27 research outputs found

    Female Presenters

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    All presenters gender, site and type of round by year between 2011 and 201

    Additional file 1: of Reproducibility of clinical research in critical care: a scoping review

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    Table S1. Clinical practices without a reproduction attempt. Table S2. Clinical practices with consistent estimates of efficacy between original studies and reproduction attempts. Table S3. Clinical practices with consistent estimates of lack of efficacy between original studies and reproduction attempts. Table S4. Clinical practices with consistent estimates of harm between original studies and reproduction attempts. Table S5. Clinical practices with inconsistent effect estimates between original studies and reproduction attempts. Figure S1. Flow diagram showing study design including electronic search strategy, article eligibility criteria, and reproducibility classification. Figure S2. The relationship between time since publication of the original study and the occurrence of a first reproduction attempt. Online Appendix. MEDLINE Search Strategy (April 4, 2016). (DOCX 1175 kb

    Systematic Review of the Risk of Adverse Outcomes Associated with Vascular Endothelial Growth Factor Inhibitors for the Treatment of Cancer

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    <div><p>Background</p><p>Anti-angiogenic therapy targeted at vascular endothelial growth factor (VEGF) is now used to treat several types of cancer. We did a systematic review of randomized controlled trials (RCTs) to summarize the adverse effects of vascular endothelial growth factor inhibitors (VEGFi), focusing on those with vascular pathogenesis.</p><p>Methods and Findings</p><p>We searched MEDLINE, EMBASE and Cochrane Library until April 19, 2012 to identify parallel RCTs comparing a VEGFi with a control among adults with any cancer. We pooled the risk of mortality, vascular events (myocardial infarction, stroke, heart failure, and thromboembolism), hypertension and new proteinuria using random-effects models and calculated unadjusted relative risk (RR). We also did meta-regression and assessed publication bias. We retrieved 83 comparisons from 72 studies (n = 38,078) on 11 different VEGFi from 7901 identified citations. The risk of mortality was significantly lower among VEGFi recipients than controls (pooled RR 0.96, 95% confidence interval [CI] 0.94 to 0.98, I<sup>2</sup> = 0%, tau2 = 0; risk difference 2%). Compared to controls, VEGFi recipients had significantly higher risk of myocardial infarction (MI) (RR 3.54, 95% CI 1.61 to 7.80, I<sup>2</sup> = 0%, tau2 = 0), arterial thrombotic events (RR 1.80, 95% CI 1.24 to 2.59, I<sup>2</sup> = 0%, tau2 = 0); hypertension (RR 3.46, 95% CI 2.89 to 4.15, I<sup>2</sup> = 58%, tau2 = 0.16), and new proteinuria (RR 2.51, 95% CI 1.60 to 3.94, I<sup>2</sup> = 87%, tau2 = 0.65). The absolute risk difference was 0.8% for MI, 1% for arterial thrombotic events, 15% for hypertension and 12% for new proteinuria. Meta-regression did not suggest any statistically significant modifiers of the association between VEGFi treatment and any of the vascular events. Limitations include heterogeneity across the trials.</p><p>Conclusions</p><p>VEGFi increases the risk of MI, hypertension, arterial thromboembolism and proteinuria. The absolute magnitude of the excess risk appears clinically relevant, as the number needed to harm ranges from 7 to 125. These adverse events must be weighed against the lower mortality associated with VEGFi treatment.</p></div

    Pooled effect of treatment with VEGFi on clinical outcomes.

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    <p>*For all-cause mortality, the value presented is number needed to treat (NNT); however for all other outcomes number needed to harm (NNH) is presented. # 8 trials presented either only any thrombotic events or specified arterial and/or venous thromosis and/or pulmonary embolism in addition to any thrombotic events; therefore the included trials (in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101145#pone-0101145-g004" target="_blank">figure 4</a>) and number of participants for any thrombotic events differed from the arterial, venous thrombosis or pulmonary embolism events.</p

    Risk of bias of included studies.

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    <p>The responses for each question in this risk of bias tool are represented by different colors, segmented along a horizontal bar. Light gray depicts the percent of studies responding with the smallest risk of bias. Medium gray depicts the percent of studies responding with a moderate or unclear risk of bias. Dark gray indicates the greatest risk of bias. The responses to “Concealed treatment allocation?” are adequate, inadequate and unclear. The responses to “Double-blinded?”, “Intention-to-treat?” and “Interim/preliminary analysis not done?” are yes, unclear and no. The responses to “Withdrawals/dropouts described” are yes, no or partial. The responses to “Total lost to follow up <10%” are yes, no or not reported. The responses to “Funding?” are government, private or mixed/other funding sources.</p

    Brief description of included randomized trials.

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    <p>NSCLC: non-small-cell lung cancer; RCC: renal cell carcinoma; SCLC: small-cell lung cancer; FOLFOX 4: oxaliplatin, leucovorin, fluorouracil; FU/LV:fluorouracil & leucovorin; IFL: irinotecan, bolus fluorouracil, leucovorin; XELOX: capecitabine & oxaliplatin; HAI Hepatic arterial infusion</p>$<p>Comparison between another arm and control was not eligible.</p><p>There are 74 rows for 72 studies reported in text: two studies, Martin 2011 had two arms Motesanib and bevacizumab comparing with placebo, Robert 2011 had two arms of capecitabine and taxane-based/anthracycline-based comparing bevacizumab versus placebo in each arm.</p><p>*These are two different trials published in the same year by the same author: Spigel et al in 2011 used bevacizumab for extensive stage small cell lung cancer in one trial and sorafenib for advanced non–small-cell lung cancer in another trial. Likewise, Escudier et al in 2007 used neovastat in metastatic renal cell carcinoma in one trial and sorafenib in advanced clear-cell renal-cell carcinoma in another trial.</p
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