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101.
102.
Henrica C. W. de Vet Raymond W. J. G. Ostelo Caroline B. Terwee Nicole van der Roer Dirk L. Knol Heleen Beckerman Maarten Boers Lex M. Bouter 《Quality of life research》2007,16(1):131-142
Background: Minimally important changes (MIC) in scores help interpret results from health status instruments. Various distribution-based
and anchor-based approaches have been proposed to assess MIC.
Objectives: To describe and apply a visual method, called the anchor-based MIC distribution method, which integrates both approaches.
Method: Using an anchor, patients are categorized as persons with an important improvement, an important deterioration, or without
important change. For these three groups the distribution of the change scores on the health status instrument are depicted
in a graph. We present two cut-off points for an MIC: the ROC cut-off point and the 95% limit cut-off point.
Results: We illustrate our anchor-based MIC distribution method determining the MIC for the Pain Intensity Numerical Rating Scale in patients with low back pain, using two conceivable
definitions of minimal important change on the anchor. The graph shows the distribution of the scores of the health status instrument for the relevant categories
on the anchor, and also the consequences of choosing the ROC cut-off point or the 95% limit cut-off point.
Discussion: The anchor-based MIC distribution method provides a general framework, applicable to all kind of anchors. This method forces researchers to choose and justify
their choice of an appropriate anchor and to define minimal importance on that anchor. The MIC is not an invariable characteristic of a measurement instrument, but may depend, among other things,
on the perspective from which minimal importance is considered and the baseline values on the measurement instrument under study. A balance needs to be struck between the
practicality of a single MIC value and the validity of a range of MIC values. 相似文献
103.
104.
1 病例报告 男,7岁.因双下肢不等长,右膝及右踝关节骨性肿大就诊.无明显外伤史,亦无红、肿、热、痛病史.查体:发育正常,营养良好.双下肢不等长,左60cm,右64cm,有跛行.右膝及右踝内侧肿大,肤色正常,关节活动无异常.X线:右侧半身诸关节(肩、肘、腕、髋、膝、踝)骨骺及干骺发育均较左侧增大,肢体较长,骨骺出现亦较对侧提早.如右尺骨茎突骨骺较左侧提早出现(图1).右肘关节肱骨小头骨骺较左侧增大(图2).右髋臼发育浅平,边缘毛糙,右股骨头骨骺较左侧明显增大,其距泪滴之距离较左侧大1.0cm,呈… 相似文献
105.
Li Qin Mirjam J. Knol Eva Corpeleijn Ronald P. Stolk 《European journal of epidemiology》2010,25(1):5-12
Obesity and physical inactivity are both risk factors for type 2 diabetes. Since they are strongly associated, it has been
suggested that they might interact. In this study, we summarized the evidence on this interaction by conducting a systematic
review. Two types of interaction have been discerned, statistical and biological interaction, which could give different results.
Therefore, we calculated both types of interaction for the studies in our review. Cohort studies, published between 1999 and
2008, that investigated the effects of obesity and physical activity on the risk of type 2 diabetes were included. We calculated
both biological and statistical interaction in these studies. Eight studies were included of which five were suitable to calculate
interaction. All studies showed positive biological interaction, meaning that the joint effect was more than the sum of the
individual effects. However, there was inconsistent statistical interaction; in some studies the joint effect was more than
the product of the individual effects, in other studies it was less. The results show that obesity and physical inactivity
interact on an additive scale. This means that prevention of either obesity or physical inactivity, not only reduces the risk
of diabetes by taking away the independent effect of this factor, but also by preventing the cases that were caused by the
interaction between both factors. Furthermore, this review clearly showed that results can differ depending on what method
is used to assess interaction. 相似文献
106.
107.
108.
A 10-year-old girl with cervical tuberculosis was treated with Isoniazid, Rimfampicin and Ethambutol. After 2 weeks of treatment a hepatotoxic reaction developed. Withdrawal of therapy resulted in complete clinical improvement and in normalization of all laboratory measurements. Treatment was restarted with Rifampicin, Pyrazinamid and Ethambutol. Liver enzyme levels were monitored weekly. Seven weeks after this three-drug regiment was started, all therapy was discontinued because of elevated liver enzyme levels. However, the patient died 2 weeks later of progressive fulminant hepatitis.Abbreviations TBC
tuberculosis
- INH
isoniazid
- RIF
Rifampicin
- EMB
Ethambutol
- GOT
glutamic oxaloacetic transaminase
- GPT
gammaglutamyl transpeptidase 相似文献
109.
Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial
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Nicole van der Roer Maurits van Tulder Johanna Barendse Dirk Knol Willem van Mechelen Henrica de Vet 《European spine journal》2008,17(9):1193-1200
Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study. In the intensive group training protocol exercise therapy, back school and operant-conditioning behavioural principles are combined. Patients were treated during 10 individual sessions along 20 group sessions. Usual care consisted of physiotherapy according to the Dutch guidelines for Low Back Pain. Main outcome measures were functional disability (Roland Morris disability questionnaire), pain intensity, perceived recovery and sick leave because of low back pain assessed at baseline and after 6, 13, 26 and 52 weeks. Both an intention-to-treat analysis and a per-protocol analysis were performed. Multilevel analysis did not show significant differences between both treatment groups on any outcome measures during the complete follow-up period, with one exception. After 26 weeks the protocol group showed more reduction in pain intensity than the guideline group, but this difference was absent after 52 weeks. We finally conclude that an intensive group training protocol was not more effective than usual physiotherapy for chronic low back pain. 相似文献
110.
Gabriella M van Dijk Cindy Veenhof Francois Schellevis Harry Hulsmans Jan PJ Bakker Henk Arwert Jos HM Dekker Guus J Lankhorst Joost Dekker 《BMC musculoskeletal disorders》2008,9(1):95