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PubMedDate not supplied

The prevalence of inflammatory and developmental odontogenic cysts in a Jordanian population: a clinicopathologic study.

OBJECTIVE: To determine the prevalence of odontogenic jaw cysts in a Jordanian population and to compare these data with previously published reports from other geographic areas. METHOD AND MATERIALS: The files on odontogenic jaw cysts treated between 1989 and 2001 in the Oral and Maxillofacial Pathology Diagnosis Service at the Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, were reviewed. Clinical and radiographic data were recorded and microscopic slides evaluated according to the most recent World Health Organization classification. Cases were analyzed with regard to age, sex, and anatomic site. RESULTS: A diagnosis of odontogenic jaw cyst was established in 654 patients, with a male-to-female ratio of 1.7:1. Radicular cyst was the most common type of odontogenic cyst found (41.7%), followed by dentigerous cysts (24.8%). The peak age affected was between the third and fifth decades. Both jaws were almost equally affected. The most common anatomic site of incidence was the maxillary incisor/canine region, followed by the mandibular molar region. CONCLUSION: This study indicates that there are some geographic differences with regard to the relative frequency, sex, and anatomic distributions of odontogenic cysts.

Adolescent↗
PubMed1996

The importance of quality of primary studies in producing unbiased systematic reviews.

BACKGROUND: Traditional and largely qualitative reviews of evidence are now giving way to much more structured systematic overviews that use a quantitative method to calculate the overall effect of treatment. The latter approach is dependent on the quality of primary studies, which may introduce bias if they are of poor methodologic quality. OBJECTIVE: To test the hypothesis that the inclusion of poor-quality trials in meta-analyses would bias the conclusions and produce incorrect estimates of treatment effect. METHODS: An overview of randomized trials of antiestrogen therapy in subfertile men with oligospermia was performed to test the hypothesis. Data sources included online searching of MEDLINE and Science Citation Index databases between 1966 and 1994, scanning the bibliography of known primary studies and review articles, and contacting experts in the field. After independent, blind assessment, nine of 149 originally identified studies met the inclusion criteria and were selected. We assessed study quality independently. Outcome data from each study were pooled and statistically summarized. RESULTS: There was a marginal improvement in pregnancy rate with antiestrogen treatment (odds ratio, 1.6; 95% confidence interval, 0.9 to 2.6). Sensitivity analyses on the basis of methodologic quality demonstrated that poor-quality studies produced a positive effect with treatment, whereas no benefit was observed with high-quality studies. CONCLUSION: The results of a meta-analysis are influenced by the quality of the primary studies included. Methodologically, poor studies tend to exaggerate the overall estimate of treatment effect and may lead to incorrect inferences.

Bias↗
PubMed2001

The cost-effectiveness of magnetic resonance imaging for investigation of the knee joint.

OBJECTIVES: This study considered the role of magnetic resonance imaging (MRI) in the diagnosis of knee injuries in a district general hospital (DGH) setting. The principal objective was to identify whether the use of MRI had a major impact on the clinical management of patients presenting with chronic knee problems, in whom surgery was being considered, whether it reduced overall costs and whether it improved patient outcome. In addition, the research: (1) explored the 'diagnostic accuracy' of initial clinical investigation of the knee by an orthopaedic trainee, consultant knee specialist and consultant radiologist; (2) considered the variability and diagnostic accuracy of interpretations of knee MRI investigations between radiologists; (3) measured the strength of preference for the potential diagnostic/therapeutic impact of knee MRI (i.e. the avoidance of surgery). METHODS - RANDOMISED CONTROLLED TRIAL: The research was based on a single-centre randomised controlled trial conducted at Kent and Canterbury Hospital. Patients attending with knee problems in whom surgery was being considered were recruited from routine orthopaedic clinics. Most patients had been referred by their general practitioner. Patients were randomised to either investigation using an MRI scan (MRI trial arm) or investigation using arthroscopy (no-MRI trial arm). The study investigated the benefits of knee MRI at two levels: diagnostic/therapeutic impact (i.e. avoidance of surgery) and patient outcome (using the Short Form with 36 items and EQ-5D quality-of-life measurement instruments). Quality of life was assessed at baseline and at 6 and 12 months. Costs were assessed from the perspectives of the NHS and patients. All analyses were by intention to treat. METHODS - SUBSTUDIES (INVESTIGATION OF DIAGNOSTIC ACCURACY): For the investigation of diagnostic accuracy of initial clinical investigation, the sample comprised 114 patients recruited in a separate study conducted at St Thomas' Hospital. The sample was drawn from patients presenting at the Accident and Emergency Department with an acute knee injury. All study patients received an MRI scan, but initial diagnosis was made without access to the scan or the radiologist's report. After 12 months, all clinical notes and MRI scans of study patients were reviewed and a final 'reference standard' diagnosis for each patient was reached. Comparison was made between the diagnosis recorded by each clinician (i.e. orthopaedic trainee, knee specialist and consultant radiologist) and the reference diagnosis. METHODS - SUBSTUDIES (INVESTIGATION OF THE GENERALISABILITY OF RESULTS): For this substudy, the MRI images from 80 patients (recruited at St Thomas' Hospital) were interpreted independently by seven consultant radiologists at DGHs and the St Thomas' Hospital MRI radiologist. For each area of the knee, the level of agreement (measured using weighted kappa) between the responses of the eight radiologists and the reference standard diagnosis was assessed. METHODS - SUBSTUDIES (INVESTIGATION OF PREFERENCES): The investigation of potential patient preferences for the diagnostic/therapeutic impact of MRI was explored using a discrete choice conjoint measurement research design. Choices involved selecting between two alternative scenarios described using four attributes, and data were collected from 585 undergraduate sports science students and analysed using a random-effects probit model. RESULTS - RANDOMISED CONTROLLED TRIAL: The trial recruited 118 patients (59 randomly allocated to each arm). The two groups were similar in important respects at baseline. The central finding was of no statistically significant differences between groups in all measures of health outcome, although a trend in favour of the no-MRI group was observed. However, the use of MRI was found to be associated with a positive diagnostic/therapeutic impact: a significantly smaller proportion of patients in the MRI group underwent surgery (MRI = 0.41, no-MRI = 0.71; p = 0.001). There was a similar mean overall NHS cost for both groups. RESULTS - SUBSTUDIES (INVESTIGATION OF DIAGNOSTIC ACCURACY): The exploration of diagnostic accuracy found that, when compared to orthopaedic trainees (44% correct diagnoses) or to radiologists reporting an MRI scan (68% correct diagnoses), the accuracy rate was higher for knee specialists (72% correct diagnoses). RESULTS - SUBSTUDIES (INVESTIGATION OF THE GENERALISABILITY OF RESULTS): This generalisability study indicated that, in general terms, radiologists in DGHs provide accurate interpretations of knee MRI images that are similar to a radiologist at a specialist centre. The one area of the knee for which this did not hold was the lateral collateral ligament. RESULTS - SUBSTUDIES (INVESTIGATION OF PREFERENCES): The central finding for this substudy was that, on average and within the range specified, choices in this group of potential patients were not significantly influenced by variation in the chance of avoiding surgery. CONCLUSIONS - IMPLICATIONS FOR HEALTHCARE: The evidence presented in this report supports the conclusions that the use of MRI in patients presenting at DGHs with chronic knee problems in whom arthroscopy was being considered did not increase NHS costs overall, was not associated with significantly worse outcomes and avoided surgery in a significant proportion of patients. CONCLUSIONS - RECOMMENDATIONS FOR FURTHER RESEARCH (IN PRIORITY ORDER): (1) The trial data demonstrated that the use of MRI in patients with chronic knee problems reduced the need for surgery. However, the link between diagnostic processes and changes in health outcome is indirect and the finding of no-MRI-related effect on health outcome may, therefore, be a consequence of the limited power of the trial. Further research to confirm (or contradict) these findings would be valuable. (2) The investigation of diagnostic accuracy involved comparison with a reference diagnosis established by a panel of two clinical members of the research team. It would be interesting to explore the extent to which the results would differ using an external panel. (3) The result from the preference study, indicating that the potential diagnostic/therapeutic impact of knee MRI was not highly valued, is a surprising finding that would be important to explore in general public or patient populations. (4) The focus for the trial-based aspects of this research was the DGH and patients presenting with chronic knee problems who were being considered for surgery. Care should be taken in generalising from these results to other patient groups (e.g. acute knee injuries) or to other settings (e.g. specialist centres). Further clinical trials would be required in order to answer such questions.

Adolescent↗
PubMedDate not supplied

"Research" and "science" in the first half of the chiropractic century.

In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Research was an ill-defined activity, and acquisition of new knowledge did not involve the experimental methodology that increasingly took hold in biology and medicine in the twentieth century. Chiropractors often viewed science and research as marketing strategies. Clinical data collection, when it occurred at all, was not described in sufficient detail to permit replication. Results were enthusiastically interpreted as indisputable proof of investigators' a priori assumptions about the effectiveness of chiropractic methods. A few in the profession recognized the general lack of understanding of the scientific method and sought reform from within. However, the colleges were unwilling to introduce coursework in research methods. At the end of World War II, the broad-scope national association of chiropractors in the United States established a nonprofit foundation for the purpose of raising funds for chiropractic research and education. Research plans were poorly conceived and grandiose: the first major initiative of the Chiropractic Research Foundation involved a nationwide publicity and fund-raising campaign modeled after the March of Dimes. When these efforts failed and the possibility of establishing free-standing research centers collapsed, the Foundation sought to shift responsibility for research to the schools. The poverty-stricken chiropractic colleges lacked the research sophistication for this task. Several more decades would pass before a sustained research effort and interest in clinical experimentation would become evident in chiropractic.

Chiropractic↗
PubMed2006

[Fraud in biomedical literature].

The basic ethical principles in science are internationally recognised in all disciplines of science. The first among these is honesty--both towards oneself and towards others. The betrayal of this principle can be seen as deviant behaviour, which may result in the most serious violation of the high ethical standards of science--scientific fraud. Fraudulent behaviour in biomedical sciences is particularly damaging, since all diagnostic and treatment decisions are based on what is published in medical literature. The betrayers of science undermine, to a great extent, the public trust in science, and may destroy the confidence scientists have in each other as well, which is a grave danger to science itself. In this article, several high profile cases of scientific fraud--involving falsification, fabrication of data, and plagiarism--are described. The damaging effect they had on both science and the scientific community led to the codification of the concept of Good Scientific Practice (GSP)--an international quality standard for designing, conducting, recording, and reporting research. The concept of GSP sets internationally valid benchmarks for quality assurance, and also provides safeguards against scientific dishonesty and fraud.

Biomedical Research↗
PubMed2006

Citation advantage of open access articles.

Open access (OA) to the research literature has the potential to accelerate recognition and dissemination of research findings, but its actual effects are controversial. This was a longitudinal bibliometric analysis of a cohort of OA and non-OA articles published between June 8, 2004, and December 20, 2004, in the same journal (PNAS: Proceedings of the National Academy of Sciences). Article characteristics were extracted, and citation data were compared between the two groups at three different points in time: at "quasi-baseline" (December 2004, 0-6 mo after publication), in April 2005 (4-10 mo after publication), and in October 2005 (10-16 mo after publication). Potentially confounding variables, including number of authors, authors' lifetime publication count and impact, submission track, country of corresponding author, funding organization, and discipline, were adjusted for in logistic and linear multiple regression models. A total of 1,492 original research articles were analyzed: 212 (14.2% of all articles) were OA articles paid by the author, and 1,280 (85.8%) were non-OA articles. In April 2005 (mean 206 d after publication), 627 (49.0%) of the non-OA articles versus 78 (36.8%) of the OA articles were not cited (relative risk = 1.3 [95% Confidence Interval: 1.1-1.6]; p = 0.001). 6 mo later (mean 288 d after publication), non-OA articles were still more likely to be uncited (non-OA: 172 [13.6%], OA: 11 [5.2%]; relative risk = 2.6 [1.4-4.7]; p < 0.001). The average number of citations of OA articles was higher compared to non-OA articles (April 2005: 1.5 [SD = 2.5] versus 1.2 [SD = 2.0]; Z = 3.123; p = 0.002; October 2005: 6.4 [SD = 10.4] versus 4.5 [SD = 4.9]; Z = 4.058; p < 0.001). In a logistic regression model, controlling for potential confounders, OA articles compared to non-OA articles remained twice as likely to be cited (odds ratio = 2.1 [1.5-2.9]) in the first 4-10 mo after publication (April 2005), with the odds ratio increasing to 2.9 (1.5-5.5) 10-16 mo after publication (October 2005). Articles published as an immediate OA article on the journal site have higher impact than self-archived or otherwise openly accessible OA articles. We found strong evidence that, even in a journal that is widely available in research libraries, OA articles are more immediately recognized and cited by peers than non-OA articles published in the same journal. OA is likely to benefit science by accelerating dissemination and uptake of research findings.

Bibliometrics↗
PubMed1973

CAN-SDI: experience with multi-source computer based current awareness services in the National Science Library, Ottawa.

CAN/SDI is Canada's national Selective Dissemination of Information Service offering a choice of nine data bases to its scientific and technical community. The system is based on central processing at the National Science Library combined with the utilization of decentralized expertise and resources for profile formulation and user education. Its greatest strength lies in its wide interdisciplinary quality. The major advantage of centralized processing of many data bases is that Canadians need learn only one method of profile formulation to access many files. A breakdown of services used confirms that a single tape service does not cover all the information requirements of most users. On the average each profile accesses approximately 1.5 data bases. Constant subscriber growth and a low cancellation rate indicate that CAN/SDI is and will continue to be an important element in Canada's information system.

Canada↗
PubMed2003

An XML message broker framework for exchange and integration of microarray data.

MOTIVATION: Microarrays are an important research tool for the advancement of basic biological sciences. However this technology has yet to be integrated with clinical decision making. We have implemented an information framework based on the Microarray Gene Expression Markup Language (MAGE-ML) specification. We are using this framework to develop a test-bed integrated database application to identify genomic and imaging markers for diagnosis of breast cancer. RESULTS: We developed extensible software architecture for retrieving data from different microarray databases using MAGE-ML and for combining microarray data with breast cancer image analysis and clinical data for correlation studies. The framework we developed will provide the necessary data integration to move microarray research from basic biological sciences to clinical applications. AVAILABILITY: Open source software will be available from SourceForge (http://sourceforge.net/projects/microsoap/).

Database Management Systems↗
PubMed1994

Ethics in scientific communication: study of a problem case.

The hypothermia experiments performed on humans during the Second World War at the German concentration camp in Dachau have been regarded as crimes against humanity, disguised as medical research. For almost 50 years, scientists maintained that the study produced valuable, even if not totally reliable, information. In recent years, the results from the Dachau hypothermia project were glamorized with life-saving potential and a heated ethical dialogue was activated about the use of life-saving but tainted scientific information. In the wake of the debate, an in-depth examination of the scientific rigour of the project was performed and revealed that neither the science nor the scientists from Dachau could be trusted and that the data were worthless. The body of medical opinion accepted the unfavourable determination but a few scientists and ethicists have continued to endorse the validity, of at least parts, of the Dachau hypothermia data. The conduct of the scientific communications about the Dachau hypothermia experiments by the scientific and ethical communities invites serious consideration of a possible ethical misadventure. It appears that for almost 50 years, the results of the study had been endorsed without careful examination of the scientific base of the experiments and that secondary citation of relevant original material may have been commonly employed. These infractions contributed to a myth that good science was practised by the Nazis at Dachau. The more recent emphasis on the life-saving potential of the Dachau data, without citation of credible supporting evidence, has also been misleading. Similarly, acceptance of a determination by an in-depth examination that the 'whole' Dachau project if flawed with simultaneous endorsement of the validity of 'parts' of the results, poses an ethical problem. It is advisable that before seeking ethical consultation about the use of unethically obtained data, scientists should examine the quality of science behind the controversial information and ethicists should verify the integrity of the material prior to engaging in a dialogue.

Biomedical Research↗
PubMed1986

Census data quality--a user's view.

"This paper presents the perspective of a major user of both decennial and economic [U.S.] census data. It illustrates how these data are used as a framework for commercial marketing research surveys that measure television audiences and sales of consumer goods through retail stores, drawing on Nielsen's own experience in data collection and evaluation. It reviews Nielsen's analyses of census data quality based, in part, on actual field evaluation of census results. Finally, it suggests ways that data quality might be evaluated and improved to enhance the usefulness of these census programs."

Americas↗
PubMed2005

Infection transmission science and models.

Infection transmission systems circulate infection through complex contact patterns related to both contact patterns and patterns of factors that affect the risk of transmission given contact. The nonlinear dynamics of infection transmission cause these patterns to make big differences in population infection levels. A science of infection transmission system analysis is needed to focus on those details that affect the control of infection transmission. This science must have a strong theoretical base because there is little chance that a dominantly data based approach not using mechanistic models of transmission will have any predictive value. The theoretical base should be built on linked transmission system models that are focused on making needed inferences for both building the theoretical base and making infection control decisions. The linking of different models is needed for a strategy of inference robustness assessment that is designed to find the model that is simple enough to effectively analyze the transmission system but not so simple that realistic violation of simplifying assumptions will change an inference. Types of models that should be used in such linked analyses include deterministic and stochastic compartmental models, discrete individual models with individual event histories but structured mass action mixing, network models that provide more detail as to who has contact with whom, and intermediate model forms such as correlation models that address some aspects of contact details while preserving the flexibility of deterministic compartmental models to structure mixing and analyze the system. While transmission system science is currently weak in regards both to its data base and its theory base, many things are now coming together that could make this science flourish. On the data side these include greater ability to detect infectious agent sequences in the environment and greater ability to sequence and genetically relate agents identified at different sites in the transmission system. On the theory sides, new model construction and model analysis methods are providing new potential to use the new sources of data. Also new parameter estimation methods provide new potential to combine models and data in effective analytic strategies.

Communicable Diseases↗
PubMed2007

Making sense of data: How public health graduate students build theory through qualitative research techniques.

Data interpretation and theory building are two key skills often taught in health sciences qualitative methods courses. However, little is known about how novice researchers make sense of data, as well as how their thought processes differ from those of expert researchers. In this classroom research project, the author explores how qualitative methods students in a public health graduate program describe their processes of making sense of data and building theory. She then compares these processes with "expert" guidelines to draw implications for how to enhance teaching in a qualitative research class.

Data Interpretation, Statistical↗
PubMed1980

[Avicenna on the musculoskeletal system].

A great scientist encyclopaedist of the Middle ages Abu Ali Ibn Sina (Avicenna) in his brillant work "Cannon of medical science" systematized and interpreted the achievments of medical sciences, made his contribution into medical theory and practice. If we take together all the data on bones and muscles presented by him in his "Cannon of medical science" and arrange them in the sequence they are given in the body, a graceful systematized table of scientific knowlege on bones and muscles--a prototype of future osteology and myology will be obtained. In the "Canon of medical science" sources of the functional trend in morphology are layed: structure of the osseous and muscular systems is closely connected with the practical medicine. In his work Ibn Sina gives a correct and precise description of anatomical structure of the osseous system and bone functions, and the muscular system, in particular. A thorough study of the "Canon of medical science" clearly demonstrates that Ibn Sina made a great contribution, for his time, into the development of anatomy, not only successfully followed his predecessors, but greatly extended their scientific researches and corrected their errors.

Anatomy↗
PubMed2006

Nursing students' knowledge and attitudes regarding pain.

The presence of pain is one of the main reasons why people seek health care, yet pain is often undertreated. Inadequate treatment has been linked to health care workers' failure to assess pain and to intervene appropriately. It may also result from the limited attention given to pain management in nursing curricula. This descriptive study explored nursing students' knowledge and attitudes about pain management. The Nurses' Knowledge and Attitude Survey Regarding Pain was used to collect data from clinical nursing students. The sample (n = 313) was obtained from approximately one fourth of the baccalaureate of science in nursing and associate degree in nursing programs in Louisiana. Data analysis revealed misconceptions about analgesic administration and duration, along with an exaggerated fear about the incidence of addiction among patients. Knowledge of pharmacology items was lower than that of nonpharmacology items. When faced with a clinical scenario that required an initial assessment of a patient's pain, most students responded appropriately. However, when the situation required reassessment based on the patient's response to the student's chosen intervention, a majority of them responded incorrectly. Overall, students in the baccalaureate degree programs scored significantly higher (65% correct) than students in the associate degree in nursing programs (60.8% correct) (t [311] = -3.321, p = .001). However, the combined mean score for both groups was 64%, indicating inadequate knowledge of pain management. Despite major initiatives by accrediting agencies, statewide Pain Initiatives, and professional organizations, knowledge of pain management is still inadequate. Nursing faculty need to critically review their curricula to determine whether students are being taught in-depth and up-to-date pain management information that incorporates evidence-based research and current standards of care.

Accreditation↗
PubMed2006

Insights into the management of emerging infections: regulating variant Creutzfeldt-Jakob disease transfusion risk in the UK and the US.

BACKGROUND: Variant Creutzfeldt-Jakob disease (vCJD) is a human prion disease caused by infection with the agent of bovine spongiform encephalopathy. After the recognition of vCJD in the UK in 1996, many nations implemented policies intended to reduce the hypothetical risk of transfusion transmission of vCJD. This was despite the fact that no cases of transfusion transmission had yet been identified. In December 2003, however, the first case of vCJD in a recipient of blood from a vCJD-infected donor was announced. The aim of this study is to ascertain and compare the factors that influenced the motivation for and the design of regulations to prevent transfusion transmission of vCJD in the UK and US prior to the recognition of this case. METHODS AND FINDINGS: A document search was conducted to identify US and UK governmental policy statements and guidance, transcripts (or minutes when transcripts were not available) of scientific advisory committee meetings, research articles, and editorials published in medical and scientific journals on the topic of vCJD and blood transfusion transmission between March 1996 and December 2003. In addition, 40 interviews were conducted with individuals familiar with the decision-making process and/or the science involved. All documents and transcripts were coded and analyzed according to the methods and principles of grounded theory. Data showed that while resulting policies were based on the available science, social and historical factors played a major role in the motivation for and the design of regulations to protect against transfusion transmission of vCJD. First, recent experience with and collective guilt resulting from the transfusion-transmitted epidemics of HIV/AIDS in both countries served as a major, historically specific impetus for such policies. This history was brought to bear both by hemophilia activists and those charged with regulating blood products in the US and UK. Second, local specificities, such as the recall of blood products for possible vCJD contamination in the UK, contributed to a greater sense of urgency and a speedier implementation of regulations in that country. Third, while the results of scientific studies played a prominent role in the construction of regulations in both nations, this role was shaped by existing social and professional networks. In the UK, early focus on a European study implicating B-lymphocytes as the carrier of prion infectivity in blood led to the introduction of a policy that requires universal leukoreduction of blood components. In the US, early focus on an American study highlighting the ability of plasma to serve as a reservoir of prion infectivity led the FDA and its advisory panel to eschew similar measures. CONCLUSIONS: The results of this study yield three important theoretical insights that pertain to the global management of emerging infectious diseases. First, because the perception and management of disease may be shaped by previous experience with disease, especially catastrophic experience, there is always the possibility for over-management of some possible routes of transmission and relative neglect of others. Second, local specificities within a given nation may influence the temporality of decision making, which in turn may influence the choice of disease management policies. Third, a preference for science-based risk management among nations will not necessarily lead to homogeneous policies. This is because the exposure to and interpretation of scientific results depends on the existing social and professional networks within a given nation. Together, these theoretical insights provide a framework for analyzing and anticipating potential conflicts in the international management of emerging infectious diseases. In addition, this study illustrates the utility of qualitative methods in investigating research questions that are difficult to assess through quantitative means.

Creutzfeldt-Jakob Syndrome↗
PubMed2006

The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG: a meta-analysis.

PURPOSE: Coronary artery bypass graft surgery (CABG) is associated with cardiac complications, including ischemia, acute myocardial infarction (AMI), and death. Volatile anesthetics have been shown to have a preconditioning-like effect. This systematic review assesses the effects of volatile anesthetics on cardiac ischemic complications and morbidity after CABG. METHODS: Data were obtained, without language restriction, from searches of MEDLINE, Science Citation Index, PubMed, and reference lists. We included only prospective randomized controlled trials evaluating volatile anesthetics during CABG. Two reviewers independently abstracted data on myocardial ischemia, acute myocardial infarction (AMI), and death. Treatment effects were calculated as odds ratio (OR) with 95% confidence intervals (CI) for binary data, and weighted mean difference (WMD) with 95% CI for continuous data. PRINCIPAL FINDINGS: Thirty-two studies (2,841 patients) were included. In comparison with iv anesthesia, volatile anesthetics were associated with reduced all-cause mortality (OR, 0.65; 95% CI, 0.36-1.18; P = 0.16). Enflurane was associated with increased AMI (OR, 1.34; 95% CI, 0.68-2.64; P = 0.40), whereas sevoflurane and desflurane reduced cardiac troponin I (cTnI) at six hours, 12 hr, 24 hr [WMD, -1.45; 95% CI (-1.73, -1.16); P < 0.00001], and 48 hr after operation. CONCLUSION: This meta-analysis demonstrates sevoflurane and desflurane reduce the postoperative rise in cTnI. Sevoflurane-mediated reduction in cardiac troponin was associated with improved long-term outcomes in one study. This meta-analysis was not able to show that these positive effects on troponin were translated into improved clinical outcomes. Well-designed large randomized control trials are needed to further elucidate the differential cardio-protective effects of volatile anesthetics.

Anesthetics, Inhalation↗
PubMed1991

Should level of measurement considerations affect the choice of statistic?

The belief that the level of measurement (nominal, ordinal, interval, ratio) achieved in the data constrains the type of statistic that may be used legitimately for analysis is examined in general, and in an optometric-vision science context. Theoretical considerations indicate that statistical statements about the data may be made independently of the level of measurement, and that although researchers must be concerned about the quality of their measurement, the role of measurement theory is in the interpretation of the meaning of the investigation's results as a whole not in the governance of the choice of statistic. Empirical studies indicate that measurement considerations can be ignored for the purposes of testing the null hypothesis with little or no resultant error. Finally, adherence to the belief that level of measurement considerations limits statistical choice would result in the use of generally less powerful statistical tests--an undesirable and, all things considered, an unwarranted consequence.

Optics and Photonics↗