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Methodological Standards (methodological + standards)
Selected AbstractsDental injury among Brazilian schoolchildren in the state of São PauloDENTAL TRAUMATOLOGY, Issue 3 2004Sylvia Grimm Abstract ,,,To describe the distribution of dental trauma in Brazilian schoolchildren and its association with demographic, environmental and clinical factors. A random sample of 73 243 schoolchildren's oral examination records from private and public units, selected from 131 cities within the state of São Paulo, Brazil, was analysed. Trauma was assessed based on international methodological standards prescribed by the World Health Organization for Oral Health Surveys (1997). Proportions obtained were compared between urban and rural schools, as well as between private and public units. Oral health status indices were estimated based on the decayed, missing and filled teeth (DMFT) index , the average number of decayed, missing and filled teeth; the proportion of caries-free 5-year-old schoolchildren and anterior maxillary overjet among 12-year-old schoolchildren. The prevalence of dental trauma in anterior dentition was of 2.4, enrolling average 1.2 teeth per child. A rate of 2.4 impaired anterior teeth per thousand was obtained, upper central incisors being those that were most affected , 7.7 in every 10. Among 8- to 11-year-old children, the rates grew regularly. The proportion of dental trauma was significantly higher in boys than in girls (P < 0.01), and gender prevalence ratio was of 1.58 for boys. The results showed positive associations between dental trauma and caries-free 5-year-old schoolchildren (P = 0.003), anterior maxillary overjet,3 mm (P < 0.001), and private school as a socio-economic proxy indicator (P = 0.048). [source] Methodological Analysis of Diagnostic Dobutamine Stress Echocardiography StudiesECHOCARDIOGRAPHY, Issue 8 2004Boudewijn J. Krenning M.D. Background: Dobutamine stress echocardiography (DSE) is an accepted test for the diagnosis of coronary artery disease (CAD), despite its wide diagnostic accuracy. Aim: Which factors cause test variability of DSE for the diagnosis of CAD. Methods: In a retrospective analysis of 46 studies in 5,353 patients, the potential causes of diagnostic variability were systematically analyzed, including patient selection, definition of CAD, chest pain characteristics, confounding factors for DSE (left ventricular hypertrophy, left bundle branch block, female gender), work-up bias (present when patient's chance to undergo coronary angiography is influenced by the result of DSE), review bias (present when DSE is interpreted in relation to CAG), DSE protocol and definition of a positive DSE. Results: Diagnostic variability was related to definition of a positive test, but not related to the definition of CAD or DSE protocol. However, only three of eight methodological standards for research design found general compliance. Differences in the selection of the study population (quality of echocardiographic window, angina pectoris), handling of confounding factors and analysis of disease in individual coronary arteries were observed. Lack of data on analysis of relevant chest pain syndromes and handling of nondiagnostic test results hampered further evaluation of these standards. Conclusion: Methodological problems may explain the wide range in diagnostic variability of DSE. An improvement of clinical relevance of DSE testing is possible by stronger adherence to common and new methodological standards. [source] Immunocytochemistry in liquid-based cervical cytology: Analysis of clinical use following a cross-sectional studyINTERNATIONAL JOURNAL OF CANCER, Issue 5 2006Shaira Sahebali Abstract Cytological screening for cervical cancer is hampered by imperfect sensitivity and low inter-observer reproducibility. Human papillomavirus (HPV) testing lacks specificity as a primary screening method. Studies indicate that immunocytochemical detection of alterations caused by HPV in the host cells can optimise screening. Here, the potential of p16INK4a (cyclin-dependent kinase inhibitor p16) and MIB-1 (Ki-67 proliferation marker) as adjunct molecular markers for cervical lesions was investigated in a prospective, cross-sectional study of 500 samples in the framework of opportunistic screening in Flanders, Belgium. A consecutive series of 200 samples and 100 samples from the cytological categories ASC, LSIL and HSIL were investigated. Surepath samples were interpreted according to the Bethesda 2001 reporting system. HPV testing was done with MY09/MY11 consensus PCR. Immunocytochemistry for p16INK4a and MIB-1 was performed with an automated staining protocol. The number of immunoreactive cells/1,000 cervical cells was assessed. There was a higher mean number of p16INK4A and MIB-1 immunoreactive cells/1,000 cells in HSIL (4.06 ± 1.93 and 11.13 ± 2.83, respectively) compared to other cytological categories. Both markers showed a large spread in counts, for all categories. In cases of HSIL without immunoreactive cells for either marker, low cellularity and long-term storage in water were often the cause of false negativity. This study confirms that positive staining for p16INK4a and MIB-1 is highly correlated with presence of high-grade lesions. These markers could be used as adjuncts to increase the sensitivity of cytological screening as well as the specificity of the HPV test. However, clear methodological standards are needed for optimal performance of immunocytochemistry in a clinical setting. © 2005 Wiley-Liss, Inc. [source] Prognostic factors for the progression of Parkinson's disease: A systematic review,MOVEMENT DISORDERS, Issue 13 2007Bart Post MD Abstract The purpose of this systematic review is to summarize studies that describe the course of Parkinson's disease (PD) and to identify factors that predict change in motor impairment, disability, and quality of life. A literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science limited to the English, French, German, Spanish, and Dutch language. Reports were selected if the study involved subjects with PD, the outcome measures described impairment, disability, or quality of life and follow-up was at least 6 months. All included studies were scored for methodological quality. Data were extracted and summarized in a best evidence synthesis. We screened 1,535 titles and abstracts, of which 27 fulfilled our inclusion criteria. A meta-analysis to quantitatively aggregate progression scores of motor impairment and disability was not possible because of the wide variety of outcome measures used and the heterogeneous study populations. Limited evidence is found for lower UPDRS-ME at baseline, dementia and SE < 70% as prognostic factors for future motor impairment. There is strong evidence for higher age at onset and higher PIGD-score; and limited evidence for higher bradykinesia-score, non-tremor dominant subtype, symmetrical disease at baseline, and depression as prognostic factors for progression of disability. Prognostic factors were identified for impairment and disability. The literature on prognosis in PD is not fulfilling the high methodological standards applied nowadays. There is a need for prospective cohorts of PD patients assembled at a common early point in the disease with long time follow-up. © 2007 Movement Disorder Society [source] Meta-analysis of the efficacy of the acetonic kava-kava extract WS®1490 in patients with non-psychotic anxiety disorders,PHYTOTHERAPY RESEARCH, Issue 3 2005Steffen Witte Abstract Introduction: The herbal medicinal product kava-kava, used for treating anxiety disorders, was assessed positively by the Cochrane Review. However, it was withdrawn from the market in Switzerland and Germany due to cases of liver failure and ,unproven' efficacy. Methods: A protocol for the meta-analysis based on patient source data was written, a literature search was done, and six placebo-controlled, randomized trials with the kava extract WS®1490 were identified. The endpoints were the change in HAMA during treatment (continuous and binary). Results: WS®1490 has an effective success rate of OR=3.3 (95% confidence interval of 2.09,5.22) in patients with non-psychotic anxiety disorders. The continuous outcome supports this result: mean improvement with WS®1490 by 5.94 (95% confidence interval ,0.86 to 12.8) points on the HAMA scale better than placebo. Kava seems to be more effective in females and in younger patients. Discussion: This meta-analysis has no publication bias, no remarkable heterogeneity and is based on trials with high methodological standards. It is concluded that WS®1490, and possibly other kava extracts, are effective. Therefore they remain alternatives to benzodiazepines, selective serotonin re-uptake inhibitors (SSRIs) and other antidepressants in the treatment of non-psychotic anxiety disorders. Copyright © 2005 John Wiley & Sons, Ltd. [source] Evolution of methodological standards in surgical trialsANZ JOURNAL OF SURGERY, Issue 10 2005Carleen Ellis Background: The Consolidated Standards of Reporting Trials (CONSORT) Statement outlines acceptable ways of performing and reporting clinical trials. The objective of the present study was to identify evolving patterns in the methodological standards of surgical trials. Methods: Compliance with 12 key standards from the CONSORT statement were evaluated in 490 trials published in either the ANZ Journal of Surgery or the British Journal of Surgery between January 1969 and December 2003. Results: There has been an irregular but progressive improvement in the methodological standards of published trials. The criteria with the greatest improvement related to estimation of sample size, randomization, concealment of the allocated intervention, baseline comparisons, and the method of expressing outcomes. Compliance rates were <50% for three criteria during the last decade of the review, that is, concealment of the allocated intervention, blindness of assessment, and the method of expressing outcomes. Conclusion: The results of surgical trials need to be interpreted with care. [source] Antibody-immobilized column for quick cell separation based on cell rollingBIOTECHNOLOGY PROGRESS, Issue 2 2010Atsushi Mahara Abstract Cell separation using methodological standards that ensure high purity is a very important step in cell transplantation for regenerative medicine and for stem cell research. A separation protocol using magnetic beads has been widely used for cell separation to isolate negative and positive cells. However, not only the surface marker pattern, e.g., negative or positive, but also the density of a cell depends on its developmental stage and differentiation ability. Rapid and label-free separation procedures based on surface marker density are the focus of our interest. In this study, we have successfully developed an antiCD34 antibody-immobilized cell-rolling column, that can separate cells depending on the CD34 density of the cell surfaces. Various conditions for the cell-rolling column were optimized including graft copolymerization, and adjustment of the column tilt angle, and medium flow rate. Using CD34-positive and -negative cell lines, the cell separation potential of the column was established. We observed a difference in the rolling velocities between CD34-positive and CD34-negative cells on antibody-immobilized microfluidic device. Cell separation was achieved by tilting the surface 20 degrees and the increasing medium flow. Surface marker characteristics of the isolated cells in each fraction were analyzed using a cell-sorting system, and it was found that populations containing high density of CD34 were eluted in the delayed fractions. These results demonstrate that cells with a given surface marker density can be continuously separated using the cell rolling column. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2010 [source] The ORION guidelines: raising research standards for the control of antimicrobial-resistant pathogens and healthcare-associated infectionCLINICAL MICROBIOLOGY AND INFECTION, Issue 11 2007M. J. StruelensArticle first published online: 7 SEP 200 Abstract The ORION (Outbreak Reports and Intervention studies Of Nosocomial Infection) guidelines were recently published with the aim of raising methodological standards and the clarity of reporting of intervention studies in hospital infection control. The guidelines provide advice on use of appropriate statistical analysis techniques and the measures necessary to prevent bias, with the aim of ensuring complete transparency in reports of such interventions, their epidemiological context and potential confounders. CMI authors and reviewers should consider these helpful proposals when designing, reporting and assessing intervention and outbreak studies. Use of these guidelines should contribute to the construction of a solid evidence base for control of antimicrobial resistance and healthcare-associated infection. [source] | ||||||||||