ecr – -Translation – Keybot Dictionary

  Examen méthodique d'étu...  

Show textShow cached sourceOpen source URL	Les avantages et désavantages relatifs des diverses techniques de CRVP ont été déterminés en examinant leur impact sur la qualité de vie, leurs complications, la mortalité, l’essoufflement (dyspnée) et la fonction pulmonaire. L’examen méthodique porte sur quatre essais cliniques contrôlés et randomisés (ECR) et dix études de cohortes comparant diverses techniques de CRVP.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	The relative benefit and harm of different LVRS procedures were determined by examining their impact on the quality of life (QoL), complications associated with treatment, mortality, shortness of breath (dyspnea) and pulmonary function. Four randomized controlled trials (RCTs) and 10 cohort studies comparing different LVRS procedures were identified.

  Les modificateurs de la...  

Show textShow cached sourceOpen source URL	Parmi les 79 articles, 24 répondaient aux critères d’inclusion du présent examen, soit six examens méthodiques, neuf ECR , cinq évaluations économiques et quatre ensembles de lignes directrices fondées sur des données probantes.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	The literature search identified 1,336 citations of which 75 were deemed potentially relevant. An additional 4 articles were identified from the grey literature. Of the 79 reports, 24 met the criteria for inclusion in this review: 6 systematic reviews, 9 RCTs, 5 economic evaluations, and 4 evidence-based guidelines.

  iStent : un traitement ...  

Show textShow cached sourceOpen source URL	Une évaluation technologique réalisée en 20112 s’est penchée sur diverses nouvelles interventions pour le traitement du glaucome, incluant le iStent. Les auteurs ont estimé que les nouvelles approches démontraient un potentiel pour le traitement du GAO, mais qu’aucun ECR de puissance suffisante ne permettait de déterminer leur efficacité.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	A 2011 technology assessment2 evaluated a variety of novel glaucoma procedures, including the iStent. The authors found that although all the new approaches showed potential for the treatment of OAG, there were no RCTs of appropriate power to determine their efficacy.

  Analyse de l’efficacité...  

Show textShow cached sourceOpen source URL	Parce que les données probantes issues des ECR ne sont d’aucune utilité pour répondre à certaines des questions de recherche, nous avons examiné des études observationnelles dont l’échantillon est de grande taille et le suivi, long.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Because of the inadequate evidence found from RCTs to answer some of the research questions, observational studies with large sample sizes and longer follow-ups were considered. Many of these observational studies were retrospective, and non-random allocation of treatment and potential confounding by indication led to concerns about the reliability of results.

  RegJoint ‘” Un implant ...  

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Un ECR comportant un suivi de deux ans et comptant 52 patients atteints d’AR a comparé l’IBP à un implant en silicone. Les résultats de pertinence clinique étaient semblables entre les deux groupes. Toutefois, on a constaté une prévalence plus élevée de subluxations palmaires récidivantes dans le groupe BPI.

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A two-year follow-up RCT involving 52 patients with RA compared a BPI with a silicone implant. Clinically relevant outcomes were similar between the two groups. However, recurrent palmar subluxation was more prevalent in the BPI group. Implant fractures, cortical perforations, and osteolysis were more common in the silicone implant group. The surgical technique used for BPI arthroplasty was described by the study authors as somewhat laborious because of the need to fix the implant both to the metacarpal bone and the palmar plate.4

  RegJoint ‘” Un implant ...  

Show textShow cached sourceOpen source URL	Un ECR comprenant 35 patients atteints de déformations rhumatoïdes de l’avant-pied a comparé l’IBP à un groupe subissant une résection conventionnelle de la tête du métatarsien. À 3 et 12 mois, la performance clinique et le taux de complications du groupe d’IBP et du témoin étaient comparables5.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	An RCT involving 35 patients with rheumatoid forefoot deformities compared a BPI with a conventional metatarsal head resection group. Clinical performance and complication rates, at 3 and 12 months, were comparable between the BPI and the control group.5

  Les triptans dans la cr...  

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Aucun des ECR répertoriés ne portait sur l’étude de l’utilisation des triptans dans le traitement précoce de la migraine, ni dans le traitement des migraines légères, bien que cela soit d’usage dans la pratique actuelle.

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The generalizability of clinical evidence to current practice requires consideration. None of the RCTsidentified investigated the effect of triptan use for early treatment or mild migraine, although this is commonly encouraged in current practice. This practice could change the magnitude of observed responses from that seen in clinical trials. Switching to a different triptan, rather than continuing with the same triptan, is encouraged in current practice and may result in different success measures than that observed in clinical trials

  iStent : un traitement ...  

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Un ECR à double insu a comparé l’efficacité de diminution de la PIO procurée par la phacoémulsification seule ou jumelée au iStent, chez 36 patients5. Les résultats ont montré que les patients traités en conjonction avec le iStent présentait une PIO significativement plus basse et une diminution significative de l’usage d’hypotensifs oculaires; 67 % des patients ne faisaient pas appel aux médicaments 15 mois après l’opération, par rapport au groupe témoin.

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A double-blinded RCT compared the IOP-lowering efficacy of phacoemulsification alone and in combination with the iStent in 36 patients.5 Results showed that the iStent-treated patients experienced significantly lower IOP and a significant reduction in the use of ocular hypotensive drugs, with 67% of patients being medication free 15-months post-operatively compared with the control group. No adverse events were reported in the study group.

  La chirurgie bariatriqu...  

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Un ECR à centre unique, sans insu, comportant une période de suivi de 12 mois, a comparé l’efficacité du TMC au TMC jumelé au PG ou à la gastrectomie longitudinale mis en œuvre dans le but d’améliorer la maîtrise glycémique chez 150 patients obèses atteints de diabète de type 2.

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A 12-month follow-up, single-centred, non-blinded RCT compared the effectiveness of SMT with SMT plus GB or sleeve gastrectomy as a means of improving glycemic control in 150 obese patients with type 2 diabetes mellitus. The authors reported that at 12-months, glycated hemoglobin levels of 6% were achieved in 12% of the SMT group versus 42% in the GB group, and 37% in the sleeve gastrectomy group. With the continued use of drugs to lower glucose, lipid and blood pressure levels decreased significantly in the BS groups but increased in patients receiving SMT alone.2

  Gestion optimale du tra...  

Show textShow cached sourceOpen source URL	Par opposition, les résultats des études primaires (deux ECR et cinq études non randomisées) indiquent l’allongement de la période durant laquelle le RIN se maintient dans l’écart thérapeutique dans le cadre de l’autosurveillance ou de l’autogestion, comparativement à la clinique d’anticoagulation, mais l’absence de différences avec les soins usuels.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	In contrast to the systematic reviews, results from additional primary studies (two RCTs, five non-randomized studies) indicated an increase in TTR with PST/PSM compared with specialized anticoagulation clinic care, but no difference compared with UC.

  Antipsychotiques atypiq...  

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Du lot des ECR, 1113-24 se penchent sur la comparaison entre la clozapine associée à un autre antipsychotique et la clozapine en monothérapie. Ils ne détectent pas de différences statistiquement significatives entre les deux interventions sous les angles examinés, sauf du point de vue de l’échelle d’impression clinique globale d’amélioration (CGI-I), en vertu de laquelle la bithérapie renfermant la clozapine est légèrement mieux que la clozapine seule après 16 semaines de traitement.

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Eleven RCTs13-24 compared combination therapy involving clozapine (CLZ) versus CLZ monotherapy. There were no statistical differences between groups for any outcome, with the exception of the Clinical Global Impression Improvement (CGI-I) scale, where slightly greater improvement was seen in the CLZ combination arm compared with CLZ monotherapy at 16 weeks.

  L’efficacité des inhibi...  

Show textShow cached sourceOpen source URL	Méta-analyse d'études comparatives randomisées (ECR) portant sur l'efficacité des IPP comparativement au placebo, aux antagonistes H2 ou aux agents stimulant la motilité gastrique.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Outcome: Number of patients experiencing either no symptoms (excellent control) or a significant improvement in symptoms (combined good and excellent control).

  Antipsychotiques atypiq...  

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Seulement un 10 des 30 ECR est mené auprès d’adolescents (âgés de 10 à 18 ans). Dans les études dont la population est adulte, la durée de la maladie au moment de l’étude va de 711 à 2212 ans (moyenne pondérée de 15,6 et écart-type [ET] de 4,8).

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Of the 30 included RCTs, only one10 was conducted in adolescents (aged 10 to 18 years). Baseline duration of illness for the adult studies ranged from 711 to 2212 years (weighted mean [SD] 15.6 [4.8]). A broad range of antipsychotic doses were used in the included trials. Common outcome measures included schizophrenia symptom scales (e.g., Positive and Negative Symptoms Scale [PANSS], Brief Psychiatric Rating Scale [BPRS] scores, Clinical Global Impression [CGI]), response rate, cognition, withdrawals, and serious adverse events. No evidence was available for relapse or remission rates.

  Analyse de l’efficacité...  

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Seize publications3-18 rendent compte de 14 essais cliniques comparatifs et randomisés (ECR) qui portent sur 11 317 patients dans l’ensemble. Les métaanalyses ne révèlent pas de différences d’importance clinique entre les interventions sur les plans du décès d’origine vasculaire, de l’angioplastie sélective en urgence, de l’IM non mortel, de l’AVC ou de l’hémorragie majeure.

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Sixteen publications3-18 reported findings from 14 randomized controlled trials (RCTs) with a total of 11,317 patients. Based on the meta-analyses performed, no clinically important differences between interventions were found in vascular death, urgent target vessel revascularization, non-fatal MI, stroke, or major bleeds. The only difference that was observed occurred in the comparison of ASA plus ticlopidine to ASA alone for the outcome measure of all target vessel revascularizations. A meta-analysis of composite end point data was considered to be inappropriate, but a narrative review of findings from large RCTs suggests that the use of ASA plus clopidogrel reduced the rates of cardiovascular events compared with ASA alone.

  Analyse de l’efficacité...  

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En effet, il est établi que les résultats statistiquement significatifs seront présentés, alors que ceux sans importance statistique ne le seront probablement pas34. Comme ce n’est pas la totalité des ECR qui se prêtent à toutes les analyses, la puissance de celles-ci s’en trouve réduite.

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This review has limitations. Not all trial reports documented data on all of the outcomes of interest. This may introduce bias, because statistically significant results are more likely to be reported than non-statistically significant results.34 Not all RCTs could be included in the analyses for all outcomes, resulting in reduced power. A handful of clinical trials were used in quantitative data analysis, and the event rates that were reported for some clinical outcomes (such as stroke, major bleeds, and some adverse events) were low. The related computational issues may limit the analyses, and the results are interpreted with caution.

  Rapports d’examen rapid...  

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L’essai clinique majeur RELY, randomisé et comparatif (ECR), qui oppose le dabigatran et la warfarine, constate que le dabigatran à la dose de 110 mg comporte moins de risque d’hémorragie grave que la warfarine à une dose adaptée, ce qui ne serait pas le cas du dabigatran à la dose de 150 mg.

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Bleeding is typically the main safety issue of concern with all anticoagulants, including dabigatran. In RE-LY, the major randomized controlled trial (RCT) comparing dabigatran with warfarin, the risk of severe bleeding was reduced with the lower 110-mg dose of dabigatran compared with adjusted-dose warfarin, but there was no such reduction with the higher, 150-mg dose. However, there was evidence that in elderly patients there was no reduction in severe bleeding risk at either dose versus warfarin, and in the post-marketing period there was some evidence from case reports that elderly patients and/or those with severe renal impairment are at risk for serious bleeding events.

  L’ablation par radiofré...  

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Résultats : Au nombre des 968 résumés ou titres recensés dans le cadre de la stratégie de recherche documentaire, 111 études de recherche primaires (11 %) satisfaisaient aux critères d'inclusion, y compris 18 études sur les syndromes de pré-excitation, 22 études sur la TRINAV, dont l'une traitait également de syndromes de pré-excitation, 16 études sur le flutter auriculaire, neuf études portant sur d'autres formes de tachycardie auriculaire, 29 études traitant généralement de la FA et 18 études sur la TV. Il s'agissait surtout de rapports de cohortes provenant d'un seul centre. Seulement dix (9 %) des études étaient des ECR.

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Results: Of the 968 abstracts/citation titles identified through the literature search strategy, 111 primary research studies (11%) met the inclusion criteria. These consisted of 18 studies on the pre-excitation syndromes, 22 studies on AVNRT with one study also reporting on the pre-excitation syndromes, 16 studies on atrial flutter, nine studies related to other atrial tachycardias, 29 studies in general on AF, and 18 studies on VT. These studies were primarily single-centre cohort reports. Only ten of these studies (9%) were RCTs.

  iStent : un traitement ...  

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Un ECR comportant une période de suivi de 12 mois, auprès de 239 patients atteints de GAO léger à modéré, a évalué l’innocuité et l’efficacité du iStent. L’étude a comparé les patients subissant une chirurgie de la cataracte jumelée à la pose d’un iStent à des patients subissant seulement une chirurgie.

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A 12-month follow-up RCT3 involving 239 patients with mild to moderate OAG assessed the safety and efficacy of the iStent. The study compared patients receiving cataract surgery in combination with the iStent versus patients receiving cataract surgery alone. The authors reported that the patients who had the iStent implant experienced statistically and clinically significant benefits in reducing IOP with less medication. The safety profile for the two patient groups was similarly favourable. Follow-up at two years found significantly better IOP control in the iStent treatment group compared with the control group in patients not taking any medication for OAG.

  iStent : un traitement ...  

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Un ECR comportant un suivi de 12 mois chez 33 patients atteints de GAO ou d’hypertension oculaire a évalué les changements dans la dynamique de l’humeur aqueuse ainsi que l’efficacité et l’innocuité du iStent.

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A 12-month follow-up RCT6 of 33 patients with OAG or ocular hypertension evaluated the changes in aqueous humour dynamics, and the efficacy and safety of the iStent. The study population consisted of patients who received two iStents in combination with cataract surgery and patients who underwent cataract surgery alone. At one year, the authors indicated that the iStent group (n = 17) showed a clinically significant increase in trabecular outflow facility, significant IOP reduction, and a reduction in reliance on ocular medications compared with the control group (n = 16).

  Les triptans dans la cr...  

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L’administration du sumatriptan par voie nasale devrait être réévaluée chez l’adolescent. Huit ECR ont permis de démontrer l’efficacité de cinq triptans chez l’adolescent en les comparant à des placebos identiques.

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Nasal sumatriptan requires consideration in adolescents. The evidence of effectiveness in adolescents was derived from eight RCTS comparing five triptans to identical placebos. Only sumatriptan 20 mg nasal spray significantly increased the likelihood of a two-hour response, with the combined results of two trials suggesting a number needed-to-treat of 10 (95% CI: 6, 36).The combined response of sumatriptan recipients from both trials showed a 38% response rate for achieving freedom from pain at two hours, with a number needed-to treatof 10 (95% CI: 6, 30]

  Le sevelamer dans l’ins...  

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Nous avons effectué une étude méthodique pour relever la documentation pertinente en cherchant dans de multiples bases de données selon une stratégie définie et en faisant une recherche manuelle dans les revues scientifiques pertinentes. Les données sur l’efficacité théorique viennent d’essais cliniques randomisés (ECR).

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We did a systematic review to identify relevant literature, by searching multiple databases using a defined strategy, and by hand searching relevant journals. Evidence of efficacy was determined from randomized controlled trials (RCTs). Evidence of harm was determined from trials or registries where data was gathered prospectively. Ten RCTs with a total of 3,025 participants were included in the efficacy analysis; 28 prospective trials with a total of 3,983 participants were identified and eligible for the review of harm. One unpublished, randomized, unblinded study of 2,103 dialysis patients was designed to measure overall survival and cardiovascular mortality.

  Le sevelamer dans l’ins...  

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Nous avons effectué une étude méthodique pour relever la documentation pertinente en cherchant dans de multiples bases de données selon une stratégie définie et en faisant une recherche manuelle dans les revues scientifiques pertinentes. Les données sur l’efficacité théorique viennent d’essais cliniques randomisés (ECR).

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We did a systematic review to identify relevant literature, by searching multiple databases using a defined strategy, and by hand searching relevant journals. Evidence of efficacy was determined from randomized controlled trials (RCTs). Evidence of harm was determined from trials or registries where data was gathered prospectively. Ten RCTs with a total of 3,025 participants were included in the efficacy analysis; 28 prospective trials with a total of 3,983 participants were identified and eligible for the review of harm. One unpublished, randomized, unblinded study of 2,103 dialysis patients was designed to measure overall survival and cardiovascular mortality.

  Les endoprothèses à  él...  

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Un ECR multinational, parrainé par l’industrie, comportant 479 patients atteints d’AP fémoro-poplitée au-dessus du genou, a comparé le Zilver PTX à l’angioplastie par ballonnet2. L’issue d’innocuité primaire fut atteinte, c’est-à-dire un taux de survie sans événement après 12 mois de 90,5 % chez les patients faisant parti du groupe de traitement avec le Zilver PTX, et de 83,9 % chez les patients du groupe témoin traités par angioplastie.

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An industry-sponsored, multinational RCT involving 479 patients with above-the-knee femoropopliteal PAD compared the Zilver PTX with balloon angioplasty.2 The primary safety end point was met, with an event-free survival rate at 12 months of 90.5% for patients in the Zilver PTX treatment group and 83.9% for patients in the angioplasty control group. Primary patency rate at 12 months was 82.7% in the Zilver PTX group and 32.7% in the angioplasty group.

  Efficacité comparative ...  

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Dans le cadre de la présente étude méthodique, seuls des essais cliniques contrôlés et à répartition aléatoire (ECR) sur l’efficacité comparative de la rosiglitazone ou de la pioglitazone et d’autres antidiabétiques ont été sélectionnés par une vaste recherche documentaire.

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In this systematic review, only randomized controlled trials comparing the efficacy of rosiglitazone or pioglitazone with other anti-diabetic agents were selected from a broad literature search. Primary outcome measures were fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c). A total of 19 relevant trials were found, 11 rosiglitazone and eight pioglitazone trials. The observation period for most studies was 52 weeks or less.

  Antipsychotiques atypiq...  

Show textShow cached sourceOpen source URL	Grâce au système d’alerte de publication d’ECR, maintenu jusqu’en mai 2011, nous avons repéré quatre études conformes aux critères d’admissibilité, mais les analyses de sensibilité, qui incorporent ces nouvelles données, ne changent rien vraiment aux résultats de l’étude méthodique.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Meta-analyses were performed, where appropriate, to obtain pooled estimates of effect. Monthly RCT alerts were maintained until May of 2011. Four studies meeting the inclusion criteria were identified via these alerts, but sensitivity analyses incorporating the new data from these trials did not significantly affect the results of the analyses.

  Analyse de l’efficacité...  

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Seize publications3-18 rendent compte de 14 essais cliniques comparatifs et randomisés (ECR) qui portent sur 11 317 patients dans l’ensemble. Les métaanalyses ne révèlent pas de différences d’importance clinique entre les interventions sur les plans du décès d’origine vasculaire, de l’angioplastie sélective en urgence, de l’IM non mortel, de l’AVC ou de l’hémorragie majeure.

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Sixteen publications3-18 reported findings from 14 randomized controlled trials (RCTs) with a total of 11,317 patients. Based on the meta-analyses performed, no clinically important differences between interventions were found in vascular death, urgent target vessel revascularization, non-fatal MI, stroke, or major bleeds. The only difference that was observed occurred in the comparison of ASA plus ticlopidine to ASA alone for the outcome measure of all target vessel revascularizations. A meta-analysis of composite end point data was considered to be inappropriate, but a narrative review of findings from large RCTs suggests that the use of ASA plus clopidogrel reduced the rates of cardiovascular events compared with ASA alone.

  Gestion optimale du tra...  

Show textShow cached sourceOpen source URL	Nous avons recensé 18 études primaires, à savoir 6 essais cliniques comparatifs et randomisés (ECR) et 12 études non randomisées, qui satisfont les critères d’admissibilité. Elles ont été publiées dans la période allant de 2006 à 2011.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Eighteen primary studies — six randomized controlled trials (RCTs) and 12 non-randomized studies — met inclusion criteria. All included primary studies (RCTs and non-randomized studies) were published between 2006 and 2011. Sample sizes ranged from 40 to 13,052.

  Antipsychotiques atypiq...  

Show textShow cached sourceOpen source URL	Les limites de l’étude méthodique relèvent de l’insuffisance et de la piètre qualité des données probantes. Les auteurs jugent que 27 des 30 ECR retenus pêchent par laxisme méthodologique. Les essais cliniques sont brefs et n’ont pas la puissance suffisante pour évaluer objectivement les aspects d’intérêt, particulièrement l’innocuité.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Limitations of this systematic review include lack of and low quality of available evidence. Of the 30 included RCTs, 27 were rated as being of “poor” methodological quality. The trials were of short duration and had inadequate study power, particularly for safety outcomes.

  Antipsychotiques atypiq...  

Show textShow cached sourceOpen source URL	Les ECR retenus examinent les stratégies thérapeutiques que voici :
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	The selected RCTs studied the following treatment strategies:

  à‰tude méthodique de la...  

Show textShow cached sourceOpen source URL	Parmi les 33 essais cliniques contrôlés et randomisés (ECR) retenus pour les besoins de l’étude, 12 sont axés sur l’AVC, 15 sur l’infirmité motrice cérébrale, deux sur la sclérose en plaques et quatre sur d’autres affections.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Of the 33 RCTs included in the review, 12 focused on patients with stroke, 15 on patients with cerebral palsy, two on patients with multiple sclerosis and four on patients with other disorders.

  Le Point sur le PCEM, n...  

Show textShow cached sourceOpen source URL	Annexe 8 : CONSORT : mode de présentation de l’ECR et du cheminement des participants de l’essai clinique
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Appendix 8: CONSORT Reporting Standard for Documenting Patient Flow

  Revêtement de polyéthyl...  

Show textShow cached sourceOpen source URL	Un ECR* en cours pourrait venir combler cette lacune.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	An upcoming RCT* may address the gap.

  Analyse de l’efficacité...  

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Les études cliniques (ECR et études observationnelles) qui se penchent sur le sujet de la durée de traitement optimale mentionnent que le traitement de longue durée est plus avantageux que le traitement à brève échéance en cas de mise en place d’endoprothèses.

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Clinical studies (RCTs and observational studies) examining the optimal duration of clopidogrel therapy suggest that patients with stent placement benefit from the longer-term use of clopidogrel compared with short-term treatment. Studies indicated that the shorter time required for a reimbursement decision in a Canadian provincial drug reimbursement program for clopidogrel therapy is associated with better patient outcomes. One observational study20 implied the possibility of a clopidogrel rebound effect. The authors were unable to identify any study that could help answer the third (plus fourth and fifth), sixth, and thirteenth research question. Few studies examine the effectiveness of dipyridamole or ASA extended-release dipyridamole.

  Gestion optimale du tra...  

Show textShow cached sourceOpen source URL	Les lignes directrices de pratique clinique publiées en 2008 par l’American College of Chest Physicians recommandent une démarche systématique et coordonnée dans la gestion de l’anticoagulation dans le cadre de services spécialisés par exemple7. Cette recommandation s’appuie sur une analyse documentaire exhaustive faisant ressortir la même divergence entre les ECR et les études observationnelles.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Clinical practice guidelines produced by the ACCP in 2008 recommend a systematic and coordinated approach to anticoagulation therapy, using specialized anticoagulation management services as an example.7 This recommendation was based on a comprehensive literature review that showed a similar discrepancy between RCT and observational studies.

  Médicaments utilisés da...  

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Conformément aux critères d’admissibilité, l’essai clinique comparatif et randomisé (ECR) évalue l’abstinence durant au moins six mois depuis l’arrêt du tabagisme en vertu d’indicateurs biochimiques validés.

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For the clinical review, a total of 155 articles (from August 1982 to June 2009) describing 143 trials were selected for inclusion in the clinical analyses. To meet the inclusion criteria, randomized controlled trials (RCTs) must have reported biochemically validated measures of smoking abstinence from the study start date or from the target quit date of at least six months. Analyses were conducted using a Bayesian random effects model for mixed treatment comparisons meta-analysis. Continuous abstinence rates (patients have not smoked at all since quitting) and point prevalence abstinence rates (patients have not smoked in the past seven days) were analyzed separately.

  L’infliximab et l’étane...  

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La recherche documentaire a débouché sur la recension de 8 rapports d’évaluation d’une technologie de la santé (ETS), 14 études méthodiques, 6 essais cliniques comparatifs et randomisés (ECR) et 1 étude observationnelle (pas de témoins prospectifs) sur le moment d’instauration du traitement; 12 études observationnelles portant sur l’adaptation posologique; 8 études observationnelles axées sur la substitution.

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There is uncertainty about the long-term (≥12 months) clinical impact compared to traditional disease-modifying anti-rheumatic drugs (DMARDs) and whether the additional cost is justifiable. There is uncertainty about the effectiveness of using one anti-TNF agent in patients who were failed by another, which agents should be used first, and whether the timing of therapeutic onset influences clinical effectiveness. There is uncertainty about the known clinical effectiveness of escalating dose.

  Médicaments utilisés da...  

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Quelques ECR comparent la multithérapie à la monothérapie. Le couple gomme à mâcher et timbre cutané de nicotine est plus efficace que le timbre seul du point de vue de l’abstinence complète pendant six mois, mais pas durant un an (un ECR, N = 374).

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There were few RCTs of combined therapy versus monotherapy. The addition of nicotine gum to nicotine patch was superior compared with nicotine patch alone for the six-month continuous abstinence rate, but not at one year of follow-up (one RCT, N = 374). The combined therapies of nicotine patch and inhaler or bupropion and NRT did not provide an added effect compared with monotherapy (four RCTs). Thus, combined therapy should be prescribed with caution because the evidence is scarce and the adverse effects unknown.

  Médicaments utilisés da...  

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Quelques ECR comparent la multithérapie à la monothérapie. Le couple gomme à mâcher et timbre cutané de nicotine est plus efficace que le timbre seul du point de vue de l’abstinence complète pendant six mois, mais pas durant un an (un ECR, N = 374).

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There were few RCTs of combined therapy versus monotherapy. The addition of nicotine gum to nicotine patch was superior compared with nicotine patch alone for the six-month continuous abstinence rate, but not at one year of follow-up (one RCT, N = 374). The combined therapies of nicotine patch and inhaler or bupropion and NRT did not provide an added effect compared with monotherapy (four RCTs). Thus, combined therapy should be prescribed with caution because the evidence is scarce and the adverse effects unknown.

  Médicaments utilisés da...  

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Quelques ECR comparent la multithérapie à la monothérapie. Le couple gomme à mâcher et timbre cutané de nicotine est plus efficace que le timbre seul du point de vue de l’abstinence complète pendant six mois, mais pas durant un an (un ECR, N = 374).

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There were few RCTs of combined therapy versus monotherapy. The addition of nicotine gum to nicotine patch was superior compared with nicotine patch alone for the six-month continuous abstinence rate, but not at one year of follow-up (one RCT, N = 374). The combined therapies of nicotine patch and inhaler or bupropion and NRT did not provide an added effect compared with monotherapy (four RCTs). Thus, combined therapy should be prescribed with caution because the evidence is scarce and the adverse effects unknown.

  Gestion optimale du tra...  

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Les études primaires ne permettent pas de déceler une tendance précise, mais leurs constatations illustrent les différences entre les ECR et les études non randomisées relevées par les études méthodiques.

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Results from systematic reviews indicate that specialized anticoagulation clinics result in higher TTR compared with UC, but do not tend to result in significant differences in bleeding events, thromboembolism, or mortality. While the additional primary studies are insufficient to identify a trend, their findings reflect the difference between RCTs and non-randomized studies described in the systematic reviews.

  Méta-analyse des bispho...  

Show textShow cached sourceOpen source URL	Aucun des bisphosphonates ne réduit les fractures de la hanche, les fractures du poignet ou d’autres fractures non vertébrales. L’effet de l’alendronate se limite à la réduction du risque de fractures vertébrales décelées à la radiographie dans un ECR.
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Bisphosphonates have no demonstrated direct impact on clinically important fractures in primary prevention. None of the bisphosphonates showed reductions in hip, wrist, or other non-vertebral fractures. The effect of alendronate is limited to an observed reduced risk of radiographic vertebral fractures in one RCT. This surrogate outcome has been linked to excess morbidity and mortality.

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On a relevé deux ECR qui ne faisaient pas partie des études méthodiques ou des ETS. Un de ces essais (n = 106) essayait de trouver si l’observance et les résultats cliniques différaient entre des patients qui devaient, être diagnostiqués de façon aléatoire, à la maison, par auto titrage par ventilation spontanée en pression positive continue ou par polysomnographie classique en laboratoire.

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Two RCTs not included in the identified HTAs or systematic reviews were retrieved. One RCT (n = 106) assessed whether CPAP compliance and clinical outcomes differed between patients who were randomly assigned to home diagnosis and CPAP autotitration or conventional laboratory PSG. At a six-week follow-up clinic visit, CPAP compliance and the clinical outcomes evaluated did not differ between the two groups. Another RCT (n = 62)

  Analyse de l’efficacité...  

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Pour les besoins de l’étude, nous reprenons les données sur le groupe présentant un syndrome coronaire aigu et celles sur le groupe atteint de vasculopathie périphérique qui proviennent de l’essai CAPRIE et celles à propos du groupe atteint de vasculopathie de l’essai CHARISMA; ces essais sont conçus pour examiner le médicament dans les deux indications. Donc, ces deux ECR ne prévoient pas de randomisation, et ce fait est à prendre en considération dans l’interprétation des résultats des analyses de sous-groupes.

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This review has limitations. Not all trial reports documented data on all the outcomes of interest. This may introduce bias, because it has been shown that statistically significant results are more likely to be reported than statistically non-significant results.26 For this review, data from the ACS and PVD groups of the CAPRIE trial and the PVD group of the CHARISMA trial were used, which were designed with a mixed population. Therefore, the groups were not randomized in these two RCTs. This needs to be considered when viewing the results of subgroup analyses.

  Le remplacement valvula...  

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Un ECR compare le RVAC – avec la valve SAPIEN – à la CRVA; un deuxième ECR compare le RVAC – avec la valve SAPIEN – au traitement non chirurgical usuel; et le troisième ECR fait la description d’un sous-groupe de l’essai PARTNER qui présente des événements neurologiques, et compare la RVAC avec la valve SAPIEN au CRVA.

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The meta-analysis14 compared TAVR — using either the Medtronic CoreValve or Edwards SAPIEN valve — with SAVR. One RCT15 compared TAVR, using the SAPIEN valve, with SAVR; a second RCT16 compared TAVR, using the SAPIEN valve, with standard, non-surgical therapy; and the third RCT reported on a subgroup of the PARTNER trial of patients experiencing neurological events, comparing TAVR using the SAPIEN valve with SAVR. The non-randomized study18 compared TAVR, using either the CoreValve or SAPIEN valve, with SAVR. None of the studies specified the type of SAPIEN valves used.

  Le remplacement valvula...  

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Un ECR compare le RVAC – avec la valve SAPIEN – à la CRVA; un deuxième ECR compare le RVAC – avec la valve SAPIEN – au traitement non chirurgical usuel; et le troisième ECR fait la description d’un sous-groupe de l’essai PARTNER qui présente des événements neurologiques, et compare la RVAC avec la valve SAPIEN au CRVA.

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The meta-analysis14 compared TAVR — using either the Medtronic CoreValve or Edwards SAPIEN valve — with SAVR. One RCT15 compared TAVR, using the SAPIEN valve, with SAVR; a second RCT16 compared TAVR, using the SAPIEN valve, with standard, non-surgical therapy; and the third RCT reported on a subgroup of the PARTNER trial of patients experiencing neurological events, comparing TAVR using the SAPIEN valve with SAVR. The non-randomized study18 compared TAVR, using either the CoreValve or SAPIEN valve, with SAVR. None of the studies specified the type of SAPIEN valves used.

  Le remplacement valvula...  

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Un ECR compare le RVAC – avec la valve SAPIEN – à la CRVA; un deuxième ECR compare le RVAC – avec la valve SAPIEN – au traitement non chirurgical usuel; et le troisième ECR fait la description d’un sous-groupe de l’essai PARTNER qui présente des événements neurologiques, et compare la RVAC avec la valve SAPIEN au CRVA.

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The meta-analysis14 compared TAVR — using either the Medtronic CoreValve or Edwards SAPIEN valve — with SAVR. One RCT15 compared TAVR, using the SAPIEN valve, with SAVR; a second RCT16 compared TAVR, using the SAPIEN valve, with standard, non-surgical therapy; and the third RCT reported on a subgroup of the PARTNER trial of patients experiencing neurological events, comparing TAVR using the SAPIEN valve with SAVR. The non-randomized study18 compared TAVR, using either the CoreValve or SAPIEN valve, with SAVR. None of the studies specified the type of SAPIEN valves used.

  Méta-analyse des bispho...  

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Il s’agit d’une étude méthodique d’essais cliniques comparatifs et randomisés (ECR) qui comparent l’étidronate, l’alendronate et le risédronate au placebo en période postménopausique. Les ECR ont été classés en deux catégories, celle de la prévention primaire et celle de la prévention secondaire, selon l’absence ou la présence de fractures avant le traitement.

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We performed a systematic review to identify randomized controlled trials (RCTs) that compared postmenopausal women taking etidronate, alendronate, or risedronate to those on placebo. RCTs were categorized as primary or secondary prevention based on the absence or presence of pre-existing fractures. We meta-analyzed data from 11 etidronate RCTs (1,248 women), 11 alendronate RCTs (12,099 women), and six risedronate RCTs (13,795 women) to estimate the impact on fractures and adverse events. Seven RCTs were primary prevention trials. Additional analyses examined the influence of dose, duration, and baseline characteristics, including age, on effect estimates.

  Antipsychotiques atypiq...  

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Les échelles PANSS et CGI sont les instruments de mesure de l’efficacité dans la majorité des ECR choisis, mais il faut savoir que la relation entre la variation du score PANSS et l’évolution de l’état de santé du patient à long terme n’a pas été précisément établie42.

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It was difficult to compare across trials because of differences in dosing and because the RCTs included patients with various treatment histories — often, dosing levels and treatment history were not reported. There was also heterogeneity in reported outcomes (e.g., different definitions for inadequate control) and lack of data on many clinically important outcomes. In particular, there was insufficient evidence available for mortality, hospitalizations, relapse rates, suicidality, health-related quality of life, level of function, and long-term adverse effects of combination or high-dose antipsychotic use. PANSS and CGI were the primary efficacy outcomes reported in the majority of included RCTs; however, the relationship between the change in PANSS score and long-term clinical outcomes has not been well-established.42

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On a relevé deux ECR qui ne faisaient pas partie des études méthodiques ou des ETS. Un de ces essais (n = 106) essayait de trouver si l’observance et les résultats cliniques différaient entre des patients qui devaient, être diagnostiqués de façon aléatoire, à la maison, par auto titrage par ventilation spontanée en pression positive continue ou par polysomnographie classique en laboratoire.

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Two RCTs not included in the identified HTAs or systematic reviews were retrieved. One RCT (n = 106) assessed whether CPAP compliance and clinical outcomes differed between patients who were randomly assigned to home diagnosis and CPAP autotitration or conventional laboratory PSG. At a six-week follow-up clinic visit, CPAP compliance and the clinical outcomes evaluated did not differ between the two groups. Another RCT (n = 62)

  Méta-analyse des bispho...  

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Il s’agit d’une étude méthodique d’essais cliniques comparatifs et randomisés (ECR) qui comparent l’étidronate, l’alendronate et le risédronate au placebo en période postménopausique. Les ECR ont été classés en deux catégories, celle de la prévention primaire et celle de la prévention secondaire, selon l’absence ou la présence de fractures avant le traitement.

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We performed a systematic review to identify randomized controlled trials (RCTs) that compared postmenopausal women taking etidronate, alendronate, or risedronate to those on placebo. RCTs were categorized as primary or secondary prevention based on the absence or presence of pre-existing fractures. We meta-analyzed data from 11 etidronate RCTs (1,248 women), 11 alendronate RCTs (12,099 women), and six risedronate RCTs (13,795 women) to estimate the impact on fractures and adverse events. Seven RCTs were primary prevention trials. Additional analyses examined the influence of dose, duration, and baseline characteristics, including age, on effect estimates.

  L’efficacité des inhibi...  

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Il est donc nécessaire de comparer, dans le cadre d'ECR, des IPP, d'autres agents stimulant la motilité gastrique (comme le dompéridone) et des antagonistes H2 dans la dyspepsie fonctionnelle, en présence et en l'absence de H. pylori.

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Conclusion This meta-analysis demonstrates that PPIs are effective in functional dyspepsia as compared with placebo. Based on other meta-analyses, prokinetic agents such as cisapride and H2-antagonists have lower NNTs than PPIs and thus might appear more efficacious. Unfortunately, there are no direct comparison trials between the three agents and therefore there is no conclusive evidence that one agent is the best. Only one trial has demonstrated no difference between PPIs and H2?antagonists. Further RCTs comparing PPIs, other prokinetic agents (such as domperidone), and H2?antagonists, in H.pylori positive and negative patients with functional dyspepsia, are needed. .

  Rapport en bref d'exame...  

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En raison du très grand nombre d’articles repérés, on n’a retenu que les évaluations des technologies de la santé, les examens méthodiques et les méta-analyses. On n’a pas tenu compte des essais comparatifs et randomisés (ECR) ni des études non randomisées.

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A limited literature search of key resources was conducted, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria. Due to the large volume of literature, the final selection of articles was restricted to health technology assessments, systematic reviews, and meta-analyses. Individual randomized controlled trials (RCTs) and non-randomized studies were not considered.

  Les dispositifs à  ultr...  

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Quant à lui, le troisième examen arrivait à la conclusion suivante : « Les données probantes provenant d’ECR sont insuffisantes pour justifier la promotion de stratégies cliniques fondées sur l’utilisation de l’échographie dans l’établissement d’un diagnostic chez les patients chez qui l’on soupçonne la présence d’un traumatisme abdominal fermé. »

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Two clinical practice guidelines suggested that focused abdominal sonography for trauma (FAST) was useful as an initial screening tool when used by surgeons for patients with blunt abdominal trauma. The recommendations from these guidelines were inconsistent with the findings of three systematic reviews. One concluded that more trials should be conducted before ultrasound is accepted as a standard test for the evaluation of blunt trauma. Another review concluded that in terms of clinically suspected abdominal trauma, other effective assessment (i.e., CT) should be performed regardless of the initial sonographic findings. The third review concluded: “There is insufficient evidence from RCTs to justify promotion of ultrasound-based clinical pathways in diagnosing patients with suspected blunt abdominal trauma.”

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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On a utilisé une échelle de Jadad modifiée pour évaluer la qualité méthodologique des ECR. Les paramètres d’intérêt étaient le contrôle de la glycémie (hémoglobine glycosylée [HbA1c] et glycémie à jeun), l’hypoglycémie, le poids corporel, la qualité de vie, la satisfaction des patients, l’utilisation des ressources en santé et les complications à long terme du diabète.

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A modified Jadad scale was used to evaluate the methodological quality of randomized controlled trials (RCTs). Outcomes of interest included glycemic control (glycosylated hemoglobin or A1C, fasting plasma glucose), hypoglycemia, body weight, quality of life, patient satisfaction, health care utilization, and long-term complications of diabetes. Two reviewers independently extracted data from each article, and appraised methodological quality. Differences were discussed and resolved by consensus. Where appropriate, quantitative pooling of results through random-effects meta-analysis was conducted using Review Manager 4.2 to generate estimates of treatment effect. In the absence of reported carry-over effects, data from crossover trials were combined with those from parallel trials in a single meta-analysis. When a carry-over effect was reported in a crossover RCT for a particular outcome, these data were excluded from meta-analysis. A number of subgroup and sensitivity analyses were conducted.

  Les analogues de l’insu...  

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Les principaux concepts de recherche étaient le diabète et les analogues de l’insuline à action prolongée (IGlar et IDét) et à courte durée d’action (glulisine, ILisp et IAsp). Un filtre a été utilisé pour limiter la recherche aux essais contrôlés et randomisés (ECR).

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The following bibliographic databases were searched through the Ovid interface: MEDLINE (MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE Daily Update), Embase, and BIOSIS Previews. The Cochrane Library was searched using the Wiley interface. The search strategy was comprised of both controlled vocabulary, such as the National Library of Medicine’s MeSH (Medical Subject Headings), and keywords. The main search concepts were diabetes and long-acting insulin analogues (glargine and detemir) and short-acting insulin analogues (glulisine, ILisp, and IAsp). A literature filter was applied to limit retrieval to randomized controlled trials.

  Risque de transmission ...  

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La recherche comporte des filtres pour l’orienter vers les ETS, les études méthodiques, les métaanalyses, les essais cliniques comparatifs et randomisés (ECR), les études comparatives non randomisées et les lignes directrices.

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An information specialist performed a literature search on key health technology assessment (HTA) resources. The search included all languages and was limited to articles published between January 1, 1990 and October 22, 2010. Regular alerts were current to January 15, 2011. Filters were applied to limit the retrieval to HTAs, systematic reviews, meta-analyses, randomized controlled trials, non-randomized controlled studies, and guidelines. The studies selected were HTAs, systematic reviews, meta-analyses, randomized controlled trials, and non-randomized controlled trials that evaluated the risk of disease transmission to health care workers exposed to aerosol-generating procedures. The outcome of interest was risk of disease transmission. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

  Risque de transmission ...  

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La recherche comporte des filtres pour l’orienter vers les ETS, les études méthodiques, les métaanalyses, les essais cliniques comparatifs et randomisés (ECR), les études comparatives non randomisées et les lignes directrices.

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An information specialist performed a literature search on key health technology assessment (HTA) resources. The search included all languages and was limited to articles published between January 1, 1990 and October 22, 2010. Regular alerts were current to January 15, 2011. Filters were applied to limit the retrieval to HTAs, systematic reviews, meta-analyses, randomized controlled trials, non-randomized controlled studies, and guidelines. The studies selected were HTAs, systematic reviews, meta-analyses, randomized controlled trials, and non-randomized controlled trials that evaluated the risk of disease transmission to health care workers exposed to aerosol-generating procedures. The outcome of interest was risk of disease transmission. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

  Le remplacement valvula...  

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La méta-analyse retenue a mis en commun des données d’études qui différaient au niveau du devis, de la taille des échantillons, et des paramètres de départ, ce qui réduit la puissance des comparaisons directes. Les trois ECR inclus dans le présent examen portent sur un seul essai (PARTNER).

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The robustness of the evidence on the comparative long-term clinical efficacy of TAVR is limited because of the nature of the available evidence. The included meta-analysis14 pooled data from studies with different designs, sample sizes, and baseline characteristics, reducing the strength of direct comparisons. All three RCTs included in the review were from one trial (PARTNER); patients were randomized, but in the included studies, most study sites were reporting on their initial experiences with TAVR, resulting in a potential learning curve impact on the results as surgeons gained experience with the technique. Patient enrollment into the non-randomized study might have influenced an investigator’s decision to attempt treatment.

  Antipsychotiques atypiq...  

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Deux examinateurs, chacun de son côté, ont sélectionné les études en fonction de critères établis au préalable; ils ont réglé les divergences d’opinions le cas échéant par la discussion ou l’intervention d’un tiers. En fin de compte, l’étude méthodique englobe 30 essais cliniques comparatifs et randomisés (ECR).

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The population of interest for this review was adolescents (aged 13 to 17 years) and adults (aged 18 years and older) with schizophrenia or schizoaffective disorder who were inadequately managed with one or more AAPs at recommended doses. For the systematic review, a literature search was conducted on June 16, 2010 in medical databases and restricted to English or French publications. Monthly alerts were monitored until publication of the report. A search of grey literature (literature that is not commercially published) was also conducted. Studies were selected independently, by two reviewers, based on set criteria, with discrepancies resolved through discussion or the judgment of a third reviewer. Ultimately, the systematic review encompassed 30 unique randomized controlled trials (RCTs).

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Le protecteur de hanche...  

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L’étude clinique a été retenue lorsqu’elle était conforme aux critères suivants : structure — ETS, étude méthodique, essai clinique comparatif et randomisé (ECR) ou étude observationnelle; population — personnes résidant dans un établissement de SLD ou de soins assistés ou supervisés (mais pas une personne bénéficiant de soins à domicile ou communautaires); intervention — un protecteur de hanche (à coque souple ou rigide); comparateur — pas établi au préalable (il pouvait s’agir des soins usuels, d’un traitement médicamenteux, etc.); critères de jugement — la blessure ou la fracture de hanche.

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Included clinical studies needed to meet the following criteria: study design — HTA, systematic review, randomized controlled trial (RCT) or observational study; population — patients in LTC or assisted or supervised care facilities (but not home care or community use); intervention — hip protectors (both hard- and soft-shelled) ; comparator — not specified a priori (could be usual care, drug therapy, etc.); outcomes — hip injuries or fractures. Criteria for the economic evaluations were similar except that the study design was a full economic evaluation and the outcome was a summary measure of the trade-off between additional cost and additional benefit. Guidelines relating to hip protector use were also reviewed. Evidence on compliance with hip protector use, as well as evidence on who might best benefit from hip protectors, was compiled.

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Le protecteur de hanche...  

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Le risque relatif (RR) varie d’une étude méthodique à une autre, principalement en raison de la disparité des études examinées dans les méta-analyses. Un ECR publié après ces études méthodiques a également été examiné.

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Five systematic reviews on the effectiveness of hip protectors were retrieved. They all found hip protectors had a protective effect on hip fractures for the elderly in residential care. The relative risk (RR) varied between the systematic reviews, largely because the individual studies included in the meta-analyses differed. One RCT published subsequent to the systematic reviews was included. It did not find a protective effect for hip protectors, but the trial did not employ the recommended use for hip protectors. One observational study, described in two separate articles, was also included. Using the same group of patients in a pre-test/post-test design, it found hip protectors reduced the incidence of hip fracture and resulted in an odds ratio of 0.31 for hip protector wearers versus non-wearers.

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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On a utilisé une échelle de Jadad modifiée pour évaluer la qualité méthodologique des ECR. Les paramètres d’intérêt étaient le contrôle de la glycémie (hémoglobine glycosylée [HbA1c] et glycémie à jeun), l’hypoglycémie, le poids corporel, la qualité de vie, la satisfaction des patients, l’utilisation des ressources en santé et les complications à long terme du diabète.

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A modified Jadad scale was used to evaluate the methodological quality of randomized controlled trials (RCTs). Outcomes of interest included glycemic control (glycosylated hemoglobin or A1C, fasting plasma glucose), hypoglycemia, body weight, quality of life, patient satisfaction, health care utilization, and long-term complications of diabetes. Two reviewers independently extracted data from each article, and appraised methodological quality. Differences were discussed and resolved by consensus. Where appropriate, quantitative pooling of results through random-effects meta-analysis was conducted using Review Manager 4.2 to generate estimates of treatment effect. In the absence of reported carry-over effects, data from crossover trials were combined with those from parallel trials in a single meta-analysis. When a carry-over effect was reported in a crossover RCT for a particular outcome, these data were excluded from meta-analysis. A number of subgroup and sensitivity analyses were conducted.

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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Au total, 26 articles ont été retenus pour le présent examen. Quatre étaient le compte rendu intégral d’ECR dont le résumé avait été utilisé dans le rapport antérieur de l’ACMTS9. Les données de trois des ECR avaient fait l’objet de deux publications et celles de l’autre ECR, de trois résumés.

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A total of 26 articles were included in the review. Four of these articles were found to be full-text publications of abstracts included in the previous CADTH report.9 Data from each of three RCTs were reported in two separate publications, while data from one RCT were reported in three abstracts. Because the various reports contained information on different outcomes, they were all included in the review. The combined total number of selections from the updating process and studies selected in the technology report9 was 58. These 58 articles represented 52 unique RCTs. Of these, 32 were on type 1 diabetes (including both pediatric and adult populations) and 20 were on adult patients with type 2 diabetes. No RCTs pertaining to long-acting insulin analogues in gestational diabetes or pediatric type 2 diabetes were identified. Trial duration ranged from four to 52 weeks. The overall quality of most RCTs was low. All studies were of open-label design.

  Les analogues de l’insu...  

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Comme aucun des ECR sur lesquels la présente méta-analyse a porté n’avait été mené à double insu, le score des ECR ne pouvait dépasser 3 sur 5 et on considérait que presque tous les essais avaient d’importantes limites méthodologiques.

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Use of the Jadad scale may be considered suboptimal given the practical difficulties associated with blinding trials comparing long-acting analogues (which are clear solutions) with NPH insulin (which is cloudy). As none of the RCTs included in this meta-analysis was double-blinded, the maximum score achievable was 3 out of 5, and nearly all studies were considered to have significant methodological limitations. Despite the practical difficulties involved, however, the lack of blinding does introduce a potential source of ascertainment bias, especially for subjective outcomes such as patient-reported hypoglycemia and quality of life. Use of the Jadad scale was therefore considered appropriate to evaluate methodological quality, especially in light of the additional items considered, which included allocation concealment, blinding of assessors, intention-to-treat analysis, and loss to follow-up. Given that the Jadad scale and additional items together measure all aspects of trial quality that are currently considered relevant to internal validity, it is unlikely that use of a different scale would have significantly affected the results. In fact, the finding that most trials of the long-acting analogues have significant methodological limitations was also reported in a previous systematic review.61

  Remplacement valvulaire...  

Show textShow cached sourceOpen source URL	1 ECR :
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	Country,

  Remplacement valvulaire...  

Show textShow cached sourceOpen source URL	Depuis la publication des ETS décrites ci-dessus, trois nouvelles études ont été publiées sur le RVAC chez les patients atteints de sténose aortique grave19-21. L’ECR de Kodali
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	1. Have HTAs been published that compare TAVR with SAVR, and has new evidence emerged on TAVR effectiveness since the HTA publication?

  Remplacement valvulaire...  

Show textShow cached sourceOpen source URL	Autre ECR
Compare text pagesCompare HTM pagesOpen source URLOpen target URLDefine cadth.ca as primary domain	SAVR

  Les analogues de l’insu...  

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Comme aucun des ECR sur lesquels la présente méta-analyse a porté n’avait été mené à double insu, le score des ECR ne pouvait dépasser 3 sur 5 et on considérait que presque tous les essais avaient d’importantes limites méthodologiques.

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Use of the Jadad scale may be considered suboptimal given the practical difficulties associated with blinding trials comparing long-acting analogues (which are clear solutions) with NPH insulin (which is cloudy). As none of the RCTs included in this meta-analysis was double-blinded, the maximum score achievable was 3 out of 5, and nearly all studies were considered to have significant methodological limitations. Despite the practical difficulties involved, however, the lack of blinding does introduce a potential source of ascertainment bias, especially for subjective outcomes such as patient-reported hypoglycemia and quality of life. Use of the Jadad scale was therefore considered appropriate to evaluate methodological quality, especially in light of the additional items considered, which included allocation concealment, blinding of assessors, intention-to-treat analysis, and loss to follow-up. Given that the Jadad scale and additional items together measure all aspects of trial quality that are currently considered relevant to internal validity, it is unlikely that use of a different scale would have significantly affected the results. In fact, the finding that most trials of the long-acting analogues have significant methodological limitations was also reported in a previous systematic review.61

  Remplacement valvulaire...  

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Ces valves portent le marquage CE (conformité européenne) et/ou sont homologuées par la Food and Drug Administration. Quatre des études sont des ECR qui comparent le RVAC à la chirurgie26-29 chez des patients à risque chirurgical intermédiaire26,28,29 ou chez des patients à risque chirurgical élevé ou très élevé27.

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Two international assessments, one from the Scottish Health Technologies Group (SHTG)11 and the other from the Belgium Health Care Knowledge Centre (KCE)12 compared TAVR with SAVR (Cohort A), and standard of care (Cohort B).11,12 The assessments reported that in patients not suitable for surgery , TAVR was an effective alternative to standard of care. In patients for whom surgery was considered to be high-risk, one assessment reported that TAVR was not inferior to surgery but was associated with a significantly higher incidence of vascular complications and neurological adverse events,11 and the other assessment reported that TAVR might be considered as an alternative to surgery for high-risk patients who are willing to accept a higher risk of stroke. It was noted that from an economic perspective it is hard to defend TAVR reimbursement as an efficient use of resources.12

  Remplacement valvulaire...  

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Depuis janvier 2009, on a publié dix ETS comparant le RVAC à la CRVA chez les patients atteints de sténose aortique grave. Depuis la publication de ces ETS, on a publié les résultats de deux ECR comportant un suivi de deux ans, ainsi que d’une analyse multivariée.

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JenaValve (JenaValve): The JenaValve device received CE Mark approval in September 2011.35 The CE Mark pivotal study was a multicentre, prospective, single-arm study of 67 patients who were at high risk for surgery. Results at 30 days showed that for successfully treated patients either no or minimal paravalvular regurgitation occurred.46 A new observational cohort study is currently recruiting patients with severe aortic stenosis who are at an increased surgical risk for the evaluation of the long-term performance and safety of JenaValve.47

  Les analogues de l’insu...  

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Les résultats d’un ECR ont montré que l’association IDét-IAsp produisait une réduction statistiquement significative du taux d’HbA1c par rapport à l’association IGlar-IAsp (DMP [IC de 95 %] = 0,20 % [0,10 à 0,30])46.

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For adult patients with type 2 diabetes receiving oral antidiabetes drugs, the pooled difference in mean A1C between treatment groups was not statistically significant for IGlar compared with NPH, and significantly favoured NPH in the comparison with IDet (WMD [95% CI] = 0.13 [0.03 to 0.22]).39-41 For patients not receiving oral antidiabetes drugs, the reduction in mean A1C for those using IGlar plus HI, compared with those using NPH plus HI, was statistically significant (WMD [95% CI] = 0.28% [0.07 to 0.49]).42 Also, A1C was statistically significantly reduced in the pooled analysis of IGlar versus thiazolidinediones (TZDs) (WMD [95% CI] = –0.20% [–0.38 to –0.01]).43-45 Results from a single RCT showed a statistically significant A1C reduction for IDet plus IAsp compared with IGlar plus IAsp (WMD [95% CI] = 0.20% [0.10 to 0.30]).46 For fasting plasma glucose (FPG), there were no statistically significant differences between treatment with IGlar versus NPH, IDet versus NPH, or IDet versus IGlar.40,41,46-54 A statistically significant decrease in FPG was shown for IGlar when compared with rosiglitazone (WMD [95% CI] = –1.04 mmol/L [–1.64 to –0.45]).44