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No / Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema. This review analyses the evidence for the effectiveness of IPC as a treatment for venous leg ulcers. OBJECTIVES: To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (December 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007; Ovid MEDLINE - 2006 to November Week 2 2007; Ovid EMBASE - 2006 to 2007 Week 49 and Ovid CINAHL - 2006 to December Week 1 2007. SELECTION CRITERIA: Randomised controlled studies either comparing IPC with control (sham IPC or no IPC) or comparisons between IPC treatment regimens, in venous ulcer management were included. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of study quality were undertaken by one author and checked by a second. MAIN RESULTS: Seven randomised controlled trials (including 367 people in total) were identified. Only one trial reported both allocation concealment and blinded outcome assessment. In one trial (80 people) more ulcers healed with IPC than with dressings (62% vs 28%; p=0.002). Four trials compared IPC with compression against compression alone. The first of these trials (45 people) found increased ulcer healing with IPC plus compression than with compression alone (relative risk for healing 11.4, 95% Confidence Interval 1.6 to 82). The remaining three trials (122 people) found no evidence of a benefit for IPC plus compression compared with compression alone. One small trial (16 people) found no difference between IPC (without additional compression) and compression bandages alone. One trial compared different ways of delivering IPC (104 people) and found that rapid IPC healed more ulcers than slow IPC (86% vs 61%; log rank p=0.003). AUTHORS' CONCLUSIONS: IPC may increase healing compared with no compression, but it is not clear whether it increases healing when added to treatment with bandages, or if it can be used instead of compression bandages. Rapid IPC was better than slow IPC in one trial. Further trials are required to determine whether IPC increases the healing of venous leg ulcers when used in modern practice where compression therapy is widely used.

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 118-128.

Source: Masters Abstracts International, Volume: 47-06, page: 3551. Advisers: Florence J. Dallo; Raul Caetano. Includes bibliographical references.

No / There is a substantial body of evidence that prescribing for care home residents is suboptimal and requires improvement. Consequently, there is a need to identify effective interventions to optimise prescribing and resident outcomes in this context. OBJECTIVES: The objective of the review was to determine the effect of interventions to optimise prescribing for older people living in care homes. SEARCH METHODS: We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library (Issue 11, 2012); Cochrane Database of Systematic Reviews, The Cochrane Library (Issue 11, 2012); MEDLINE OvidSP (1980 on); EMBASE, OvidSP (1980 on); Ageline, EBSCO (1966 on); CINAHL, EBSCO (1980 on); International Pharmaceutical Abstracts, OvidSP (1980 on); PsycINFO, OvidSP (1980 on); conference proceedings in Web of Science, Conference Proceedings Citation Index - SSH & Science, ISI Web of Knowledge (1990 on); grey literature sources and trial registries; and contacted authors of relevant studies. We also reviewed the references lists of included studies and related reviews (search period November 2012). We included randomised controlled trials evaluating interventions aimed at optimising prescribing for older people (aged 65 years or older) living in institutionalised care facilities. Studies were included if they measured one or more of the following primary outcomes, adverse drug events; hospital admissions;mortality; or secondary outcomes, quality of life (using validated instrument); medication-related problems; medication appropriateness (using validated instrument); medicine costs. Two authors independently screened titles and abstracts, assessed studies for eligibility, assessed risk of bias and extracted data. A narrative summary of results was presented. The eight included studies involved 7653 residents in 262 (range 1 to 85) care homes in six countries. Six studies were cluster-randomised controlled trials and two studies were patient-randomised controlled trials. The interventions evaluated were diverse and often multifaceted. Medication review was a component of seven studies, three studies involved multidisciplinary case-conferencing, two studies involved an educational element for care home staff and one study evaluated the use of clinical decision support technology. Due to heterogeneity, results were not combined in a meta-analysis. There was no evidence of an effect of the interventions on any of the primary outcomes of the review (adverse drug events, hospital admissions and mortality). No studies measured quality of life. There was evidence that the interventions led to the identification and resolution of medication-related problems. There was evidence from two studies that medication appropriateness was improved. The evidence for an effect on medicine costs was equivocal. Robust conclusions could not be drawn from the evidence due to variability in design, interventions, outcomes and results. The interventions implemented in the studies in this review led to the identification and resolution of medication-related problems, however evidence of an effect on resident-related outcomes was not found. There is a need for high-quality cluster-randomised controlled trials testing clinical decision support systems and multidisciplinary interventions that measure well-defined, important resident-related outcomes.

Background. The randomized controlled clinical trial is currently the most scientific method for evaluating the effect of medical interventions. The sample size of a trial is crucial for reliably estimating the effect. However, many clinical trials may not be sufficiently large in size to detect the effect of interventions assessed. Previous studies of the statistical power, a relative measure of the largeness of a study, were normally small, mainly examined trials with a statistically insignificant result and were flawed because of the biased or purely hypothetical estimate of the effect for the computation of the power. By using meta-analysis, we conducted this study with improved methods for estimating the power and included a larger number of trials. / Findings. A total of 2,923,912 patients from 2,872 clinical trials from 466 systematic reviews were included in the analyses of this thesis. Of the 466 systematic reviews, 24% (113) were identified from the five journals and the remaining 76% (353) were from the Cochrane Library. 1,000 trials and 1,583,204 patients were obtained from 113 systematic reviews identified in the journals, in which 13.7% (95% C.I.: 11.6%, 15.8%) of trials had a sufficient power and the overall power was 34.0% (95% C.I.: 33.7%, 34.3%). 1,872 trials and 1,340,708 patients were obtained from 353 systematic reviews identified in the Cochrane Library, in which 16.7% (95% C.I.: 15.0%, 18.4%) of trials had a sufficient power and the overall power was 37.8% (95% C.I.: 37.6%, 38.0%). (Abstract shortened by UMI.) / Methods. We identified trials from systematic reviews of clinical trials with binary outcomes published in five medical journals and the Cochrane Database of Systematic Reviews. We analyzed the power of trials with a significant result as well as those with an insignificant result. In estimating the power, we used the combined odds ratio of the meta-analysis as the estimate of the effect for trials from systematic reviews with a statistically significant result and a relative risk reduction of 25% for trials from systematic reviews with a statistically insignificant result. In addition to use of the conventional method to estimate the power, we also developed a new "counting method" that does not need any assumption about the effect. Furthermore, the power is also expressed as a relative and absolute difference between the number of subjects required for a power of 80% and that actually recruited by the trials. / Tsoi Kam Fai. / "July 2005." / Adviser: Jin Ling Tang. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0161. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 107-113). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Thesis (Ph.D. in Biostatistics) -- University of Colorado at Denver and Health Sciences Center, 2006. / Typescript. Includes bibliographical references (leaves 72-75). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D. in Biostatistics, Department of Preventive Medicine and Biometrics) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 89-93). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Made available in DSpace on 2015-12-06T23:02:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2001 / Qualidade dos ensaios clinicos aleatorios em Cirurgia Plastica. Contexto. A avaliacao da qualidade dos ensaios clinicos aleatorios e importante, pois a observacao dos erros e falhas nos permite evita-los no planejamento. conducao, analise e publicacao de futuros estudos. E e fundamental para se determinar o grau de confiabilidade dos resultados dos estudos publicados. Objetivo. Avaliar a qualidade dos ensaios clinicos aleatorios em Cirurgia Plastica. A hipotese testada foi a de que os estudos sao de ma qualidade. Tipo de estudo. Estudo descritivo com a avaliacao realizada por dois pesquisadores, de maneira independente, seguida de uma reuniao de consenso. Selecao da amostra. Ensaios clinicos aleatorios em Cirurgia Plastica, com sigilo de alocacao descrito adequadamente, realizado por/ou com a participacao de pelo menos um cirurgiao plastico, foram identificados atraves da busca eletronica nas bases de dados LILACS, MEDLINE, EMBASE e CCTR. Variavel estudada. Qualidade dos ensaios clinicos aleatorios, por meio da Lista de Delphi, de uma escala de qualidade (JADAD et al., 1996) e de cinco itens complementares. Resultados. Dos 139 estudos publicados como ensaios clinicos aleatorios, 63 por cento (88/139) nao descreveram o sigilo de alocacao, em 17 por cento (23/139) o sigilo de alocacao foi inadequado e 20 por cento (28/139) descreveram o sigilo de alocacao adequadamente. Dos 28 ensaios clinicos aleatorios, com sigilo de alocacao descrito adequadamente, 25 por cento nao descreveram a geracao da sequencia de alocacao, 82 por cento nao descreveram as perdas e exclusoes, 68 por cento nao descreveram se os grupos eram comparaveis, 50 por cento nao especificaram os criterios de inclusao e exclusao, 68 por cento nao apresentaram as medidas de variabilidade e as estimativas dos pontos para a variavel primaria, 61 por cento nao apresentaram uma analise por intencao de tratar. Na pontuacao pela escala de qualidade (JADAD et al., 1996), 71 por cento (20/28) receberam dois ou menos pontos. Conclusao. Os ensaios clinicos aleatorios em Cirurgia Plastica sao de ma qualidade / Quality of randomized clinical trials in Plastic Surgery. Context. The valuation of the quality of the randomized clinical trials is important since the observation of the mistakes and failures allows us to avoid them during planning, performing, analysis and publishing of future studies. It is fundamental in order to determine the reliability degree of the results of the published studies. Objective. To evaluate the quality of randomized clinical trials in Plastic Surgery. The hypothesis tested was the one stating that the studies are low quality ones. Type of study. Descriptive study with the valuation performed by two appraisers, in an independent way, followed by a consensus meeting. Study selection. Randomized clinical trials in Plastic Surgery, with allocation concealment suitably described, performed by/or with the participation of, at least, one plastic surgeon, were identified through electronic search in the basis of LILACS, EMBASE, MEDLINE and CCTR data. Studied variable. Quality of the randomized clinical trials, through Delphi List, through a quality scale (JADAD et al., 1996) and five complementary items. Results. From 139 studies published as randomized clinical trials, 63% (88/139) didn’t describe allocation concealment, in 17% (23/139) it was unsuited and 20% described it suitably. From 28 randomized clinical trials with allocation concealment suitably described, 25% didn’t describe the formation of the allocation sequence, 82% didn’t describe the loss and exclusion, 68% didn’t describe if the groups were comparable, 50% didn’t specify the inclusion and exclusion criteria, 68% didn’t present the variability measures and the points estimation for a primary variable, 61% didn’t present an analysis for a treating intention. In the punctuation by the quality scale (JADAD et al., 1996), 71% (20/28) got two or less points. Conclusion. The randomized clinical trials in Plastic Surgery are low quality ones. / BV UNIFESP: Teses e dissertações

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