60 research outputs found
Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.
This is the final version of the article. Available from American Medical Association via the DOI in this record.Importance: Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. Objective: To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Design: Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. Findings: The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. Conclusions and Relevance: The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.The research was supported by grant 375751 from the Canadian Institute for Health Research; funding from the Canadian Agency for Drugs and Technologies in Health; funding from the Standards for Reporting of Diagnostic Accuracy Studies Group; funding from the University of Ottawa Department of Radiology Research Stipend Program; and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula
The breadth of primary care: a systematic literature review of its core dimensions
Background: Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level.
Methods: A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit.
Results: Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health.
Conclusions: A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health
Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases
The production of peroxide and superoxide is an inevitable consequence of
aerobic metabolism, and while these particular "reactive oxygen species" (ROSs)
can exhibit a number of biological effects, they are not of themselves
excessively reactive and thus they are not especially damaging at physiological
concentrations. However, their reactions with poorly liganded iron species can
lead to the catalytic production of the very reactive and dangerous hydroxyl
radical, which is exceptionally damaging, and a major cause of chronic
inflammation. We review the considerable and wide-ranging evidence for the
involvement of this combination of (su)peroxide and poorly liganded iron in a
large number of physiological and indeed pathological processes and
inflammatory disorders, especially those involving the progressive degradation
of cellular and organismal performance. These diseases share a great many
similarities and thus might be considered to have a common cause (i.e.
iron-catalysed free radical and especially hydroxyl radical generation). The
studies reviewed include those focused on a series of cardiovascular, metabolic
and neurological diseases, where iron can be found at the sites of plaques and
lesions, as well as studies showing the significance of iron to aging and
longevity. The effective chelation of iron by natural or synthetic ligands is
thus of major physiological (and potentially therapeutic) importance. As
systems properties, we need to recognise that physiological observables have
multiple molecular causes, and studying them in isolation leads to inconsistent
patterns of apparent causality when it is the simultaneous combination of
multiple factors that is responsible. This explains, for instance, the
decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference
Minimal residual disease in breast cancer: an overview of circulating and disseminated tumour cells
Reducing barriers to post-9/11 veterans’ use of programs and services as they transition to civilian life
Inhibitory influences of xanthine oxidase inhibitor and angiotensin I-converting enzyme inhibitor on multinucleated giant cell formation from monocytes by downregulation of adhesion molecules and purinergic receptors
Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement
Importance: Systematic reviews of diagnostic test accuracy synthesize data from
primary diagnostic studies that have evaluated the accuracy of 1 or more index
tests against a reference standard, provide estimates of test performance, allow
comparisons of the accuracy of different tests, and facilitate the identification
of sources of variability in test accuracy.
Objective: To develop the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone
extension of the PRISMA statement. Modifications to the PRISMA statement reflect
the specific requirements for reporting of systematic reviews and meta-analyses
of diagnostic test accuracy studies and the abstracts for these reviews.
Design: Established standards from the Enhancing the Quality and Transparency of
Health Research (EQUATOR) Network were followed for the development of the
guideline. The original PRISMA statement was used as a framework on which to
modify and add items. A group of 24 multidisciplinary experts used a systematic
review of articles on existing reporting guidelines and methods, a 3-round Delphi
process, a consensus meeting, pilot testing, and iterative refinement to develop
the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA
diagnostic test accuracy guideline checklist was approved by the group.
Findings: The systematic review (produced 64 items) and the Delphi process
(provided feedback on 7 proposed items; 1 item was later split into 2 items)
identified 71 potentially relevant items for consideration. The Delphi process
reduced these to 60 items that were discussed at the consensus meeting. Following
the meeting, pilot testing and iterative feedback were used to generate the
27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal
contemporary systematic review methods for diagnostic test accuracy, 8 of the 27
original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2
were omitted.
Conclusions and Relevance: The 27-item PRISMA diagnostic test accuracy checklist
provides specific guidance for reporting of systematic reviews. The PRISMA
diagnostic test accuracy guideline can facilitate the transparent reporting of
reviews, and may assist in the evaluation of validity and applicability, enhance
replicability of reviews, and make the results from systematic reviews of
diagnostic test accuracy studies more useful
Spatially Controlled Surface Modification of Porous Silicon for Sustained Drug Delivery Applications
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