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PubMed2006

[Randomized and nonrandomized controlled clinical trials in a German surgical journal].

BACKGROUND: Comprehensive identification of relevant literature is mandatory for valid assessment of the effectiveness of surgical interventions. Thus, electronic database searches are often complemented by handsearching of relevant surgical journals. The aim of this study was to assess the quantity and quality of randomized controlled (RCTs) and controlled clinical trials (CCTs) in the German surgical journal Der Chirurg. METHODS: Quantitative and qualitative assessment was made after handsearching of studies published from 1948 to 2005 in Der Chirurg. Systematic database search (MEDLINE) was used for comparison of RCTs published in Der Chirurg and international surgical journals. RESULTS: Overall, 112 controlled clinical trials (90 RCTs, 22 CCTs) were identified by handsearching. The implementation of sample size calculation was reported in 12 of 90 (13%) RCTs. Forty-six (51%) did not specify the randomization process, and five (6%) incorporated the "intention to treat" principle in their analyses. After 2000, RCTs were published in declining frequency in Der Chirurg, whereas international surgical journals printed stable quantities of these studies. CONCLUSION: Improving the prerequisites of patient-centered clinical research in surgery, rigorous implementation of principles of the CONSORT statement, and modified publication strategies may improve the quality and quantity of reports on clinical studies in Germany.

Controlled Clinical Trials as Topic↗
PubMed2001

[Reference manager EndNote 4. Further development and new functions].

Bibliography database managers are used to manage information resources: specifically, to maintain a database of references and create bibliographies and reference lists for written works. It should offer tools that let you find and retrieve references quickly, and it should be able to produce the bibliography in the format required for a particular publication. There are many computer programs, but very few stands out as truly useful, time saving, and work enhancing. One of them is EndNote. The reference manager EndNote 4 was recently released in Germany and, as long-time fans of this excellent program, we upgraded from the previous version. The use of the software package EndNote 4 for Windows is described, and we want to report about our own experiences with the new version of this database manager. The main reason for getting EndNote 4 is its clearly improved functions and features: for instance a new library window, a better search functions, an automatic updates and completion of term lists and an improved identification of duplicate references. Altogether EndNote 4 provides also an excellent combination of features and ease of use.

Database Management Systems↗
PubMed2007

[Impact factors and publication time spans in urological journals].

The impact factor, cited half-life, and immediacy index are three important methods that can be used to demonstrate how a journal's articles are cited over the course of a specific time span. These three factors thus represent instruments for measuring the importance and reputation of a scientific magazine. The goal of our study was to evaluate the constancy of journals specialized in the field of urology and to analyze those listed in the 2005 Journal Citation Report (JCR) using the standardized methods specified by the Institute of Scientific Information (ISI) and JCR. Primarily we wanted to examine the different time spans needed for publication of original papers submitted to certain journals; in more exact terms: the time span from submission of an article or original paper to its publication and from the time of acceptance of an original paper or article to its publication in a urological journal. Furthermore, we wanted to investigate the dynamics of urological journals regarding their impact factors for the years 2000-2005. The study was performed using the ISI JCR and the library as well as the online library of the Friedrich Alexander University in Erlangen. A very satisfactory development can be observed in the field of urology with the standardized methods of the (ISI) JCR.

Bibliometrics↗
PubMed2002

One hundred citation classics in general surgical journals.

The number of times an article is cited in scientific journals reflects its impact on a specific biomedical field or specialty and reflects the impact of the authors' creativity. Our objective was to identify and analyze the characteristics of the 100 most frequently cited articles published in journals dedicated to general surgery and its close subspecialties. Using the database (1945-1995) of the Science Citation Index of the Institute for Scientific Information, 1500 articles cited 100 times and more were identified and the top 100 articles selected for further analysis. The 100 articles were published between 1931 and 1990, with more than two-thirds of them published after 1960. The mean number of citations per article was 405, (range 278-1013). Altogether, 84 of the articles originated from North America (USA 78, Canada 6) and the UK (12). New York State led the list of U.S. states with 14, and Harvard and Columbia University led the list of institutions with 6 articles each. The 100 articles were published in 10 surgical journals led by the Annals of Surgery (n = 40), followed by Surgery (n = 15), Archives of Surgery (n = 12), Surgery, Gynecology and Obstetrics (n = 11), and British Journal of Surgery (n = 10). A total of 80 of the articles reported clinical experiences, 6 were clinical review articles, and 14 dealt with basic science. Eighteen articles reported a new surgical technique and six a prosthetic device. Gastrointestinal surgery and trauma and critical care led the list of the surgical fields, each with 25 articles, followed by vascular surgery (n = 15). Thirty-four persons authored two or more of the top-cited articles. This list of the top-cited papers identifies seminal contributions and their originators, facilitating the understanding and discourse of modern surgical history and offering surgeons hints about what makes a contribution a "top-cited classic." To produce such a "classic" the surgeon and his or her group must come up with a clinical or nonclinical innovation, observation, or discovery that has a long-standing effect on the way we practice-be it operative or nonoperative. Based on our findings, to be well cited such a contribution should be published in the English language in a high-impact journal. Moreover, it is more likely to resonant loudly if it originates from a North American or British "ivory tower."

Authorship↗
PubMed2005

Metabolomics and its role in understanding cellular responses in plants.

A natural shift is taking place in the approaches being adopted by plant scientists in response to the accessibility of systems-based technology platforms. Metabolomics is one such field, which involves a comprehensive non-biased analysis of metabolites in a given cell at a specific time. This review briefly introduces the emerging field and a range of analytical techniques that are most useful in metabolomics when combined with computational approaches in data analyses. Using cases from Arabidopsis and other selected plant systems, this review highlights how information can be integrated from metabolomics and other functional genomics platforms to obtain a global picture of plant cellular responses. We discuss how metabolomics is enabling large-scale and parallel interrogation of cell states under different stages of development and defined environmental conditions to uncover novel interactions among various pathways. Finally, we discuss selected applications of metabolomics.

Biochemistry↗
PubMed2000

[Online literature search].

The internet offers charge-free access to electronic online databases and thus has revolutionized the handling of information. Today's challenge is the rational management of the large amount of attainable data. This overview presents the various databases--particularly databases for online Medline search--and basic knowledge for effective and successful search strategies. There are numerous important advantages of online access to literature databases: availability at any time and any place in the world, easy handling due to the user-friendly surface of the World Wide Web, capability of linking directly to the private database. Clinicians, scientists, and ophthalmologists in private practice can equally profit from the advantages of fast, easy, and charge-free online-search in medical literature databases. Literature search should thus be an important tool to obtain the latest scientific knowledge for every physician.

Databases, Bibliographic↗
PubMed2005

Crème de la crème in forensic science and legal medicine. The most highly cited articles, authors and journals 1981-2003.

The importance and prestige of a scientific journal is increasingly being judged by the number of times the articles it publishes are cited or referenced in articles published in other scientific journals. Citation counting is also used to assess the merits of individual scientists when academic promotion and tenure are decided. With the help of Thomson, Institute for Scientific Information (Thomson ISI) a citation database was created for six leading forensic science and legal medicine journals. This database was used to determine the most highly cited articles, authors, journals and the most prolific authors of articles in the forensic sciences. The forensic science and legal medicine journals evaluated were: Journal of Forensic Sciences (JFS), Forensic Science International (FSI), International Journal of Legal Medicine (IJLM), Medicine, Science and the Law (MSL), American Journal of Forensic Medicine and Pathology (AJFMP), and Science and Justice (S&J). The resulting forensics database contained 14,210 papers published between 1981 and 2003. This in-depth bibliometric analysis has identified the creme de la creme in forensic science and legal medicine in a quantitative and objective way by citation analysis with focus on articles, authors and journals.

Bibliometrics↗
PubMed2006

Effectiveness and efficiency of a literature search strategy to answer questions on the etiology of occupational diseases: a controlled trial.

OBJECTIVES: To evaluate the effectiveness and efficiency of a search strategy to find evidence-based answers to questions related to the possible occupational etiology of diseases. METHODS: A controlled trial of 70 occupational health physicians and 55 insurance physicians who were asked to answer one out of four 'occupational disease case-vignettes' following the steps of evidence-based medicine (EBM). The intervention group were given the search strategy as a tool. RESULTS: The intervention group scored significantly better than the control group in answering the main question of the case-vignette correctly (57% versus 37%) using more adequate search terms. The intervention group scored significantly better regarding satisfaction with the applied search strategy (28% very satisfied versus 8%). We found no differences in time spent in solving the case or in the intention of future practice of EBM. CONCLUSIONS: The introduction and application of specific search strategies can have a positive effect on the effectiveness of searching literature. Future initiatives for developing and testing specific search strategies in the field of occupational health should be encouraged.

Adult↗
PubMed1998

MTHFR association with arteriosclerotic vascular disease?

Complex diseases are far more common than diseases that follow simple Mendelian patterns of inheritance. Difficulties are experienced in the designing of experiments to dissect out the contribution of a single allele to a complex phenotype. We review the literature regarding a point mutation in methylenetetrahydrofolate reductase, a candidate gene for susceptibility to vascular diseases.

Alleles↗
PubMed2004

Antibiotic prophylaxis in elective laparoscopic cholecystectomy. Lack of need or lack of evidence?

BACKGROUND: The need to administer antibiotic prophylaxis (ABP) during laparoscopic cholecystectomy (LC) is still a matter of significant controversy. The purpose of this study was to resolve this issue by performing a meta-analysis of the available randomized controlled trials (RCT) on this topic. METHODS: Papers identified via a systematic literature search were evaluated according to standard criteria. Data regarding the patient sample, study methods, and outcomes were abstracted and summarized across studies. The outcome measures were the rates of all perioperative infections, the rates of surgical site infections, and the rates of infections at other sites. Results were examined for 974 patients randomized to ABP or placebo prior to LC in six RCT published from 1997 to 2001. RESULTS: The cumulative rates of all infections were 2.8% in the ABP group and 4.4% in the placebo group. The pooled odds ratio (OR) (95% confidence interval [CI]) was 0.69 (0.34-1.43; p = 0.32). The cumulative rates of surgical site infections were 2.1% in the ABP group and 2.9% in the placebo group. The pooled OR (95% CI) was 0.82 (0.36-1.86; p = 0.63). The cumulative rates of infections at other sites were 0.7% in the ABP group and 1.5% in the placebo group. Pooled OR (95% CI) was 0.82 (0.18-1.90; p = 0.37). No significant heterogeneity was found in any data pooling. CONCLUSIONS: Based on the available evidence, there appears to be no need to administer routine ABP to low-risk patients during LC. However, the number of patients enrolled to date into RCT is insufficient to avoid a type II error. A large and well-designed trial is urgently needed to find a conclusive answer to this question.

Antibiotic Prophylaxis↗
PubMed2000

Consensus conferences must include a systematic search and categorization of the evidence.

BACKGROUND: Ideally, a consensus panel combines expert knowledge with external evidence derived from the literature. To date, many consensus conferences do not use a structured approach to search the literature, but simply compile an add-on reference list from all papers cited by the panelists. This study examined how well such panelists retrieved the relevant literature. METHODS: We used the reference lists of nine surgeons who took part in a consensus conference on common bile duct stones. We included all papers that were referred to as randomized controlled trials (RCTs). We then compared this list with a database search in order to calculate sensitivity and specificity. RESULTS: The nine experts cited between 35 and 518 papers, but only eight papers on average were RCTs. Of the 49 papers that the experts believed to be RCTs, only 23 actually were RCTs. The sensitivity resp. specificity for correctly identifying an RCT was 0.21 (95% Cl, 0.11-0.30) resp. 0.80 (95% Cl; 0.64-0.95). RCTs that included the word "randomized" in their title were significantly more likely to be identified (relative risk, 1.31; 95% Cl, 1.18-1.45). CONCLUSION: Our data indicate that consensus panelists usually do not perform systematic literature searches, but simply use their favorite papers to back up their arguments. Because this may lead to a biased selection of the evidence base on which the consensus statements are founded, a systematic search of all relevant articles should become a mandatory task in any consensus or guideline process.

Consensus Statements as Topic↗
PubMed2001

Terminal sedation in palliative medicine--definition and review of the literature.

This paper reviews the reported use of nonopioid medications for terminal sedation. To provide a summary of the available literature, an electronic database search was performed. Thirteen series and 1 4 case reports were identified. Various symptoms, including agitation, pain, and confusion, required terminal sedation. Eleven drugs were used in 342 patients. Most patients were also treated with concurrent opioids and received terminal sedation in an inpatient hospice unit. Midazolam was the most common sedative employed. A good response--defined as adequate sedation--ranged between 75% and 100%. The median time to death following the introduction of terminal sedation was greater than 1 day. No agent appears to have superior efficacy or limiting toxicity.

Analgesics, Non-Narcotic↗
PubMed2005

The prevalence of neck pain in the world population: a systematic critical review of the literature.

The objective of this study was to determine the prevalence of neck pain (NP) in the world population and to identify areas of methodological variation between studies. A systematic search was conducted in five databases (MEDLINE, EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of reference lists of relevant papers. Included papers were extracted for information and each paper was given a quality score. Mean prevalence estimates were calculated for six prevalence periods (point, week, month, 6 months, year, and lifetime), and considered separately for age, gender, quality score, response rate, sample size, anatomical definition, geography, and publication year. Fifty-six papers were included. The six most commonly reported types of prevalence were point, week, month, 6 months, year, and lifetime. Except for lifetime prevalence, women reported more NP than men. For 1-year prevalence, Scandinavian countries reported more NP than the rest of Europe and Asia. Prevalence estimates were not affected by age, quality score, sample size, response rate, and different anatomical definitions of NP. NP is a common symptom in the population. As expected, the prevalence increases with longer prevalence periods and generally women have more NP than men. At least for 1-year prevalence Scandinavian countries report higher mean estimates than the rest of Europe and Asia. The quality of studies varies greatly but is not correlated with the prevalence estimates. Design varies considerably and standardisation is needed in future studies.

Asia↗
PubMed2005

A critical review of guidelines for low back pain treatment.

MAIN PROBLEM: Little is known about the methodological quality of guidelines for low back pain treatment. We evaluated the methods used by the developers according to established standards. METHODS: PubMed, guideline databases, and the World Wide Web were used to identify guidelines. Seventeen guidelines met the inclusion criteria: interventions for low back pain stated, recommendations based on or explicitly linked to evidence, and English version available. Guidelines were evaluated independently by two appraisers using a practical tool for this purpose, Users' Guides to the Medical Literature, and the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. RESULTS: Thirteen guidelines (76%) specified the most important therapies applied, but only nine (53%) included a complete description of the target population. Explicit processes to identify, select, and combine evidence were described in only six guidelines (35%). Few guidelines (3; 18%) explicitly considered all main outcomes when formulating therapeutic recommendations, and none contained a process to determine the relative value of different outcomes. Methodological criteria for grading the strength of the recommendations varied, and were often insufficiently specified. None of the guidelines assessed the impact of uncertainty associated with the evidence and values used. According to AGREE the quality score was highest for the scope and purpose, and clarity and presentation domains, and lowest for editorial independence and applicability. With regard to the recommendations, there was consensus for some of the interventions for acute pain (analgesics and NSAIDs, maintaining physical activity, and avoiding excessive bed rest), but explicit recommendations were lacking or ambiguous for 41% of the interventions. Most of the guidelines did not contemplate specific recommendations for chronic pain. CONCLUSIONS: A small number of the available guidelines for low back pain treatment achieved acceptable results for specific quality criteria. In general, the methods to develop the guidelines' therapeutic recommendations need to be more rigorous, more explicit and better explained. In addition, greater importance should be placed on the recommendations for chronic pain.

Activities of Daily Living↗
PubMed2006

Identification of chromosomal regions linked to premature myocardial infarction: a meta-analysis of whole-genome searches.

Myocardial infarction (MI) is a complication of coronary artery disease and the leading cause of death in the Western world. MI is considered a distinct phenotype with an increased genetic component for its premature type. MI's exact inheritance pattern is still unknown. Genome searches for identifying susceptibility loci for premature MI produced inconclusive or inconsistent results. Thus, a genome search meta-analysis (GSMA) was applied to available genome search data on premature MI. GSMA is a non-parametric method to identify genetic regions that rank high, on average in terms of linkage statistics across genome searches unweighted or weighted by study size. The significance of each region's average and heterogeneity, unadjusted or adjusted by neighbouring average simulated ranks, was calculated using a Monte Carlo test. The meta-analysis involved five genome searches in Caucasians. Eight regions (6p22.3-6p21.1, 14p13-14q13.1, 13q33.1-13q34, 5p15.33-5p15.1, 8q13.2-8q22.2, 1p36.21-1p35.2, 12q24.31-12q24.33, 8q24.21-8q24.3) were found to have significant average rank by either unweighted or weighted analyses. In addition, region 8q24.21-8q24.3 produced significant low heterogeneity (P (unadjusted)=0.03 and P (adjusted)=0.05). Four regions (6p22.3-6p21.1, 14p13-14q13.1, 8q13.2-8q22.2, 8q24.21-8q24.3) were not identified by the individual studies. The meta-analysis suggests that these four regions should be further investigated for genes that confer susceptibility to MI.

Adult↗
PubMed2006

A review of the psychosocial effects of false-positive results on parents and current communication practices in newborn screening.

As more states adopt expanded newborn screening for metabolic disorders, the overall number of false positives increases. False-positive screening results have been associated with increased anxiety and stress in parents of infants who require follow-up testing, even after the infant's good health is confirmed. This article reviews the literature on the negative impact of false-positive newborn screening results on parents, along with a review of current communication practices for follow-up screening. The results of this review suggest that parental stress and anxiety can be reduced with improved education and communication to parents, specifically at the time of follow-up screening. Communication strategies with sample materials are proposed.

Anxiety↗