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11.
Inter-study differences: How should they influence the interpretation and analysis of results? 总被引:2,自引:0,他引:2
K R Bailey 《Statistics in medicine》1987,6(3):351-360
In determining the role inter-study variation should play in an overview analysis, it is important to consider three factors: which question one is trying to answer; the degree of similarity or dissimilarity of design, and the degree to which heterogeneity of outcomes can be explained. Three questions one might be interested in are: whether treatment can be effective in some circumstances; whether treatment is effective on average, and whether treatment was effective on average in the trials at hand. Under the assumption of no qualitative interaction, the answers to these questions coincide. The O-E analysis most directly answers the third question. Other analyses are suggested when the first question is of interest, using the aspirin post-MI studies as an example. 相似文献
12.
Spatial patterns of use of health services in the Kingston metropolitan area, Jamaica 总被引:4,自引:0,他引:4
This study focuses on the influence of distance, transport and accessibility on the use of health services in Kingston, Jamaica. It reviews various factors affecting the use of health care with particular reference to Third World cities and presents results from a case study of utilization in the Kingston Metropolitan Area. Three pairs of sites of contrasting social status were selected and 50 respondents questioned in each about spatial patterns of primary health care (PHC) attendance. Types of facility attended, mode of transport, travel times, distance and frequency of utilization were discussed. Some distinctive differences appeared between low and high status site respondents with regard to distances to facilities and travel times, which were almost always higher for the low status respondents. Most respondents were not using their nearest facilities, for varying reasons which included, for poorer respondents, need to attend frequently distant public facilities and, for wealthier respondents, loyalty to old family doctors and use of company-related doctors. The mobility of the higher status respondents afforded them considerable choice of locations used for health care and their attendance was much more convenient than that of lower status respondents. Utilization rates were somewhat higher in the high status sites although not to the extent found by some earlier studies in similar settings. 相似文献
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15.
H. -J. Möller H. M. van Praag B. Aufdembrinke P. Bailey T. R. E. Barnes J. Beck H. Bentsen F. X. Eich L. Farrow W. W. Fleischhacker J. Gerlach K. Grafford B. Hentschel A. Hertkorn S. Heylen Y. Lecrubier J. P. Leonard P. McKenna W. Maier V. Pedersen A. Rappard W. Rein J. Ryan M. Sloth Nielsen R. -D. Stieglitz G. Wegener J. Wilson 《Psychopharmacology》1994,115(1-2):221-228
There is little agreement about the methodology of clinical trials of antipsychotic drugs in patients with negative symptoms. A literature review revealed wide variation in experimental design, rating scales and study duration. This reflects differing views as to the definition and response to treatment of negative symptoms. Some degree of standardization would improve comparability of studies and aid the development of new compounds. Patients included in such studies should have displayed negative symptoms for at least 6 months. Depressive symptoms, positive schizophrenic symptoms and extrapyramidal signs may all influence or be confused with negative symptoms and may respond to treatment; they should be at a low level at baseline and should be measured during the study period. Studies should last at least 8 weeks. Several scales are available for measuring negative symptoms and are reviewed; a global impression score should be used additionally. 相似文献
16.
Expression of gelatinases within the trabecular bone compartment of ovariectomized and parathyroidectomized adult female rats 总被引:4,自引:0,他引:4
Ovariectomized (ovx) and parathyroidectomized (ptx) rat models of disturbed bone metabolism have been widely used in evaluating bone changes resulting from hormonal depletion, and are characterized by elevated and depressed bone turnover, respectively. We report here the expression of gelatinases extracted from native trabecular bone in these models. Nine-month-old female Sprague-Dawley rats were sacrificed after 3 weeks following ovx or 10 days post ptx to determine the influence of these procedures on the levels of proximal tibial bone tissue gelatinases. Identification and quantitation of these enzymes were performed via gelatin gel zymography of native tissue extracts and laser densitometry of developed gels, respectively. In the ptx model, a reduction in tissue levels of pro- and active-MMP-2 and 45 kDa activated fragment was seen, whereas ovx exhibited significant increases in these enzymes. The MMPs are therefore clearly under the influence of factors known to modulate bone remodeling in vivo. The study of MMP levels directly extracted from bone using these experimental models may assist in developing management regimes for metabolic bone diseases through the use of drugs aimed at controlling turnover. 相似文献
17.
AHT Pang MRCPsych KYC Lai MRCPsych V Bailey DPM FRCPsych 《International journal of clinical practice》1997,51(6):412-413
An adolescent with a history of attempted suicide who refused to involve his father in the treatment plan is presented. Issues surrounding consent to psychiatric treatment in childhood are discussed and the assessment process outlined. Contributions by primary healthcare professionals are emphasised. 相似文献
18.
Sixty consecutive pregnant women with asymptomatic (covert) bacteriuria detected between 16 and 30 weeks gestation were randomly allocated to treatment with either a single 600 mg dose or a standard five-day course of trimethoprim. Twenty-seven of 30 women were cured with a single dose. Six of these 27 women were reinfected later in the pregnancy. Twenty-four of 30 women treated with a five-day course of trimethoprim were cured, and five became reinfected later in the pregnancy. One women vomited the single dose. There were no detrimental effects on the outcome of the pregnancies. Single dose therapy should be considered as the treatment of choice for asymptomatic bacteriuria in pregnancy. 相似文献
19.
Margaret Hogg Maxine Braithwaite Michael Bailey Tom Kotsimbos John W Wilson 《Journal of cystic fibrosis》2007,6(3):223-227
With increasing numbers of cystic fibrosis (CF) patients surviving to adulthood, issues related to vocation inevitably arise and warrant specific attention. We examined the percentage of participants with CF currently working and explored risk factors for work disability among adults with CF. METHOD: We recruited 50 consecutive patients from an adult cystic fibrosis service. Demographic, employment history, illness severity indicators and CF-attributed work disability factors were evaluated. Demographic risk factors for work disability using the illness severity measures of FEV(1), S-K score, CRDQ, and recent hospitalisation as independent variables were determined. RESULTS: Factorial analysis of a disability index (DI) indicated no dependency on FEV(1) or S-K score, but dependency on quality of life indices (p<0.05), age (p<0.05) and hospital admission rate (p<0.05). Hours worked per week were dependent on quality of life (p<0.01) (mastery of disease domain), fewer hospital admissions (p<0.01) and age (p<0.05). Sixty-eight percent of the sample reported that CF resulted in significant impediments to employment. However, few had sought vocational guidance (6%). CONCLUSION: Determinants of workforce participation shows that hours worked and perceived disability are more dependent on mastery of disease, age, and time in hospital, than on clinical severity scores. Health professionals may assist productivity through career counselling or tailored programs. 相似文献
20.
J S Fleming A H Hashish J H Conway M A Nassim S T Holgate P Halson E Moore A G Bailey T B Martonen 《Journal of aerosol medicine》1996,9(3):317-327
Multimodality medical imaging enables measurement of the three-dimensional spatial distribution of a radiolabeled aerosol within the lung. Using a conceptual spatial morphological model these data may be transformed to provide information on deposition per airway generation. This methodology has been used to study the intrapulmonary deposition patterns of two formulations of a metered dose inhaler and two nebulizers in control subjects. The nebulizer study has also been stimulated using a computer model of deposition. The comparison between derived experimental results and those from computer modeling shows areas of agreement, although there are also areas of discrepancy. The new methodology has considerable potential value in the fields of inhalation therapy and deposition modeling, although more detailed validation is still required. 相似文献