." The relevance and validity of papers was assessed using previously established criteria. RESULTS: The survey of family medicine journals revealed a total of 170 original research articles. Ninety eight were from academic family practice programs, and the remaining 72 were from other medical specialties or health care institutions. Most of the papers were cross-sectional surveys. There were seven qualitative studies, six randomized controlled trials, and no systematic reviews from family practice programs in these journals. Eight of the articles were from practice-based research networks. A total of 79 articles were considered relevant or highly relevant, and 22 of these were also considered valid (Patient-oriented Evidence That Matters or POEMs). The survey of 16 non-family medicine journals revealed 37 clinical research papers: 16 surveys, nine prospective cohort studies, seven randomized controlled trials, three systematic reviews/meta-analysis, one qualitative study, and one case-control study. There were nine "highly relevant" papers--seven could be classified as POEMs. CONCLUSIONS: Most clinical family medicine research uses less-rigorous study designs, such as the cross-sectional survey. The majority of papers do not meet established criteria for relevance and validity. There are no standards or comparable studies to compare these results to prior years or to other disciplines.

Cross-Sectional Studies↗
PubMed2001

Evaluation of a fatigue model using data from published napping studies.

The authors have previously published the development and empirical validation of a work-related fatigue model. However, published work has not involved data from napping studies. The aim of this paper is to determine how closely the model predicts changes in subjective and objective measures from data published from napping studies. The regression results between the model outputs and logical reasoning, multiple sleep latency test scores, self-rated alertness, profile of mood state fatigue, visual vigilance and reaction time were all strong to very strong (R2 = 0.4-0.9). Only digit symbol substitution revealed moderate (R2 = 0.1-0.2) regression values. The outputs of the model reflect changes due to naps of varying duration and timing measured at varying periods following a nap. Together with the outputs from previous investigations, these results further support the potential use of the fatigue model in operational settings. This appears to be true in settings that utilise napping as well as those that do not.

Circadian Rhythm↗