Meta-analysis of method comparison studies

Methods for the meta-analysis of results from randomized controlled trials are well established. However, there are currently no methods for the meta-analysis of method comparison studies. Here the combination of results from studies comparing two methods of measurement on the same unit of observation is required. We compare standard methods for the pooling of k samples from the same Normal population to those for pooling parameter estimates, in order to estimate the pooled mean difference and 95 per cent limits of agreement. Methods for investigating heterogeneity across studies and for calculating random effects estimates are proposed. We postulate that for published studies either the estimated mean or variance of the difference between measurements will tend to be smaller than for unpublished studies and investigate the evidence for the existence of such publication bias. The methods are illustrated with an example evaluating the accuracy of temperature measured at the axilla compared to the rectum in children.     

中药复方制剂工艺中澄清技术对有效成分影响探讨

从４个方面对中药复方制剂工艺中澄清技术对有效成分的影响进行了探讨。即水提醇沉法使用已久,虽然使单服剂量缩小,但对有效成分的损失较大,使原方的治疗效果明显降低;高速离心法、超滤法、１０１果汁澄清法等是近几年报道较多,应用效果较好的方法,各有特点,既能单独,也可结合应用,能保证复方中主要有效成分不受损失,是值得推广和需要进一步探讨的方法。     

6种沙丁胺醇气雾剂的质量比较

 目的:对国内市场上6种沙丁胺醇气雾剂的每喷药量和粒径分布特征进行比较?方法:按照英国药典,采用手动喷射和二室碰撞取样器,利用HPLC进行测定,并分别计算标示喷数前、中、后10喷的平均每喷药量和零、一、二级沉积百分数?结果:6种产品的每喷药量均能控制在药典规定范围内,但粒径分布差异较大:两种溶液型产品的可呼吸分数均低于10%;混悬型产品中,F的第二级沉积量较低(21.72%),A产品与D,E产品接近(均高于35%),其中A略优?结论:国产沙丁胺醇气雾剂的粒径分布与合资药厂相比仍存在较大的差距,需要对制剂工艺进行改进?由于不同品牌间质量的可能差异,临床医生在进行用药替换时,需要考虑不同厂牌药物的生物等效性问题?     

体脂分布与高血压关系的生态比较研究

目的 ]研究体脂分布与高血压的关系。 [方法 ]以≥ 15岁的城市居民为研究对象 ,以锥削度指数 (CI)为指标 ,进行生态比较研究。 [结果 ]高血压患病率高的人群 ,其CI阳性率也高 ;高血压患病率低的人群 ,其CI阳性率也低。无论在男性人群还是女性人群 ,均显示出同样的规律。 [结论 ]体脂集中腹部分布 ,可能易患高血压     

Quality of life assessment in a cross-cultural context: Use of the Rotterdam Symptom Checklist in a multinational randomised trial comparing CMF and Zoladex (Goserlin) treatment in early breast cancer

Aim: The aim of the study is to investigate quality of life (QoL) in the context of a multinational trial. The questions addressed are: is the Rotterdam Symptom Checklist (RSCL) 1) feasible and 2) reliable in cross cultural reearch, 3) is earlier validation confirmed in a multinational trial and 4) are there systematic differences in QoL accross cultures?Patients and methods: Patients with histologically confirmed stage II, node positive breast cancer, were randomised in a multinational trial (the ZEBRA-study) comparing standard chemotherapy (CMF) or temporary ovarian ablation by treatment with a LHRH analogue (Zoladex, Goserlin). Patients originating from 13 countries completed a QoL questionnaire at baseline and three months after the start of treatment.Results: 1) The questionnaire was completed by 689 patients at the first and 544 at the second measurement (response 78% and 68% respectively). The proportion of missing data was <2.5% for 87.8% and 92.7% of the items at the respective time points. 2) Reliabilities of the physical and psychological distress scale were ranging from 0.68 to 0.90 across cultures. Reliability of the activity scale ranged from 0.42 to 0.89. 3) The structure at baseline was in agreement with the two factor structure proposed earlier. 4) Cross-cultural comparison indicated a systematic difference in QoL across cultures (P = 0.0028–<0.0001) as well as a difference in change across cul-tures.Conclusions: QoL assessment using the RSCL proved feasible in the context of multinational clinical trials. Psychometric qualities were satisfactory. Systematic differences in QoL were found between cultures. This finding implies that in multinational clinical trials, treatment comparisons with respect to QoL should carefully account for a differential impact of cultures on the results.     

A study of factors facilitating and inhibiting the willingness of the institutionalized disabled elderly for rehabilitation: A United States–Japanese comparison

The high prevalence of 'bedridden elderly' in Japan is at least three times higher than that of any other industrialized country. To decrease likelihood of being bedridden, it is important to cultivate and maintain the willingness of older disabled patients for rehabilitation, and to preserve functioning in activities of daily living (ADL). The purpose of this study was to identify the factors facilitating and inhibiting the willingness of institutionalized disabled older adults for rehabilitation with respect to physical, goal-attainment, psychological and cultural aspects. The convenience sample consisted of 71 disabled older adults (45 in Japan and 26 in the USA). 46 subjects (64.8%) were identified as 'willing for rehabilitation', whereas 25 (35.2%) were 'unwilling for rehabilitation'. The data were gathered using structured interviews to subjects and administering questionnaires to the nurses. The data were compared between the 'willing' and the 'unwilling', and between those from Japan and from the USA by cross-tabular and correlational analyses. The major findings in this study were as follows: (1) Factors found to facilitate willingness of older persons for rehabilitation included: high independence level in ADL, generalized endurance/stamina, lack of pain, mutual goal agreement between old people and care staff, and no presence of regressive behavior. (2) Factors found to inhibit willingness of older persons for rehabilitation included: lower independence in ADL, presence of pain, generalized little stamina, depression, presence of regressive behavior, and dementia, and expectation of another person's help all the time. Healthcare workers need to be aware of patients who are subject to factors inhibiting willingness, and to promote factors facilitating willingness, in order to prevent the elderly with disabilities from becoming bedridden. In addition, the implications of this study are for a multidimensional functional assessment to be part of the rehabilitation intake in order to better understand each individual and motivate his/her optimum level of functional ability.     

应用湿润烧伤膏治疗面部Ⅱ度烧伤的疗效观察

目的探索面部Ⅱ度烧伤的最佳疗法.方法对我院1998年1月至2004年5月收治的烧伤患者中随机抽取了143例烧伤患者进行调查分析.对目前常用的湿润烧伤膏(MEBO)治疗(M组)和磺胺嘧啶银(SD-Ag)干燥暴露治疗(S组)、0.5%碘伏(PVP-I)半暴露治疗(I组)进行对比分析.结果 M组平均创面愈合时间15.3 d,色素改变10/51,瘢痕形成3/51,创面感染2/51.均低于S组和 I组.结论 MEBO对面部Ⅱ度烧伤的治疗优于SD-Ag干燥暴露和0.5% PVP-I半暴露疗法.     

糖蛋白药物的研究进展

糖蛋白是生命活动的重要物质,细胞的识别及体内功能多为糖蛋白介导.其独特免疫原性使其在抗肿瘤、抗艾滋病等方面具显著效果.近年来,国外在海洋生物糖蛋白生物活性以及糖蛋白疫苗的研究方面已取得很大进展.就糖蛋白结构、功能及分离分析技术以及近年来国内外在糖蛋白结合疫苗方面的研究进展进行综述.     

The Stress of Being Chronically Ill: From Disease-Specific to Task-Specific Aspects

The assumption that disease-related stressors are exclusive for particular diagnoses characterizes many studies of chronically ill patients. In this study the perceptions of 1305 patients from 10 different chronic disease categories were compared with respect to a number of important stressors. Differences were found in the amount and type of stressors experienced, but these differences could not solely be explained by type of disease. Personal characteristics such as age, sex, education level, living situation, and illness duration were also important in determining the degree and type of stress experienced. The implications of these findings for stress/coping research as well as the clinical implications are discussed.