Overview of drugs in arterial thrombosis

1981 ◽  
Vol 294 (1072) ◽  
pp. 291-303
Keyword(s):  
Randomized Controlled Trials ◽  
Arterial Thrombosis ◽  
Arterial Disease ◽  
Controlled Trials ◽  
Large Trial ◽  
Factorial Designs ◽  
Homogeneous Groups ◽  
Randomized Controlled ◽  
The Past ◽  
History Of

The recent history of randomized controlled trials in the prevention of ischaemic heart disease (i.h.d.) is considered. In 1970, it seemed that little could be done to prevent recurrence of the disease and there was almost no information on the potential for preventing its onset. Over the past decade, this rather pessimistic view has changed to one of guarded optimism. Yet there are still no drug regimes that command general support. One reason for the inconclusive results of recent trials may have been the assumption that myocardial infarction and sudden death share the same pathology. Another reason is the diversity of pathogenetic mechanisms and prognoses in i.h.d. Many patients probably stand little chance of benefiting from a particular drug either because it affects mechanisms other than those responsible for their disease or because their prognosis, excellent or hopeless, is unlikely to be influenced whatever treatment they receive. It is consequently difficult to ensure reasonable chances of demonstrating benefits in those who may really stand to gain. A tendency for pharmacological information to become available during or after a large trial, rather than beforehand, has added to the difficulties. Despite all their problems, randomized controlled trials remain the only way of testing drugs for the prevention of arterial disease. Suggestions are made for increasing the chances of clear results in future trials and of reaching the stage of benefit demonstrated sufficiently convincingly to form a basis for clinical practice. These suggestions include the use of factorial designs enabling the evaluation of more than one drug in a particular trial and the development of methods for selecting homogeneous groups of patients.

scholarly journals Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials

2019 ◽  
Vol 9 (12) ◽  
pp. 371 ◽  
Author(s):  
Alexander Sweetman ◽  
Leon Lack ◽  
Célyne Bastien
Keyword(s):  
Sleep Apnea ◽  
Randomized Controlled Trials ◽  
Behavioral Therapy ◽  
Controlled Trials ◽  
Research Attention ◽  
Pressure Therapy ◽  
Randomized Controlled ◽  
History Of ◽  
Methodological Considerations ◽  
Insomnia Symptoms

Co-morbid insomnia and sleep apnea (COMISA) is a highly prevalent and debilitating disorder, which results in additive impairments to patients’ sleep, daytime functioning, and quality of life, and complex diagnostic and treatment decisions for clinicians. Although the presence of COMISA was first recognized by Christian Guilleminault and colleagues in 1973, it received very little research attention for almost three decades, until the publication of two articles in 1999 and 2001 which collectively reported a 30%–50% co-morbid prevalence rate, and re-ignited research interest in the field. Since 1999, there has been an exponential increase in research documenting the high prevalence, common characteristics, treatment complexities, and bi-directional relationships of COMISA. Recent trials indicate that co-morbid insomnia symptoms may be treated with cognitive and behavioral therapy for insomnia, to increase acceptance and use of continuous positive airway pressure therapy. Hence, the treatment of COMISA appears to require nuanced diagnostic considerations, and multi-faceted treatment approaches provided by multi-disciplinary teams of psychologists and physicians. In this narrative review, we present a brief overview of the history of COMISA research, describe the importance of measuring and managing insomnia symptoms in the presence of sleep apnea, discuss important methodological and diagnostic considerations for COMISA, and review several recent randomized controlled trials investigating the combination of CBTi and CPAP therapy. We aim to provide clinicians with pragmatic suggestions and tools to identify, and manage this prevalent COMISA disorder in clinical settings, and discuss future avenues of research to progress the field.

Plastic and reconstructive surgery

2016 ◽  
Keyword(s):  
Randomized Controlled Trials ◽  
Plastic Surgery ◽  
Reconstructive Surgery ◽  
Controlled Trials ◽  
Evidence Based ◽  
Trial And Error ◽  
Plastic And Reconstructive Surgery ◽  
Randomized Controlled ◽  
The Past ◽  
Evidence Based Surgery

In plastic and reconstructive surgery, innovation and creativity have been foremost, with science and evidence following. Unlike for a number of other specialties, the advances in plastic surgery have largely come from imagination, innovations, and trial and error, rather than from scientific trials. Somewhat more than for the rest of surgery, in plastics (where the art and craft of each particular surgeon counts immeasurably), randomized controlled trials of techniques have failed to be generated in the past, due to the difficulty of objectively assessing the success of surgery with an aesthetic-based nature. Consequently, evidence-based study of plastic surgery is a relatively new and developing field. This chapter focuses on the growing importance of evidence-based surgery in this specialty, showing that scientific trials are now being performed with increasing frequency.

scholarly journals Quality Assessment of Randomized Controlled Trials Published in the Korean Journal of Urology Over the Past 20 Years

2011 ◽  
Vol 52 (9) ◽  
pp. 642 ◽  
Author(s):  
Joo Yong Lee ◽  
Jae Hoon Chung ◽  
Dong Hyuk Kang ◽  
Jung Woo Lee ◽  
Hong Sang Moon ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Past ◽  
Korean Journal

scholarly journals Pharmacist and patient perspectives on recruitment strategies for randomized controlled trials: a qualitative analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jane M. Fletcher ◽  
Terry Saunders-Smith ◽  
Braden J. Manns ◽  
Ross Tsuyuki ◽  
Brenda R. Hemmelgarn ◽  
...  
Keyword(s):  
Focus Groups ◽  
Randomized Controlled Trials ◽  
Low Income ◽  
Intrinsic Value ◽  
Trial Registration ◽  
Controlled Trials ◽  
Patient Recruitment ◽  
Large Trial ◽  
Recruitment Strategies ◽  
Randomized Controlled

Abstract Background Although recruitment is a major challenge for most randomized controlled trials, few report on the difficulties of recruitment, or how it might be enhanced. The objective of our study was to qualitatively explore the experiences of both patients and pharmacists related to recruitment for ACCESS, a large trial involving low-income seniors, given that two of our most successful recruitment strategies were direct patient recruitment materials and use of community pharmacists. Methods Using qualitative descriptive methods, we collected data from pharmacists and study participants. Pharmacists were asked about their impressions of the study, as well as challenges they faced and methods they used to recruit potential participants. Focus groups with trial participants centered on the patient recruitment materials. Interviews and focus groups were recorded, transcribed and analyzed using thematic analysis. Results Pharmacists noted that their first impressions of the study were positive as they described being enticed to help the study team by the potential benefit of copayment elimination for their patients and the low time commitment. Pharmacists noted they were more likely to recruit if they were well informed on the study, as they could answer their patients’ questions. Participants noted that their primary motivations for participating were the tangible benefits of free medications and the intrinsic value of participating in research. Conclusions We noted that recruitment through pharmacies was an effective method as most patients have trusting relationships with their pharmacist. To optimize recruitment through pharmacies, study procedures should be straightforward, and pharmacists need to be equipped with good knowledge of the study. When promoting a study to potential participants, messaging should ensure the individuals are aware of the tangible benefits of participation while still presenting a full overview of the trial. Trial registration Trial Registration Number: NCT02579655 – initially registered Oct 19, 2015.

scholarly journals A Description of the Trials, Reviews, and Practice Guidelines Indexed in the PEDro Database

2008 ◽  
Vol 88 (9) ◽  
pp. 1068-1077 ◽  
Author(s):  
Christopher G Maher ◽  
Anne M Moseley ◽  
Cathie Sherrington ◽  
Mark R Elkins ◽  
Robert D Herbert
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
History Of

This perspective provides an overview of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy. Data from the Physiotherapy Evidence Database (PEDro) are used to describe key events in the history of physical therapy research and the growth of evidence of effects of interventions used in the various subdisciplines of physical therapy. The 11,494 records that were identified reveal a rich history of physical therapy research dating back to the first trial in 1929. Most of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy have been published since the year 2000. This rapid growth presents a challenge for physical therapists who want to keep up to date in clinical practice.

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