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Biomedical subjects

Chris Frampton

Publications and source records attributed to Chris Frampton.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of usual surgical advice versus a nonaggravating six-month gym-based exercise rehabilitation program post-lumbar discectomy: results at one-year follow-up.

BACKGROUND CONTEXT: Discectomy is the surgery of choice for the lumbosacral radicular syndrome. Previous studies on the postsurgical management of these cases compare one exercise regime to another. This study compares an exercise-based group with a control group involving no formal exercise or rehabilitation. PURPOSE: The outcomes of a formal postsurgical exercise-based rehabilitation when compared with the usual rehabilitative surgical advice were evaluated. STUDY DESIGN: A randomized clinical trial comparing management regimes after lumbar discectomies. PATIENT SAMPLE: Ninety-three lumbar discectomy patients were randomized to two groups. OUTCOME MEASURES: The following postoperative outcomes were used: levels of pain; levels of function; psychological well-being; time off work; levels of medication; and number of doctor/therapist visits. METHODS: Ninety-three lumbar discectomy patients were randomized to two groups. The treatment group undertook a 6-month supervised nonaggravating exercise program. The control group followed the usual surgical advice to resume normal activities as soon as the pain allowed. Both groups were followed for 1 year by using validated outcome measures. RESULTS: The results are based on an intention-to-treat analysis. Patients in both groups improved during the 1-year follow-up (p=.001). There was no statistical significance between the groups at the clinical endpoint. The treatment group returned to work 7 days earlier and had fewer days off work in the 1-year follow-up period. CONCLUSION: There was no statistical advantage gained by the group that performed the 6-month supervised nonaggravating exercise program at 1-year follow-up. They did, however, have fewer days off work.

Adolescent↗
PubMed2006

Modulation of the systemic inflammatory response by recombinant human interleukin-11: a prospective randomized placebo controlled clinical study in patients with hematological malignancy.

The immunomodulatory activities of recombinant human interleukin-11 (rhIL-11) were investigated in a clinical trial among patients with hematological malignancy, randomized to either rhIL-11 or placebo throughout chemotherapy. Daily serum concentrations of sTNFRI, IL-6, IL-8, TNFalpha, and CRP were measured. Higher sTNFRI levels [mean pg/ml (95% CI)] were detected in patients receiving rhIL-11 compared to placebo [1749.7 (1626-1882.9) versus 1038.5 (953.3-1131.3)] respectively (P = 0.01) for all 898 observations and during febrile days [2327.6 (2142.6-2528.2) versus 1308.9 (1163-1473.2), P = 0.12] and during days without infection [1406.6 (1266.1-1563) versus 871.3 (774.9-979.6), P < 0.001]. A similar pattern in CRP concentrations was observed. Multivariate analysis indicated rhIL-11 was associated with elevated sTNFRI or CRP independent of infectious episodes and other factors. 7 patients (all receiving placebo) of 40 had elevated TNFalpha levels. IL-6 and IL-8 levels were not substantially affected by rhIL-11. Bacteremia, fungal infections, and fever of unknown origin (FUO) were reduced in rhIL-11-treated patients. Given the role of sTNFRI in dampening the deleterious effects of a hyperactive TNFalpha environment, rhIL-11-induced upregulation of sTNFRI shedding is a potentially important mechanism for modulating immune and inflammatory responses in humans.

Adolescent↗
PubMed2006

The glycemic load estimated from the glycemic index does not differ greatly from that measured using a standard curve in healthy volunteers.

Glycemic load (GL) is calculated indirectly as glycemic index (GI) times the weight of available carbohydrate. Alternatively, GL may be measured directly using a standard glucose curve. The purpose of this study was to test the agreement between GL values obtained using direct and indirect methods of measurement in 20 healthy volunteers. A standard curve in which glucose dose was plotted against blood glucose incremental area under the curve (iAUC) was generated using beverages containing 0, 12.5, 25, 50, and 75 g glucose. The GI and available carbohydrate content of 5 foods were measured. The foods (white bread, fruit bread, granola bar, instant potato, and chickpeas) were consumed in 3 portion sizes, yielding 15 food/portion size combinations. GL was determined directly by relating the iAUC of a test food to the glucose standard curve. For 12 of 15 food/portion size combinations, GL determined using GI x available carbohydrate did not differ from GL measured from the standard curve (P > 0.05). For 3 of the test products (100 g white bread, and 100- and 150-g granola bars), GI x available carbohydrate was higher than the direct measure. Benefits of the direct measure are that the method does not require testing for available carbohydrate and it allows portion sizes to be tested. For practical purposes, GI x available carbohydrate provided a good estimate of GL, at least under circumstances in which available carbohydrate was measured, and GI and GL were tested in the same group of people.

Blood Glucose↗
PubMed2006

An open study of the comparative efficacy and safety of caspofungin and liposomal amphotericin B in treating invasive fungal infections or febrile neutropenia in patients with haematological malignancy.

In a clinical non-trial setting, the efficacy and safety of caspofungin was compared with liposomal amphotericin B for the management of febrile neutropenia or invasive fungal infections in 73 episodes in patients with haematological malignancy. There were fewer episodes of drug toxicity with caspofungin than liposomal amphotericin B (58.3 vs 83.7 %, P=0.02). The favourable response rate for episodes of febrile neutropenia treated with caspofungin or liposomal amphotericin B was similar at 37.5 and 53.8 %, respectively, but more breakthrough fungal infections occurred with caspofungin than with liposomal amphotericin B (33.3 vs 0 %, P<0.05) in these patients who did not receive antifungal prophylaxis. None of four episodes of candidaemia or hepatosplenic candidiasis responded to caspofungin compared with three of four episodes treated with liposomal amphotericin B. Mortality was significantly higher with caspofungin treatment compared with liposomal amphotericin B (6/24 vs 2/49, P=0.01), mainly due to an excess of fungal infections (P=0.04). Caspofungin treatment was a significant independent predictor of mortality [odds ratio=7.6 (95 % confidence interval 1.2-45.5)] when sepsis severity, prolonged neutropenia and length of antifungal therapy were considered in a multiple logistic regression model. In clinical practice, there is a suggestion that caspofungin may not be as effective as liposomal amphotericin B in preventing breakthrough invasive fungal infections in febrile neutropenia or in preventing fungus-related deaths. Because of the potential biases in this observational study, these preliminary findings should be interpreted with caution and clarified with a larger cohort of patients.

Adult↗
PubMed2006

Gout in renal transplant recipients.

AIMS: The aims of the present audit were to determine the prevalence of gout in renal transplant recipients in Canterbury, New Zealand, to identify risk factors for gout, and to assess the range of treatments used, their efficacy and complications. In addition, the authors wished to assess the impact of post-renal transplant gout on the patient. METHODS: Patients with post-transplantation gout were identified from the Christchurch Hospital Nephrology database. For each patient with gout a post-renal transplantation recipient without gout post transplant was found matched for age, sex and date of transplant. Case notes were audited and patients interviewed. RESULTS: In total, 47/202 (23%) living renal transplant recipients had gout post transplant. Those patients with gout were more likely to be taking a loop diuretic (68%vs 34%, P < 0.001), to have a higher serum urate and impaired renal function and to have had gout prior to the transplant. Of those patients who developed gout post transplant 70% had an attack at least every 3 months. Of those who returned to work post transplant 48% required time off work because of gout. CONCLUSION: out is an important problem in the post-transplant population causing significant morbidity and time off work. Diuretics, impaired renal function, gout prior to transplantation and hyperuricaemia are important risk factors. The need for diuretic therapy should be kept under review in these patients. Hypouricaemic therapy should be considered early in those who develop gout post renal transplantation. Further studies are required to determine whether treatment for asymptomatic hyperuricaemia is justified.

Adult↗
PubMed2006

Normobaric hypoxia inhalation test vs. response to airline flight in healthy passengers.

INTRODUCTION: There is little data available to determine the normal response to normobaric hypoxia inhalation testing (NHIT) and air travel. Quantifying a healthy response may assist in the evaluation of passengers considered at risk for air travel. The aims of this study were: (1) to quantify the degree of desaturation in healthy subjects during a NHIT and air travel; and (2) assess the validity of the NHIT when compared with actual in-flight responses. METHODS: There were 15 healthy adults (age 23-57; 10 women) who volunteered for this study. Preflight tests included lung function, arterial blood gas, pulse oximetry (SpO2), and NHIT (inspired oxygen 15%). SpO2 and cabin pressure were measured continuously on each subject during a commercial air flight (mean cabin altitude 2178 m; range 1719-2426 m). In-flight oxygenation was compared with the preflight NHIT. RESULTS: Lung function testing results were normal. There was significant desaturation (SpO2) during the NHIT (pre: 98 +/- 2%; post: 92 +/- 2%) and at cruising altitude (pre: 97 +/- 1%; cruise: 92 +/- 2%). There was no difference between the final NHIT SpO2 and the mean in-flight SpO2. There was a significant difference between the lowest in-flight SpO2 (88 +/- 2%) vs. the lowest NHIT SpO2, (90 +/- 2%). DISCUSSION: Oxygen saturation decreases significantly during air travel in normal individuals. In this group of healthy passengers the NHIT approximates some, but not all, aspects of in-flight oxygenation. These results can be used to describe a normal response to the NHIT and air-travel.

Adult↗
PubMed2005

Shared care between geriatricians and orthopaedic surgeons as a model of care for older patients with hip fractures.

AIMS: To evaluate the effect of shared care between geriatricians and orthopaedic surgeons as a model of care for older patients with hip fractures. METHODS: All patients over the age of 65 years are under the shared care of an orthopaedic surgeon and geriatrician (the Ortho-Medicine Service) when they are admitted to the Orthopaedic Service, Christchurch Hospital, New Zealand. This retrospective case records audit includes all patients over the age of 65 years with hip fracture admitted to this service over a 6-month period from December 2002 to June 2003. RESULTS: There were 150 patients. The median age was 83 years (range 66-99 years). Median total length of stay was 23 days. Median time delay until theatre was 43.5 hours. Inpatient mortality was 0.7%. Of 97 patients admitted from home, 86(88.6%) returned home, 6 (6.2%) went to rest home care, and 5 (5.2 %) went to hospital level care. Of 43 patients admitted from rest home care, 40 (93%) returned to rest home care, and 3 (7.0 %) were discharged to hospital level care. Three patients admitted from rest home dementia care and six patients admitted from hospital level care were discharged back to their pre-morbid place of domicile. At discharge, 86.8% of patients were on Vitamin D supplementation and over 80% were on calcium. Only 10.6% were discharged on bisphosphonates. CONCLUSIONS: Shared care between geriatricians and orthopaedic surgeons for older people with hip fractures is associated with a low in-patient mortality, with the majority returning to their pre-morbid place of domicile. Length of stay has increased. Most patients are discharged on treatment for osteoporosis.

Aged↗
PubMed2005

Colorectal cancer treated at Christchurch Hospital, New Zealand: a comparison of 1993 and 1998 cohorts.

AIM: To compare clinicopathological variables, management, and outcome of two cohorts of unselected patients treated for colorectal cancer (CRC) at Christchurch Hospital, New Zealand in 1993-94 and 1998-99. METHODS: Retrospective review from hospital discharge codes, oncology referral database, and histology database. Data was stored in a Microsoft Access database. RESULTS: 356 patients in 1993-94 and 317 patients in 1998-99 had a confirmed diagnosis of adenocarcinoma of the colon or rectum. At the minimum follow-up time of 42 months, 54% (40% of CRC) of the 356 patients in the first cohort, and 36% (26% of CRC) of the 317 patients in the second cohort had died. The Kaplan-Meier survival curves showed significant improvement in 1998-99 overall, as well as for Dukes stages A plus B, stage C, and stage D disease. Computed tomography (CT) scan-staging increased from 11.3% to 62.8%. On multivariate analysis, cohort, stage, vascular/lymphatic invasion, and elective surgery were independent prognostic factors for disease-specific mortality. Over the 5 years (1993-94 to 1998-99), surgery by consultant increased from 44% to 82%, adjuvant chemotherapy for Dukes stage C increased from 21% to 45%, and chemotherapy for metastatic disease increased from 2.4% to 23% of stage D and from 2.5% to 36.5% of those patients who developed metastases. CONCLUSION: The improvement in outcome is attributed to more specialised surgery, more frequent CT scan staging, and greater use of chemotherapy.

Adenocarcinoma↗
PubMed2005

Significance of the CC chemokine RANTES in patients with haematological malignancy: results from a prospective observational study.

Regulated on activation, normal T cell expressed and secreted (RANTES) serum concentrations were explored in a prospective observational study of haematological-malignancy patients undergoing chemotherapy. During systemic inflammatory response syndrome/sepsis or severe sepsis/septic shock mean concentrations were 3394 or 2939 pg/ml, respectively, significantly lower than those prior to fever (6031 pg/ml) (P < 0.01) or at bone-marrow recovery (6433 pg/ml, P < 0.001). Levels during febrile-bacteraemia were lower compared with febrile-non-bacteraemia (3022 pg/ml vs. 5111 pg/ml, respectively, P < 0.01). Sixty-three of 67 infection episodes resolved despite low RANTES concentrations, suggesting RANTES is not a prerequisite for recovering from most infection events. However, in four patients dying from septic shock associated with aspergillosis, candidosis, pneumonia or infectious colitis, RANTES concentrations were persistently and extremely low (1629 pg/ml), compared with four matched patients who recovered (6780 pg/ml). RANTES concentrations were highly correlated to platelet counts [median correlation coefficient 0.82 (inter-quartile range, 0.72-0.89)]. RANTES concentrations rose 4.5 d before platelet counts (P < 0.001), suggesting an additional extra-platelet source for RANTES. A nested mixed model regression analysis demonstrated that platelet level was the only independent variable associated with RANTES concentration (P < 0.001) among steroids, haematopoietic-colony-stimulating-factor, recombinant-human-interleukin-11, sepsis status, and neutropenia. A significant 'hypo-RANTES' serum environment occurs following chemotherapy, is driven by thrombocytopenia, but does not affect the ability of most patients to recover from infection.

Antineoplastic Agents↗
PubMed2004

Application of asthma action plans to childhood asthma: national survey repeated.

AIMS: Define the way childhood asthma action plans are currently being used in New Zealand; determine New Zealand doctor's recommendations about the use of an increased dose of inhaled steroids in asthma action plans; and determine if there has been any change (during the last 7 years) in the way asthma action plans are used. METHODS: A postal survey was sent to all 297 paediatricians and paediatric registrars in New Zealand, and to a random sample of 500 general practitioners (GPs). The questions related to asthma action plan use, the inclusion of an increased dose of inhaled steroid in those plans, and details of the way doctor's adjusted inhaled steroid dose. Comparisons were made for selected questions between this survey and the same survey conducted in 1995. RESULTS: Valid responses were received from 179 (60%) paediatricians and paediatric registrars, and 233 (47%) GPs. 165 (70.8%) GPs and 137 (76.5%) paediatricians/paediatric registrars indicated that they used written action plans for children with asthma in their care. 184 (61.5%) respondents who used asthma action plans included a step involving an increase in the dose of inhaled steroid, compared to 83.6% in 1995 (p<0.001). GPs in 2002 were less likely to use action plans (p<0.001) and include a step with an increased dose of inhaled steroid (p=0.003) Paediatricians and paediatric registrars in 2002 were just as likely to use action plans (p=0.549), but less likely to include a step with an increased dose of inhaled steroid (p<0.001). GPs in 2002 were significantly more likely (than paediatricians and paediatric registrars) to include a step involving an increased dose of inhaled steroid (p<0.001) There has been a change in the practice of New Zealand GPs, paediatricians, and paediatric registrars--with a decreased tendency to double the dose of inhaled steroids in childhood action plans, thus suggesting doctors are cognisant of conclusions drawn by 'evidence-based medicine'. CONCLUSIONS: There has also been a decline in the proportion of asthmatic children receiving a written asthma action plan, and this is inconsistent with recommendations contained in consensus documents.

Administration, Inhalation↗
PubMed2004

Postoperative follow-up strategies for patients after potentially curative surgery for colorectal cancer at Christchurch Hospital.

AIM: To describe the follow-up patterns of patients with colorectal cancer (CRC) having had surgery with curative intent. METHODS: A retrospective study was undertaken of follow-up patterns in patients who had undergone 'curative' surgery for colorectal cancer at Christchurch Hospital from 1 January 1996 to 31 December 2000. Patients were identified from three sources: the General Surgical Audit Database (Otago system), the hospital clinical Casemix DRG Database, and the Oncology Service database. Patients were included only if they had surgery with curative intent, within the stated period, and had follow-up at Christchurch Hospital. Data extracted included: patient demographics, details of initial surgery, adjuvant therapies, recurrences, and details of follow-up arrangements (including investigations). RESULTS: Of 893 patients coded as having CRC, 284 patients met the inclusion criteria. Patients were excluded for the following reasons: no operation (64), operation before 1996 (18), palliative surgery (345), previous cancer (55), no cancer (32), died within 30 days of surgery (26), follow-up outside of Christchurch region (39), and notes unavailable (30). The median age was 72 (range 28.6-99.9 years). Median follow-up time was 732 days. Most patients (91%) were followed-up by their surgeon. Patients had an average of 2.6 visits to their specialist in the first year of follow-up. Unplanned clinic visits accounted for 8.3% of all clinic visits--resulting in a number of unplanned investigations. During the follow-up period, patients had 112 colonoscopies, 68 CT scans, 8 abdominal ultrasounds, and 7 barium enemas. Recurrence was detected in 58 patients (20.4%); 23 (39.7%) recurrences were detected in the first year of follow-up. Of the 279 patients who had some form of follow-up, 9 asymptomatic patients had recurrent disease (detected as a result of a planned clinic visit) and had a potentially curative procedure for recurrence. CONCLUSIONS: The number of visits per year correlated closely with the earlier findings of Connor et al,4 however the number of investigations carried out was variable and substantially less than had been reported. Follow-up visits have limited value for the detection of asymptomatic potentially curable recurrent disease.

Adult↗
PubMed2004

Stability of benzylpenicillin during continuous home intravenous therapy.

OBJECTIVES: The aim of this study was to investigate the temperature profile of home intravenous (iv) antibiotic reservoirs and the stability of 16 megaunits of benzylpenicillin sodium in 120 mL of sodium chloride 0.9% at constant and variable temperatures. METHODS: A Tinytag computerized thermometer recorded temperatures every minute in the home iv antibiotic reservoir pouches of nine patients over a 24 h period. Similar bags containing benzylpenicillin sodium (16 megaunits) were maintained either at a constant 36 degrees C, 26 degrees C or 21-22 degrees C or were worn in a pouch by five healthy volunteers for a 24 h period. Other bags were stored at 3-5 degrees C for 10 days. The bags were sampled at timed intervals and benzylpenicillin concentrations assayed by HPLC. RESULTS: Median temperatures recorded in the infusion bags worn by the nine patients were in the range 16.7-34.1 degrees C. For infusion bags maintained at 36 degrees C, 26 degrees C and 21-22 degrees C, the concentrations of benzylpenicillin dropped below 90% of the initial concentration at a mean time of 5 h 18 min, 12 h 54 min and 13 h 20 min, respectively, whereas for bags worn by the healthy volunteers the mean time for 10% loss of benzylpenicillin was 9 h 20 min. In contrast, at 3-5 degrees C, concentrations of benzylpenicillin only dropped below 90% of the initial concentration at 8 days. CONCLUSIONS: Significant temperature-dependent degradation of benzylpenicillin occurs during continuous home iv antibiotic programme infusions, which could result in loss of efficacy.

Drug Stability↗
PubMed2004

Holmium laser resection of the prostate versus transurethral resection of the prostate: results of a randomized trial with 4-year minimum long-term followup.

PURPOSE: It has previously been shown that holmium laser resection of the prostate (HoLRP) is superior to transurethral resection of the prostate (TURP) with regard to perioperative morbidity and is equivalent to TURP in the short term. We present the long-term results of a randomized, prospective trial comparing HoLRP to TURP since information regarding the durability of holmium prostatectomy is lacking in the literature to date. MATERIALS AND METHODS: A total of 120 patients with urodynamic obstruction were randomized (April 1996 to August 1997) into 2 comparable groups and assigned to HoLRP or TURP. All patients were assessed preoperatively and followed prospectively at 3 weeks, 3, 6, 12, 24 and 48 months postoperatively with an American Urological Association symptom score, quality of life score, peak urinary flow rate, and questionnaires concerning sexual function and continence. Preoperative pressure flow studies, ultrasound prostatic volume assessment and post-void residual volume measurement were repeated at the 6-month visit. All adverse events were noted. RESULTS: Of 120 patients 73 completed the 48-month assessment. HoLRP and TURP resulted in significant improvements in all parameters. There was no difference between the 2 techniques in terms of urodynamic parameters, potency, continence and symptom scores at the 48-month assessment. HoLRP took significantly longer to perform but perioperative morbidity, catheter time, nursing contact time and hospital stay were significantly less for HoLRP compared to TURP. CONCLUSIONS: HoLRP and TURP give equivalent and satisfactory long-term results, with no differences noted in major morbidity. This confirms the durability of these 2 treatments. Peri-operative morbidity is less with HoLRP.

Aged↗
PubMed2003

Amino-terminal pro-C-type natriuretic peptide in heart failure.

The levels and pathophysiological role of amino terminal C-type natriuretic peptide in heart failure are unknown. The potential of plasma amino-terminal C-type natriuretic peptide (N-CNP) as a marker of cardiac function was investigated in symptomatic patients. In 305 patients with recent-onset dyspnea and/or peripheral edema, presenting to primary care, assay of plasma amino-terminal C-type natriuretic peptide and other plasma vasoactive hormones was conducted together with echocardiography. Heart failure was diagnosed in 77 (of the 305) patients by rigorous application of predefined criteria. Plasma amino-terminal C-type natriuretic peptide concentrations were elevated in patients with heart failure, and by univariate analysis were related to age, renal function, and other hormones. On multivariate analysis, tertile of plasma N-CNP interacted with tertile of plasma amino-terminal B-type natriuretic peptide to predict heart failure independent of age, gender, renal function, or echocardiographic left ventricular fractional shortening. N-CNP showed significant relations to concurrent plasma CNP, atrial natriuretic peptide (ANP), N-ANP, B-type (or brain) natriuretic peptide (BNP), N-BNP, endothelin-1, and adrenomedullin but not to echocardiographic indicators of left ventricular systolic function. Plasma amino-terminal C-type natriuretic peptide is elevated in heart failure and is related to other plasma hormones in heart failure. These findings suggest a possible compensatory response from the peripheral vasculature to heart failure by an endothelium-based vasodilator peptide and mandate further exploration of the role of C-type natriuretic peptide in this condition.

Adult↗
PubMed2003

The influence of differential survival on the distribution of fluctuating asymmetry--a modelling approach.

Fluctuating asymmetry (FA) is frequently used as a potential marker of developmental stress. It is usually assumed that the distribution of FA within a population is statistically normal with a mean of zero. The relationships between three different FA-dependent survival functions and the resultant FA distribution of surviving individuals are explored. It is shown that with any biologically plausible relationship between survival and FA the resultant distribution is not normal and that this non-normality is dependent upon the form of the survival-FA relationship. Two survival probability functions resulted in leptokurtic distributions, whereas a third generated a slight decline in kurtosis values.

Animals↗
PubMed2003

Relationships among measures of treatment outcome in depressed patients.

BACKGROUND: Studies attempting to identify predictors of antidepressant response in patients with major depression have reported inconsistent results. One explanation may be the different definitions of outcome used. METHODS: 187 depressed subjects were recruited and were randomised to treatment with fluoxetine and nortriptyline. At baseline and 6 weeks, subjects completed Hamilton Depression Rating Scale HDRS-17 and 27, Montgomery Asberg Depression Rating Scale (MADRS), the Hopkins Symptom Checklist (SCL-90) and the Social Adjustment Scale (SAS) as well as the Clinical Global Impression Scale (CGI). Relationships among outcome measures were assessed. Receiver Operator Characteristic (ROC curves) were used to show the diagnostic ability of the MADRS and HDRS in predicting the clinician's rating. RESULTS: All outcome measures were moderately to highly correlated. All measures were significantly related to the clinician's global impression, but the strongest associations were with the MADRS score. Using ROC curves we showed that a score of 8 on the HDRS or 14 on the MADRS was the optimal compromise between sensitivity and specificity in dividing this sample into responders and non-responders. A 60% reduction in HDRS and MADRS scores rather than a 50% reduction appeared the most valid division between responders and non-responders. LIMITATIONS: We relied on clinician judgement as the validating criterion. The results only apply to a sample of moderately depressed outpatients. CONCLUSIONS: The MADRS score seemed to most accurately reflect a clinician's impression of change. Dividing a sample into responders and non-responders can be approached empirically.

Adult↗
PubMed2003

Randomized controlled trials in psychiatry. Part 1: methodology and critical evaluation.

OBJECTIVE: To introduce clinicians to the methodology and critical appraisal of randomized controlled trials (RCTs) in psychiatry. METHOD: The methodology of RCTs in psychiatry is discussed. Using a systematic approach to critical appraisal, a published RCT of treatments for severe depression is examined and evaluated. RESULTS AND CONCLUSIONS: The RCT appraised illustrates certain problematic areas in the methodology of trials in psychiatry. A detailed knowledge of methodology and critique of RCTs is essential in determining whether reported results will influence clinicians' practice.

Cyclohexanols↗