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Biomedical subjects

Amit Sood

Publications and source records attributed to Amit Sood.

11 recordsLinked to original sources
PubMed2006

Complementary treatments for tobacco cessation: a survey.

Little information is available regarding the prevalence of use and interest in future use of complementary and alternative medicine (CAM) for tobacco cessation among tobacco users. We conducted a self-administered anonymous survey among 1,175 patients seen at a midwestern outpatient tobacco treatment specialty clinic between November 2003 and July 2005. Patient use of CAM for tobacco cessation, perceived efficacy of these treatments, and interest in future use of CAM were ascertained. Data were summarized using descriptive statistics, and logistic regression models were used to determine the characteristics associated with past CAM use or interest in future use of CAM for tobacco cessation. All of the patients who received the survey completed it. A total of 27% of patients reported previous use of CAM for tobacco cessation. The interventions most commonly used were hypnosis, relaxation, acupuncture, and meditation. CAM treatments most commonly perceived to be efficacious were yoga, relaxation, meditation, and massage therapy. A total of 67% of the patients reported interest in future use of CAM for tobacco cessation. The treatments of greatest interest for use in the future were hypnosis, herbal products, acupuncture, relaxation, and massage therapy. Female gender, previous use of conventional tobacco cessation products, previous use of CAM treatments, and a higher level of education were significantly associated with interest in future CAM use. The high level of interest in CAM among tobacco users underscores the need to conduct further research in this field.

Acupuncture↗
PubMed2006

Search strategies for retrieving complementary and alternative medicine clinical trials in oncology.

PURPOSE: Several Medline search strategies exist to retrieve complementary and alternative medicine (CAM) literature related to oncology. The objective of this study was to compare different search methods to ascertain the most optimal strategy. METHODS: All clinical trials with CAM interventions in patients with cancer, published from 1965 to 2004, were abstracted using 4 different approaches. In the CAM filter search, the PubMed complementary medicine filter was used. The Ovid search was performed using a complex search strategy with the Ovid search engine. CAM keyword and not phytogenic searches involved the CAM filter search with the addition of the search terms "AND (complementary OR alternative)" and "NOT (antineoplastic agents, phytogenic), respectively. Articles were evaluated by 3 reviewers to ascertain whether they were clinical trials, the study intervention was related to CAM, and the condition prevented/treated was cancer related (inclusion criteria). RESULTS: The CAM filter search retrieved 10 718 citations, Ovid retrieved 1190, CAM keyword retrieved 2895, and not phytogenic retrieved 1806. Compared to the CAM filter search, all other methods had significantly lower sensitivity (Ovid 48.3% +/- 3.2%, CAM keyword 5.8% +/- 1.5%, and not phytogenic 77.9% +/- 2.7%, P < .001). The specificity of Ovid (38.4% +/- 2.8%) and not phytogenic (40.8% +/- 2.3%) searches was significantly higher (P < .001) compared to CAM filter (8.8% +/- 0.5%) and CAM keyword searches (1.9% +/- 0.5%). CONCLUSION: The search strategy using PubMed's complementary medicine filter, although comprehensive, lacks specificity; other methods, although more specific, lack sensitivity. Future indexing of all CAM clinical trials with a common medical subject heading term complementary medicine would enhance efficient retrieval of relevant citations.

Clinical Trials as Topic↗
PubMed2006

Can complementary and alternative medicine clinical cancer research be successfully accomplished? The Mayo Clinic-North Central Cancer Treatment Group experience.

Some critics question whether research on complementary and alternative modalities for patients with cancer can be done efficiently in traditional clinical settings. This article reviews a program of complementary medicine research that has been done in a traditional clinical setting over the past 30 years. Trials using complementary therapies for both symptom management and cancer treatment done by the Mayo Clinic and the North Central Cancer Treatment Group are reviewed. Twenty-seven studies have been developed using complementary therapies, addressing such issues as mucosal and epidermal toxicity, hot flashes, lymphedema, anorexia and cachexia, insomnia, cognitive dysfunction, fatigue, and cancer treatment. Nineteen of them have been completed and have had results published in peer-reviewed clinical journals, whereas two manuscripts are in press. Two other trials have recently completed accrual, and the data are being analyzed so that manuscripts can be prepared. In addition, four clinical trials are actively accruing patients. The data presented in this article demonstrate that complementary and alternative medicine research can be done in a scientifically sound manner. Well-designed and adequately powered studies can be implemented, and large numbers of patients can be accrued. The resulting research evaluations can be published in peer-reviewed medical journals.

Biomedical Research↗
PubMed2005

Randomized trials stopped early for benefit: a systematic review.

CONTEXT: Randomized clinical trials (RCTs) that stop earlier than planned because of apparent benefit often receive great attention and affect clinical practice. Their prevalence, the magnitude and plausibility of their treatment effects, and the extent to which they report information about how investigators decided to stop early are, however, unknown. OBJECTIVE: To evaluate the epidemiology and reporting quality of RCTs involving interventions stopped early for benefit. DATA SOURCES: Systematic review up to November 2004 of MEDLINE, EMBASE, Current Contents, and full-text journal content databases to identify RCTs stopped early for benefit. STUDY SELECTION: Randomized clinical trials of any intervention reported as having stopped early because of results favoring the intervention. There were no exclusion criteria. DATA EXTRACTION: Twelve reviewers working independently and in duplicate abstracted data on content area and type of intervention tested, reporting of funding, type of end point driving study termination, treatment effect, length of follow-up, estimated sample size and total sample studied, role of a data and safety monitoring board in stopping the study, number of interim analyses planned and conducted, and existence and type of monitoring methods, statistical boundaries, and adjustment procedures for interim analyses and early stopping. DATA SYNTHESIS: Of 143 RCTs stopped early for benefit, the majority (92) were published in 5 high-impact medical journals. Typically, these were industry-funded drug trials in cardiology, cancer, and human immunodeficiency virus/AIDS. The proportion of all RCTs published in high-impact journals that were stopped early for benefit increased from 0.5% in 1990-1994 to 1.2% in 2000-2004 (P<.001 for trend). On average, RCTs recruited 63% (SD, 25%) of the planned sample and stopped after a median of 13 (interquartile range [IQR], 3-25) months of follow-up, 1 interim analysis, and when a median of 66 (IQR, 23-195) patients had experienced the end point driving study termination (event). The median risk ratio among truncated RCTs was 0.53 (IQR, 0.28-0.66). One hundred thirty-five (94%) of the 143 RCTs did not report at least 1 of the following: the planned sample size (n = 28), the interim analysis after which the trial was stopped (n = 45), whether a stopping rule informed the decision (n = 48), or an adjusted analysis accounting for interim monitoring and truncation (n = 129). Trials with fewer events yielded greater treatment effects (odds ratio, 28; 95% confidence interval, 11-73). CONCLUSIONS: RCTs stopped early for benefit are becoming more common, often fail to adequately report relevant information about the decision to stop early, and show implausibly large treatment effects, particularly when the number of events is small. These findings suggest clinicians should view the results of such trials with skepticism.

Clinical Trials Data Monitoring Committees↗
PubMed2005

Cancer-related fatigue: an update.

Fatigue, one of the most common symptoms experienced by cancer patients, is multidimensional and is associated with significant impairment in functioning and overall quality of life. Although the precise pathophysiology of cancer-related fatigue is not well understood, a number of metabolic, cytokine, neurophysiologic, and endocrine changes have been described in these patients. A better understanding of these abnormalities is likely to lead to novel therapeutic interventions. Clinically, all patients presenting with significant fatigue should be evaluated for treatable conditions that might contribute to this symptom. Exercise and treatment of anemia are the two most established interventions for cancer-related fatigue. Psychostimulants seem promising based on early studies. Several complementary medicine treatments that showed efficacy in preliminary studies merit further testing.

Anemia↗
PubMed2005

Cochrane systematic reviews in acupuncture: methodological diversity in database searching.

BACKGROUND: Since the early 1970s, the efficacy of acupuncture for treating clinical conditions has been evaluated in several hundred randomized trials. Results from these trials have been synthesized in systematic reviews. A well-designed systematic review provides the highest level of evidence for establishing the efficacy of a clinical intervention. OBJECTIVES: The present study assesses the source of original literature contributing to Cochrane reviews on acupuncture. Databases searched to retrieve original studies are evaluated. The distribution of controlled trials in acupuncture across different topic areas and journals, the ability of the reviews to provide conclusive results, and the proportion of original studies indexed with MEDLINE are evaluated. METHODS: Systematic reviews on acupuncture were extracted from the Cochrane Database of Systematic Reviews. The key search term used was "acupuncture." When more than one systematic review was retrieved on the same topic, the most recent review was included. Indexing of individual clinical trials with MEDLINE was searched using the Single Citation Matcher in PubMed. RESULTS: A total of 94 papers were retrieved from the Cochrane database, of which 10 were included in the analysis. The most common subject areas were related to chronic pain. Considerable heterogeneity was observed in the number of databases searched (median 5, range 3-12). A total of 69% (74/108) papers were indexed with PubMed. Only 13% (14/108) of the papers were published in the primary acupuncture journals. Conclusive statements about the efficacy of acupuncture were made in only 2 of the 10 systematic reviews. CONCLUSIONS: Considerable methodological diversity exists in the comprehensiveness of database searches for Cochrane systematic reviews on acupuncture. This diversity makes the reviews prone to bias and adds another layer of complexity in interpreting the acupuncture literature.

Abstracting and Indexing↗
PubMed2004

Using advanced search tools on PubMed for citation retrieval.

PubMed (www.pubmed.gov) provides health care professionals with free access to one of the largest searchable biomedical databases available. However, attempting to find relevant literature in PubMed without an understanding of basic search strategies and tools may be daunting and frustrating. In a previous issue of the Mayo Clinic Proceedings, we presented an overview of searching in PubMed and introduced its basic features. In this article, we build on this foundation and present advanced search tools designed to assist clinicians in performing efficient and focused literature searches.

Information Storage and Retrieval↗
PubMedDate not supplied

Use of methylphenidate in patients with cancer.

Cancer and its treatment are often associated with symptoms such as depression, somnolence, cognitive abnormalities, and fatigue. Methylphenidate, a stimulant medication, is commonly used to treat these symptoms. Several small pilot and a few adequately powered studies have assessed the safety and efficacy of methylphenidate in patients with cancer Overall, the studies so far suggest that methylphenidate is well-tolerated in patients with cancer Further, the studies have provided initial evidence of efficacy of this agent in patients with cancer The present article reviews the evidence base behind the use of methylphenidate in these patients.

Central Nervous System Stimulants↗