Is there publication bias in the reporting of cancer risk in Barrett's esophagus?

AbstractBackground & Aims: The published risk of adenocarcinoma in the setting of Barrett's esophagus (BE) varies. Publication bias, the selective reporting of studies featuring positive or extreme results, may result in overestimation of this cancer risk in the literature. The aim of this study was to assess those publications reporting a cancer risk in BE for evidence of publication bias. Methods: A MEDLINE search for all published estimates between 1966 and 1998 of cancer risk in BE was performed. All studies reporting a cancer risk expressible in cancers per patient-year of follow-up were retrieved. Bibliographies of these studies were surveyed for additional estimates. All publications that required an initial endoscopy with histologic confirmation of BE and any cancer were included. The relationship of reported cancer risk to size of the study was assessed. Multivariable regression controlling for differences in definition of BE, as well as other study characteristics, was performed. The data were also analyzed by means of a funnel diagram, an epidemiologic method to assess publication bias. Results: Five hundred fifty-four abstracts were reviewed. Twenty-seven publications met the stated criteria for inclusion. There was a strong correlation between cancer risk and the size of the study, with small studies reporting much higher risks of cancer than larger studies. This association persisted when differences in the definition of BE, retrospective vs. prospective nature of the study, surveillance interval, and the effect of cancer detected in the first year were considered. The funnel diagram analysis suggested publication bias. Conclusions: The cancer risk in BE may be overestimated in the literature due to publication bias.GASTROENTEROLOGY 2000;119:333-33

Justifying the Implementation of a Collaborative Drug Therapy Management (CDTM) Protocol in an Outpatient Psychiatric Clinic: A Retrospective Chart Review

Background: Patients taking typical and atypical antipsychotic medications are at risk for extrapyramidal side effects and metabolic syndrome, respectively. While psychiatric pharmacists have been shown to improve antipsychotic monitoring through collaborative practice agreements, literature to date is limited. Objective: The objective of this study was to justify outpatient clinical pharmacy services through a CDTM protocol within Gallahue Mental Health Center in Indianapolis, Indiana. Methods: A retrospective chart review was performed of patients who visited the center from November 2012 through December 2013. A review was also completed of patients followed at two primary care clinics within Community Health Network, Jane Pauley Primary Care Clinic and Eastside Medical Center, during the same time frame for comparison. Patients included were at least 18 years old and had at least one active antipsychotic prescription. A standardized data collection sheet was used to collect information on frequency and appropriateness of antipsychotic monitoring as recommended by 2004 American Diabetes Association (ADA) guidelines, in consensus with the American Psychiatric Association, the American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity. Information on patients\u27 medical history, social history, time between clinic visits, and overall antipsychotic use was also collected. Results: Of those primarily followed in Gallahue, only 1% had any documented fasting blood glucose or lipid panel, 23% had any documented blood pressure, and 53% had any documented weight. This differed greatly from the primary care clinics\u27 results of 63%, 100%, and 92%, respectively. The majority of providers did not adequately document reasons for not performing recommended monitoring. Conclusion: Substantial discrepancies exist between current and guideline-recommended monitoring practices of patients on antipsychotics, thereby supporting CDTM between clinical pharmacy specialists and providers as a possible solution to improve evidence-based patient care

Off-balance sheet financing : an explosive situation? : an honors thesis ([HONRS] 499)

There is no abstract available for this thesis.Thesis (B.?.)Honors Colleg