Evaluation of the use and the impact of the physician data query system (PDQ) on clinical practice in six european countries

Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Evaluation of the use and the impact of the physician data query system (PDQ) on clinical practice in six european countries

Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Post-basic cancer nursing education in Belgium: an innovative collaboration between a nursing school, a comprehensive cancer centre and the Oncology Nursing Society

Since 1989, the Nursing School attached to the Free University, Brussels, has organized post-basic courses in cancer nursing, with the collaboration of the Belgian Oncology Nursing Society (French speaking) (SIO) and a comprehensive cancer centre, the Jules Bordet Institute. The 1-day-a-week course evolves over 30 weeks and is open to registered nurses. Its structure and its content respect the recommendations of the Core Curriculum for a Post-Basic Course in Cancer Nursing (EONS, 1989). However, there are some differences related to the entry requirements, the clinical experience, and the evaluation of both the course and the students' performance. So far, 72 nurses from different cancer units from the southern part of Belgium have obtained the certificate at the end of this course. In parallel with the 1-day-a-week course, seven modular courses were set up during the first semester of 1992, with the financial support of the 'Europe against Cancer' Programme. Each module tackles a specific theme: Basic Principles in Oncology Nursing; Training the Trainers; Prevention and Early Screening; Rehabilitation--Palliative Care--Psycho-oncology (one short and one long module); Radiotherapy; and Chemotherapy.SCOPUS: ar.jFLWNAinfo:eu-repo/semantics/publishe

Meta-analysis and indirect comparisons of levetiracetam with other second-generation antiepileptic drugs in partial epilepsy

Few comparative clinical trials of newer antiepileptic drugs (AEDs) in patients with refractory partial epilepsy are available. Therefore, meta-analysis is a widely used and useful method for comparing them. Despite the limitations of indirect comparisons, and recognizing that these drugs were tested at different doses, such comparisons can be helpful to physicians making practical treatment decisions. The purposes of this study were to present newer meta-analysis results for add-on levetiracetam compared with placebo and to estimate its efficacy and tolerability compared with other new AEDs (gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, and zonisamide) in a meta-analysis using methods for making indirect comparisons. Randomized placebo-controlled clinical trials of add-on therapy with levetiracetam, gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, and zonisamide in patients with refractory partial epilepsy were identified in the Cochrane Library 2002. A fixed effects model was used to estimate Mantel-Haenszel odds ratios for the responder rate (efficacy measure) and withdrawal rate (mainly tolerability measure) of levetiracetam and other new AEDs versus placebo. Because no head-to-head clinical trials comparing these new AEDs exist, adjusted indirect comparisons were then made between levetiracetam and each other AED using the meta-analysis results. At the doses tested, levetiracetam was more effective in terms of responder rate than gabapentin (odds ratio 2.64 with 95% CI 1.514.63) and lamotrigine (odds ratio 1.86 with 95% CI 1.04-3.34) and equally well tolerated. Levetiracetam had a significantly lower withdrawal rate than topiramate (odds ratio 0.52 with 95% CI 0.290.93) and oxcarbazepine (odds ratio 0.55 with 95% CI 0.33-0.92), with comparable efficacy. Although levetiracetam did not differ significantly from the other AEDs, numerical trends favoring levetiracetam were obtained in response rate and in withdrawal rate (tiagabine, zonisamide). Indirect comparisons based on meta-analysis suggest that add-on therapy with levetiracetam has a favorable responder and/or withdrawal rate relative to several AEDs in patients with partial epilepsy with doses used in clinical trials. These meta-analyses give only short-term efficacy and safety data. Comparative clinical trials and long-term studies of these agents are needed to confirm these findings