PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Clinical protocols”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources

[Clinical protocol for study and treatment of bronchogenic carcinoma (author's transl)].

Bronchogenic carcinoma constitutes one of the primary causes of death in our population. The only means of controlling the disease in a significant way is by surgery, which about a third of the patients undergo. This fact, together with the age at which the pathology appears, its frequent association with chronic pulmonary disease, and the rapidity of its metastatic spread, make it necessary to establish a protocol for the study, diagnosis, and treatment of bronchogenic carcinoma. These norms should be applicable in prospective epidemiologic studies and for evaluating methods of diagnosis and treatment. The Interhospital Bronchogenic Carcinoma Co-operative Group has established a protocol, which includes the criteria of operability, resectability, preoperative examinations, indications of mediastinoscopy, etc. The authors mention the histopathologic classification, the TNM criteria, and the characteristics of localized or advanced disease.

Biopsy↗

Time-of-flight techniques. Pulse sequences and clinical protocols.

Time-of-flight, the most commonly used angiographic sequence, relies on the inflow of bright, relaxed blood into a region whose magnetization is suppressed by radiofrequency pulses. Good angiographic contrast relies on pulse rates (i. e., repetition times) that are fast enough and pulse amplitudes (i. e., flip angles) that are large enough to saturate the magnetization of the background without saturating the magnetization of entering blood.

Humans↗

An ethnographic study of collaborative clinical trial protocol writing.

Clinical trial protocol documents play an important role in clinical research. However, clinical protocol writing remains a complex and relatively un-studied process. Protocols are often written by teams of people, yet little prior research has captured the problems or analyzed the collaboration support needs of protocol writers. Here we present the results of an initial ethnographic study into the clinical trial protocol writing processes at a representative cooperative clinical trial group funded by National Cancer Institute (NCI). We analyzed the collaborative nature of the writing process, identified common problems, derived information and communication support needs of collaborative clinical protocol writers, and provided recommendations to streamline the process. We believe that this paper contributes useful implications for the design of future collaborative clinical protocol writing tools.

Anthropology, Cultural↗

[The protocol of clinical trial and basic experiments for esophageal cancer using gene transduction].

We examined whether antitumor effect could be produced by retrovirally expressed interleukin-2(IL-2) gene, glanulocyte macrophage-colony stimulating factor(GM-CSF) gene, herpes simplex virus-thymidine kinase(HSV-tk) gene and p53 gene in human esophageal cancer cells using nude mice. Loss of tumorigenicity of IL-2 or GM-CSF producing cancer cells were observed. The antitumor effect was also evidenced by the injection of these cells into established tumors of wild-type cells. In suicide gene therapy on esophageal cancer, the growth suppression of esophageal cancer cells transducing HSV-tk gene tumors in nude mice induced by ganciclovir treatment and all the tumors disappeared. The wild-type p53 transduced tumor cells became markedly susceptible to irradiation and anticancer agents. Administration of cisplatine noticeably suppressed the growth of p53 transduced tumors inoculated in nude mice. We established the clinical protocol of gene therapy for esophageal cancer using wild-type p53 gene with adenovirus vector. In this autumn we are going to start this clinical trial.

Animals↗

Intra- and inter-observer agreement of a protocol for clinical examination of dairy cows.

In 2004,five veterinarians examined 283 dairy cows from four Danish dairy herds and independently assigned scores for the clinical signs lameness, hock lesions and other cutaneous lesions to each cow using a clinical protocol. We evaluated the inter-observer and the intra-observer agreement using prevalence-adjusted, bias-adjusted kappa (PABAK). We chose two different cut-offs between the ordinal scores for classifying cows as healthy or diseased for each of the clinical signs, and we compared the ability of the observers to discriminate between healthy and diseased cows for the two cut-offs. Without any formal training of the observers we found PABAK in the range 0.36-0.88 and we concluded that the choice of cut-off had an effect on the observed agreement among the observers.

Animals↗

Clinical guidelines and care protocols.

Clinical guidelines and care protocols are intended to provide information, based on an appraisal of the current best evidence of clinical and cost-effectiveness, regarding therapeutic interventions for given conditions. With the establishment of the National Collaborating Centre for Nursing as a part of National Institute for Clinical Excellence (NICE), it is anticipated that an increasing number of clinical guidelines that focus on aspects of nursing care will be developed at a national level. The Department of Health also aims to introduce nationally agreed multidisciplinary care protocols which will dictate how certain conditions are to be managed. These developments have the potential to enhance healthcare provision and nursing practice. However, they also introduce potential dilemmas for nurses. This paper discusses some of the issues involved in the development and implementation of clinical guidelines and care protocols in intensive care nursing.

Academies and Institutes↗

Clinical management protocols: the bedside answer to clinical practice guidelines.

TOPIC: Clinical Management Protocols for trauma patients. PURPOSE: The goals and process for developing and implementing Clinical Management Protocols are presented. Protocol development and the differences between clinical practice guidelines, critical pathways, and clinical management protocols are discussed. SOURCES: Published literature, experience, and clinical expertise. CONCLUSIONS: Utilizing annotated algorithms, the protocols are designed for and driven by patient care based on patient need and require the collaboration of experts and trauma team members.

Algorithms↗

[Adenovirus vectors and their clinical application in gene therapy].

The potential therapeutic application of the gene transfer technology with adenovirus vectors seems to be enormous. Adenovirus vectors offer several advantages over other vectors, but several important limitations of adenovirus mediated gene transfer are also known. Great number of studies in inherited diseases and in different cancer therapy clinical trials have provided information of critical importance for design of efficient clinical protocols. Clinical trials have been extended to the treatment of many other diseases, too. There are about thirty currently active gene therapy protocols for the treatment only of HIV-1 infection in the USA. These programs aim to confer protective immunity against HIV-1 transmission to individuals who are in risk of infection, to develop preventive or therapeutic vaccines for patients with AIDS and other infectious diseases. Gene therapy represents one of the most important developments in oncology, however, before this can be realised as standard treatment the technical problems of gene delivery and higher safety must be overcome. The early--first and second generation--adenovirus vectors are now likely to be phased out for most diseases, and further experiments seem to be necessary. It might be change to the third generation or other, more modern vector application in clinical trials, as the helper dependent vectors. Almost all transcriptional unit is removed from the DNA of these vectors ("gutless vectors"), therefore they cannot reproduce, give higher gene expression and far less inflammatory. Despite the latest achievement reported in vector design it is not possible to predict yet to what extent and when gene therapy will be effective.

Adenoviridae↗

The effect of continuous quality improvement on compliance with clinical practice guidelines in an optometric clinic: a retrospective review.

BACKGROUND: Quantitative documentation of quality is becoming increasingly more important. The SUNY State College of Optometry established clinical protocols outlining clinical standards for patient care. We compared documentation of actual clinical performance to these standards. METHODS: The Primary Care Service's Quality Management Team retrospectively reviews a random 10% sample of charts of patients seen in the teaching clinic of the SUNY State College of Optometry on an ongoing basis. They compare the care documented in the medical record to internally distributed clinical protocols. We reviewed the resultant data from January 1995 through June 1997 by analyzing the number of indicators that were out of compliance for each month. Then we graphed these data to ascertain trends and variability to determine what effect this continuous quality improvement process had on clinical care as measured by compliance with clinical protocols. RESULTS: A least-squares regression analysis demonstrated a correlation (0.717) between the decreasing number of items out of compliance and the time during which feedback was provided (r2 = 0.5143, p = 0.0001). These data show a distinct downward trend, indicating better compliance with the clinical protocols over time. We also found that the variability of the data decreased during the time period studied. CONCLUSIONS: A properly designed continuous quality improvement program that gives appropriate feedback to faculty optometrists and student interns measurably increased their compliance with--and decreased their variability from--this clinic's internally distributed clinical protocols over a 30-month time period.

Clinical Competence↗

Development of Design-a-Trial, a knowledge-based critiquing system for authors of clinical trial protocols.

Many published clinical trials are poorly designed, suggesting that the protocol was incomplete, disorganised or contained errors. This fact, doctors' limited statistical skills and the shortage of medical statisticians, prompted us to develop a knowledge-based aid, Design-a-Trial, for authors of clinical trial protocols. This interviews a physician, prompts them with suitable design options, comments on the statistical rigour and feasibility of their proposed design and generates a 6-page draft protocol document. This paper outlines the process used to develop Design-a-Trial, presents preliminary evaluation results, and discusses lessons we learned which may apply to the developed of other medical decision-aids.

Clinical Trials as Topic↗