101 research outputs found

    Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons

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    BACKGROUND: Data comparing duloxetine with existing antidepressant treatments is limited. A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine, the other antidepressant in the same therapeutic class with a significant market share, has been undertaken. In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal, indirect comparisons are the most rigorous way to go. We conducted a systematic review of the efficacy of duloxetine, fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder (MDD), and performed indirect comparisons through meta-regressions. METHODS: The bibliography of the Agency for Health Care Policy and Research and the CENTRAL, Medline, and Embase databases were interrogated using advanced search strategies based on a combination of text and index terms. The search focused on randomized placebo-controlled clinical trials involving adult patients treated for acute phase Major Depressive Disorder. All outcomes were derived to take account for varying placebo responses throughout studies. Primary outcome was treatment efficacy as measured by Hedge's g effect size. Secondary outcomes were response and dropout rates as measured by log odds ratios. Meta-regressions were run to indirectly compare the drugs. Sensitivity analysis, assessing the influence of individual studies over the results, and the influence of patients' characteristics were run. RESULTS: 22 studies involving fluoxetine, 9 involving duloxetine and 8 involving venlafaxine were selected. Using indirect comparison methodology, estimated effect sizes for efficacy compared with duloxetine were 0.11 [-0.14;0.36] for fluoxetine and 0.22 [0.06;0.38] for venlafaxine. Response log odds ratios were -0.21 [-0.44;0.03], 0.70 [0.26;1.14]. Dropout log odds ratios were -0.02 [-0.33;0.29], 0.21 [-0.13;0.55]. Sensitivity analyses showed that results were consistent. CONCLUSION: Fluoxetine was not statistically different in either tolerability or efficacy when compared with duloxetine. Venlafaxine was significantly superior to duloxetine in all analyses except dropout rate. In the absence of relevant data from head-to-head comparison trials, results suggest that venlafaxine is superior compared with duloxetine and that duloxetine does not differentiate from fluoxetine

    Geographical perspectives on location for location based services

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    In this position paper the question of how location is employed in location based services (LBS) is considered. The importance of the notion of location is highlighted as a means of blurring the boundary between forms of experiences that are direct, and sensed in the environment, and those that are indirect, and learned from information. It is suggested that current methods for modeling location are limited by their lack of strong theoretical underpinning. To help bridge this gap the notions of Space, Place, and Region, from geographical theory, are proposed and implications of these for considering location in LBS outlined

    Analysing and aggregating visitor tracks in a protected area

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    The advent of location-based technologies deployed in protected areas provides both visitors and managers of such areas with new opportunities. In this paper we investigate the potential for mining individual tracks of visitors’ geospatial lifelines to both extract information describing aggregated patterns of group behaviour and characterise individual actions. Methods to spatio-temporally cluster individual behaviour and identify potential locations for specific actions (e.g. do visitors stop here to look at wildlife), whilst handling uncertainty in location, are described and applied to test the hypotheses that firstly, visitor behaviour is altered by the provision of information, and secondly whether the mode of information provision (e.g. in the form of a paper map or though an location-based service) influences visitor behaviour. The results of experiments with 140 visitors to a nature trail on the island of Texel in the Netherlands show statistically significant differences in time spent at locations where information was “pushed” to the visitors

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    Techniques for on the-fly generalisation of thematic point data usin
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