A unified approach for subgroup identification and individualized treatment recommendation with applications to randomized control trials and observational studies

2017 ◽  
Vol 12 (3) ◽  
pp. 287-301
Author(s):  
Haoda Fu ◽  
Jin Zhou
Keyword(s):  
Observational Studies ◽  
Individualized Treatment ◽  
Treatment Recommendation ◽  
Randomized Control Trials ◽  
Unified Approach ◽  
Subgroup Identification ◽  
Randomized Control

scholarly journals Systematic Differences in Effect Estimates Between Observational Studies and Randomized Control Trials in Meta-Analyses Combining Both Study Designs in Nephrology

2020 ◽  
Author(s):  
Miho Kimachi ◽  
Akira Onishi ◽  
Aran Tajika ◽  
Kimihiko Kimachi ◽  
Toshi Furukawa
Keyword(s):  
Systematic Reviews ◽  
Observational Studies ◽  
Statistical Significance ◽  
Randomized Control Trials ◽  
Causal Inferences ◽  
Randomized Controlled ◽  
The Past ◽  
Randomized Control ◽  
Meta Analyses ◽  
Study Designs

Abstract The limited availability of randomized controlled trials (RCTs) in nephrology undermines causal inferences in meta-analyses. Systematic reviews of observational studies have grown more common under such circumstances. We conducted systematic reviews of all comparative observational studies in nephrology from 2006 to 2016 to assess the trends in the past decade. We then focused on the meta-analyses combining observational studies and RCTs to evaluate the systematic differences in effect estimates between study designs using two statistical methods: by estimating the ratio of odds ratios (ROR) of the pooled OR obtained from observational studies versus those from RCTs and by examining the discrepancies in their statistical significance. The number of systematic reviews of observational studies in nephrology had grown by 11.7-fold in the past decade. Among 56 records combining observational studies and RCTs, ROR suggested that the estimates between study designs agreed well (ROR: 1.05, 95% confidence interval: 0.90-1.23). However, almost half of the reviews led to discrepant interpretations in terms of statistical significance. In conclusion, the findings based on ROR might encourage researchers to justify the inclusion of observational studies in meta-analyses. However, caution is needed as the interpretations based on statistical significance were less concordant than those based on ROR.

scholarly journals Current randomized control trials, observational studies and meta analysis in off-pump coronary surgery

2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Haralabos Parissis ◽  
Man Chi Lau ◽  
Mondrian Parissis ◽  
Savvas Lampridis ◽  
Victoria Graham ◽  
...  
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Coronary Surgery ◽  
Off Pump ◽  
Randomized Control

scholarly journals Benefits of Exercise on Influenza or Pneumonia in Older Adults: A Systematic Review

2020 ◽  
Vol 17 (8) ◽  
pp. 2655 ◽  
Author(s):  
Yang Song ◽  
Feng Ren ◽  
Dong Sun ◽  
Meizi Wang ◽  
Julien S. Baker ◽  
...  
Keyword(s):  
Older Adults ◽  
Immune Responses ◽  
Aerobic Exercise ◽  
Martial Arts ◽  
Observational Studies ◽  
Future Research ◽  
Randomized Control Trials ◽  
Cross Sectional ◽  
Randomized Control ◽  
Asian Martial Arts

A coronavirus pandemic has recently become one of the greatest threats the world is facing. Older adults are under a high risk of infection because of weaker immune systems. Therefore, the purpose of this review is to summarize the recent scientific evidence that outlines the effects of exercise on influenza or pneumonia in older adults. An electronic literature search was conducted using the WEB OF SCIENCE, SCIENCEDIRECT and GOOGLE SCHOLAR databases using the following keywords, “Exercise,” “Older adult,” “Influenza,” and “Pneumonia.” Any randomized control trials, cross-sectional and observational studies that related to this topic were all included. Twenty studies met the eligibility criteria for this review. Thirteen randomized control trials investigated the effects of exercise on the immune responses to influenza or pneumonia vaccination: seven trials employed moderate aerobic exercise, three employed resistance exercise, and the remaining three used Asian martial arts or special home-based exercises. Five cross-sectional and two observational studies examined the associations between exercise/physical condition and influenza/pneumonia. Most of the current studies suggested that prolonged moderate aerobic exercise may help to reduce the risk of influenza-related infection and improve the immune responses to influenza or pneumonia vaccination in older adults. In addition, training in traditional Asian martial arts was also found to be beneficial. Future research should focus on the different effects of moderate and vigorous exercise on influenza-related diseases.

scholarly journals 1619. Meta-analysis of Randomized Control Trials Evaluating New Beta-Lactamase Combination Antibiotics

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S802-S802
Author(s):  
Geneva M Wilson ◽  
Margaret A Fitzpatrick ◽  
Kyle Walding ◽  
Beverly Gonzalez ◽  
Katie J Suda ◽  
...  
Keyword(s):  
Observational Studies ◽  
Clinical Success ◽  
Meta Analysis ◽  
New Combination ◽  
Randomized Control Trials ◽  
Beta Lactamase ◽  
Success Rates ◽  
Beta Lactam ◽  
Randomized Control ◽  
Tract Infections

Abstract Background Ceftolozane/ Tazobactam (C/T), Ceftazidime/ Avibactam (C/A), Meropenem/ Vaborbactam (M/V) and Imipenem/ Relebactam (I/R) are new combination beta-lactam/ beta-lactamase inhibitor antibiotics primarily used to treat multidrug-resistant (MDR) Gram-negative infections. This study synthesized outcomes of comparative observational studies and randomized control trials (RCTs) that evaluated clinical success of these antibiotics compared to other therapies. Methods PubMed, EMBASE, and Google Scholar were searched from January 1st, 2013 through October 1st, 2019 for comparative observational studies and RCTs of C/T, C/A, M/V and I/R in patients with pneumonia, complicated intra-abdominal and urinary tract infections. Study and patient demographics were collected along with clinical and microbiological success rates. Meta-regression analysis was used to determine the pooled effectiveness of C/T, C/A, M/V, and I/R. Heterogeneity and publication bias were assessed via I2 values and funnel plots, respectively. Results Literature search returned 1,645 results. After exclusion criteria, 21 publications representing 6,246 patients were retained: 16 RCTs (8 C/A, 3 C/T, 3 I/R, 2 M/V) and 5 comparative observational studies (3 C/A, 2 C/T). Pooled risk ratios for clinical success showed that all four antibiotics were non-inferior to comparator antibiotics (0.99 (95% CI (0.97-1.01)). Eleven of the sixteen RCTs evaluated microbiological success; pooled risk ratio was 1.08 (95% CI 1.04-1.13), indicating that older therapies were more successful at microbiological eradication than newer antibiotics. Only 6 of the included studies (3 RCTs and 2 observational studies) focused on patients with MDR infections. Limiting the analysis to MDR RCTs did not change the overall conclusions. Conclusion Although older therapies had slightly higher microbiologic clearance, pooled clinical success rates for C/A, C/T, M/V, and I/R were non-inferior to older therapies, including in studies focused on patients with MDR infections. Additional studies are needed to further evaluate these drugs’ effectiveness for treatment of MDR infections. Disclosures All Authors: No reported disclosures

scholarly journals A Systematic Review to Identify the Effects of Biologics in the Feet of Patients with Rheumatoid Arthritis

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 23
Author(s):  
Laura Ramos-Petersen ◽  
Christopher James Nester ◽  
Andres Reinoso-Cobo ◽  
Pilar Nieto-Gil ◽  
Ana Belen Ortega-Avila ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Wound Healing ◽  
Observational Studies ◽  
Randomized Control Trials ◽  
Site Infection ◽  
Delayed Wound Healing ◽  
Disease Evolution ◽  
X Ray ◽  
Randomized Control

Background and objective: Ninety percent of patients with rheumatoid arthritis (RA) feel foot pain during the disease process. Pharmacological treatment of RA has a systematic effect on the body and includes: Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. The objective of our review was to examine the impact of biologics on patients with RA ‘foot. Methods and material: A systematic review of randomized control trials and observational studies that evaluated the efficacy of biologics against other pharmacological treatment, and included a foot outcome measure. The search covered MEDLINE Ovid, Pubmed, CINAHL, Cochrane Library, Evidence Search, and Web of Science. Risk of bias was evaluated using Cochrane guidance and the Newcastle Ottawa Scale adapted version. Results: A total of eight studies fully met the inclusion criteria: Three randomized control trials, and five observational studies were the basis of our review. A total sample of 1856 RA patients with RA treatment participated. The use of biologics was not associated as a risk factor for post-operative surgical site infection or delayed wound healing. The benefits of biologics, in terms of the disease evolution, were assessed using X-ray. Conclusion: Evidence suggests that the use of biologics is not a risk factor for post-operative surgical site infection or delayed wound healing. The use of biologics presents benefits in terms of the disease evolution assessed through X-ray.

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