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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 631 records · Page 35Linked to original sources
PubMedDate not supplied

End-of-life care: issues relevant to the geriatric psychiatrist.

Most deaths in the United States occur in the context of chronic diseases in later life and are too often accompanied by potentially remediable emotional or physical suffering. Geriatric psychiatrists and other mental health professionals can contribute meaningfully to the provision of optimal care during the final phases of life. This review provides an overview of end-of-life care, focusing on issues most relevant to the geriatric psychiatrist. The author examined palliative care textbooks and review papers to determine the topics to be included in this article, and searched computerized literature databases on these topics. Many of the recommendations provided herein stem from experts' clinical experience; however empirical evidence is also incorporated and critiqued. Topics covered include conversations with patients and families about end-of-life care; the evaluation and treatment of suffering, including pain, depression, suicidality, anxiety, and delirium; the role of individual and family therapies in caring for dying patients; capacity determination; advance care planning; withholding life-sustaining treatments; and "last resort" (and, in some cases, quite controversial) options, such as terminal sedation, assisted suicide, and euthanasia. The author also notes the relevance of such end-of-life-care considerations to patients with dementia. Geriatric psychiatrists' skills across these multiple domains are of particular usefulness. Through such clinical skills and the application of empirical research tools to the many unanswered questions in the care of dying patients, geriatric psychiatry can make increasingly valuable and visible contributions to improving quality of life for people suffering from life-threatening illnesses.

Affect↗
PubMed2005

Effectiveness of different databases in identifying studies for systematic reviews: experience from the WHO systematic review of maternal morbidity and mortality.

BACKGROUND: Failure to be comprehensive can distort the results of a systematic review. Conversely, extensive searches may yield unmanageable number of citations of which only few may be relevant. Knowledge of usefulness of each source of information may help to tailor search strategies in systematic reviews. METHODS: We conducted a systematic review of prevalence/incidence of maternal mortality and morbidities from 1997 to 2002. The search strategy included electronic databases, hand searching, screening of reference lists, congress abstract books, contacting experts active in the field and web sites from less developed countries. We evaluated the effectiveness of each source of data and discuss limitations and implications for future research on this topic. RESULTS: Electronic databases identified 64098 different citations of which 2093 were included. Additionally 487 citations were included from other sources. MEDLINE had the highest yield identifying about 62% of the included citations. BIOSIS was the most precise with 13.2% of screened citations included. Considering electronic citations alone (2093), almost 20% were identified uniquely by MEDLINE (400), 7.4% uniquely by EMBASE (154), and 5.6% uniquely by LILACS (117). About 60% of the electronic citations included were identified by two or more databases. CONCLUSIONS: This analysis confirms the need for extending the search to other sources beyond well-known electronic databases in systematic reviews of maternal mortality and morbidity prevalence/incidence. These include regional databases such as LILACS and other topic specific sources such as hand searching of relevant journals not indexed in electronic databases. Guidelines for search strategies for prevalence/incidence studies need to be developed.

Female↗
PubMed2005

[Medical registries].

BACKGROUND: The target-oriented distribution of increasingly limited health care resources requires knowledge about the benefit of established measures and the health care situation. This is the purpose of health care research. In this overview, the role of registries in regard to health care research is described. MEDICAL REGISTRIES: Registries, a collection of standardized medical and socioeconomic data, investigate systematically and comprehensively for a certain purpose and are therefore appropriate to describe the actual treatment in regard to undersupply, excess supply, and missupply. One example would Allbe the use of statins in risk profile-oriented primary and secondary prevention of cardiovascular events. Furthermore, positive experience from registries is available, as in the case of quality assurance management. In registries for myocardial infarction like MIR, MITRA and ACOS, feedback about therapy compared with guidelines along with the request to explain deviation from guidelines resulted in a significant reduction of hospital mortality. The methodological necessities and limitations of the informational value are pointed out. CONCLUSION: Registries are able to contribute substantially to health care research.

Clinical Trials as Topic↗
PubMed1999

Statistical quality control in clinical trials.

We propose to apply statistical methods of industrial process and quality control to accumulating data in a statistical monitoring center of a clinical trial. We discuss some specific issues connected with the application of these methods over calendar time to patients' characteristics (at a particular individual patient time) or to more formal monitoring characteristics (like the number of queries per case record form). The tools used are Shewart charts, plots, breakpoint regression, and recursive residuals with cusums and V-charts, applied to measurement and event data. A software program based on SAS macros allows easy application of the methods. Some examples, with graphical outputs, from an ongoing trial on patients with primary malignant melanoma, illustrate the methods.

Cholesterol↗
PubMed2004

[The Swiss HIV Cohort Study--multifaceted network supporting patient care as well as large international research projects].

The Swiss HIV Cohort Study (SHCS) integrates networks at several different levels. Initiated as a national collaboration of five University and a Cantonal hospital the SHCS currently also integrates numerous regional hospitals and specialized physicians in private practice. The standardized anonymous data collection allowed a variety of scientific projects--even beyond strictly medical domains such as psychosocial and legal aspects. Although the SHCS is one of the largest HIV cohorts worldwide some important medical questions cannot readily be answered without collaborating in international networks. These networks on different levels facilitate an efficient information exchange aimed at an optimal and standardized care of patients with HIV and AIDS in Switzerland.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Further statistics in dentistry Part 8: Systematic reviews and meta-analyses.

A systematic review of research evidence is an efficient approach to integrating existing information, invariably a multiplicity of published articles, with a view to establishing whether the scientific findings are consistent. If so, it may be possible to draw conclusions and make recommendations about treatment regimens or observed effects which have greater credence than those obtained from individual studies. The systematic review relies on a specified checklist which determines which articles should be included in the review, and how each should be critically appraised to provide relevant information relating to the focus of the review.

Algorithms↗
PubMedDate not supplied

Information and communication systems for the assistance of carers based on ACTION.

Recent advances in telecommunication technologies allow the design of information and communication systems for people who are caring for others in the home as family members or as professionals in the health or community centres. The present paper analyses and classifies the information flow and maps it to an information life cycle, which governs the design of the deployed hardware, software and the data-structure. This is based on the initial findings of ACTION (assisting carers using telematics interventions to meet older persons' needs) a European Union funded project. The proposed information architecture discusses different designs such as centralized or decentralized Web and Client server solutions. A user interface is developed reflecting the special requirements of the targeted user group, which influences the functionality and design of the software, data architecture and the integrated communication system using video-conferencing. ACTION has engineered a system using plain Web technology based on HTML, extended with JavaScript and ActiveX and a software switch enabling the integration of different types of videoconferencing and other applications providing manufacturer independence.

Adult↗
PubMed2003

[AUO Urogenital Cancer Studies].

Quality assessment of oncological studies is mandatory. The German Cancer Society (Deutsche Krebsgesellschaft) and its affiliated organizations attained the mayer role for such purposes. The present paper demonstrates that the Association of Urological Oncoloy (AUO), which is part of the German Cancer Society, became the most widely accepted and integrative workinggroup on urogenital cancers in Germany (97 studies). The AUO does not only provide the largest public data base on urogenital cancer studies (65 items, http: www.auo-online.de) - with 18 open studies presented in the paper - but also serves as the principal driving force for interdisciplinary urogenital cancer networks and international intergroup activities (AUO/EORTC).

Clinical Trials as Topic↗
PubMed2000

Towards a common framework for clinical trials information systems.

This work describes the strategies for data modeling and implementation and the general architecture of COATI, a Clinical Trials information system that has been in production for more than three years. We discuss how the ICH guidelines influenced the system design, how we used conventional relational and EAV tables and how we integrated third-party software packages into our system. We describe a new architecture that forms the basis of a common framework for Clinical Trials information systems. This structure is based on the concept of a Common Information Framework (CIF). We have defined standard objects and corresponding methods for the CIF as an essential step towards the development of Clinical Trials Informatics.

Clinical Trials as Topic↗
PubMed2004

[University qualifying work (dissertations), their current registration, electronic access and related technical, administrative and legal questions].

Many countries (USA, Australia, Canada, Latin America, Spain, France, SRN) have national or international systems (e.g. Networked Digital Library of Theses and Dissertations--NDLTD), which openly (NDLTD) or commercially (University Microfilm International--UMI) present up to 50% of master dissertations and doctoral theses in a full text form. Such systems are in agreement with legal regulations of the given country and the author is the only holder of the work--of the dissertation. Authors are at the same time informed that dissertation represents a university document, which presents results of the given scientific community and it should be therefore distributed free of charge. Presentation is also the matter of honour of the author and his university. In the contemporary Czech Auctorial Law (No. 121/2000 Sb.) dissertation is considered as not fully defined "Educational work" and from the practical point the duration of necessary storage is not solved. For the contemporary worldwide conversion to electronically presented dissertations, the necessary technical and library standards has been prepared with the first positive experience. The supplement of the Auctorial and University Law appears to be necessary. It is inevitable to be prepared for that situation before the Czech Republic will join EU.

Academic Dissertations as Topic↗
PubMed1983

Online searching of the pharmaceutical literature.

Online databases that cover pharmaceutical topics are described and then illustrated with four sample searches. The online databases useful for searching pharmaceutical topics can be grouped into three categories: (1) databases devoted exclusively to drugs and the pharmacy profession, such as International Pharmaceutical Abstracts, Pharmaceutical News Index, and Ringdoc; (2) databases covering the clinical medicine literature, such as MEDLINE and its related files and Excerpta Medica; and (3) other scientific databases that include coverage of the pharmaceutical literature, such as BIOSIS Previews, Chem, Scisearch, and NTIS. Databases from each of these groups are discussed. The fields, which are categories of information contained in each record (e.g., author, article title, journal reference, abstract, and assigned indexing terms), are delineated, along with descriptions of how these fields function during the searching operation. The implications of the indexing policies of the various databases on search strategy are also explained. Sample search strategies are illustrated to compare file retrievals on specific subjects.

Drug Information Services↗
PubMed1999

Quality-assessed reviews of health care interventions and the database of abstracts of reviews of effectiveness (DARE). NHS CRD Review, Dissemination, and Information Teams.

OBJECTIVES: Database of Abstracts of Reviews of Effectiveness (DARE) (http:@www.york.ac.uk/inst/crd/) at the NHS Centre for Reviews and Dissemination provides a unique international resource of structured summaries of quality-assessed reviews of health care interventions. These reviews have been identified from searches of electronic databases and by hand-searching journals. This paper describes and summarizes the DARE database, including the topic areas covered and the review methods used. METHODS: The first 480 structured abstracts on the DARE database were summarized. Data were extracted from each database field and coded for analysis. RESULTS: Most of the systematic reviews investigated the effectiveness of treatments: 54% investigated the effectiveness of medical therapies, and 10% assessed surgical interventions. Around two-thirds used meta-analytic methods to combine primary studies. The quality of the reviews was variable, with just over half of the reviews (52%, n = 251) having systematically assessed the validity of the included primary studies. Narrative reviews were more likely than meta-analyses to reach negative conclusions (42% vs. 25%, p = .0001). The 21 reviews that reported drug company funding were more likely to reach positive conclusions (81% vs. 66%, p = .15). CONCLUSION: The DARE database is a valuable source of quality-assessed systematic reviews, and is free and easily accessible. It provides a valuable online resource to help in filtering out poorer quality reviews when assessing the effectiveness of health technologies.

Abstracting and Indexing↗
PubMedDate not supplied

Analysis of current nuclear cardiology literature in MEDLINE database: a study of gated SPECT imaging using PubMed.

BACKGROUND: Easy access to relevant clinical information is necessary for physicians to make the best decisions for patient management. The increasing amount of information available has made it difficult for physicians to retrieve up-to-date information efficiently. We sought to determine the accessibility and accuracy of indexing in the nuclear cardiology literature by conducting sample searches in the MEDLINE database on the topic of gated single photon emission computed tomography (SPECT) imaging. METHODS AND RESULTS: The MEDLINE database was initially searched by use of both a primary and a comprehensive search strategy on PubMed for publications in English from 1994 to 2000. A total of 260 papers were retrieved from the primary search and 306 additional papers from the comprehensive search. Only 204 of the 566 citations from the combined electronic searches were truly relevant to gated SPECT. The resulting specificity index (precision) was 36%. A hand search was conducted in 11 top journals from 1994 to 2000. It yielded 81 additional citations that were missed by the PubMed search. The sensitivity index (recall) was calculated for all 11 journals. The Journal of Nuclear Cardiology had the highest rate of publication but the lowest rate of recall (44%). The clinical nuclear cardiology terminology and classifications were compared with the available Medical Subject Headings (MeSH) and MeSH Trees used for indexing in MEDLINE. CONCLUSIONS: There are 6 nuclear cardiology techniques, including gated SPECT and myocardial perfusion imaging, that are not specifically indexed in the current MEDLINE database. The lack of specific MeSH headings and indexing structure results in low recall and precision for retrieval of nuclear cardiology literature. We recommend 2 additions to the MeSH Tree Structure and 6 new MeSH headings.

Cardiology↗
PubMed2006

[German Competence Network on Atrial Fibrillation (AFNET). A nationwide cooperation for better research and patient care].

The Atrial Fibrillation Competence Network is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF). The aim of the network--founded in 2003--is to improve the treatment of atrial fibrillation, the most common clinically important arrhythmia of the heart. A decentralized patient registry has been established. This registry, which comprises the manifestation, diagnostics and therapy of atrial fibrillation in Germany, is being used as a data basis for epidemiologic clinical studies. Epidemiologic projects are being conducted to study, e.g., the prevalence of atrial fibrillation as well as the occurrence of complications. Four multicenter clinical trials have been started to optimize pharmacological treatments (ANTIPAF trial, Flec-SL trial), preventive pacing (BACE-PACE trial) and catheter-based ablation (GAP-AF trial). Other clinical projects are being conducted to study the risk of neurologic complications and to develop new diagnostic imaging techniques. Experimental basic research projects are focusing on different aspects of atrial remodeling in order to find out in which way the molecular mechanisms can be manipulated by new methods of treatment. First results are presented.

Atrial Fibrillation↗