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[Contribution of Galician hospitals to national and international Internal Medicine scientific meetings].

OBJECTIVES: To evaluate the scientific contributions of internal medicine services from Galicia to nationals and internationals specialty meetings and to describe theirs preferences in clinical research. MATERIAL AND METHOD: We analysed the communications from the Abstracts books of the last four Spanish Internal Medicine National Congress (1994-2000 period) in comparison with that of 1984, the last two European Congress (1999 and 2001) and the last World Congress (2000). Case reports were excluded. RESULTS: An increasing number of communicating hospitals and a sustained number of reports was observed with a minimum of 2 hospitals (1984) to a maximum of 12 (1996) with 5-6 hospitals on average. Number of communications became stable and reached 5% of the whole spanish reports. Cardiovascular and AIDS-Infectious diseases were the preferred research fields. CONCLUSIONS: An increment of scientific communications from a growing number of galician hospitals was observed. This scientific production became continuous and stabilized notoriously on cardiovascular and AIDS-infectious disease fields.

Bibliometrics↗

Finding, reading and documenting literature.

Before embarking on an evaluation project it is important to be familiar with the relevant literature. Critical reading of the literature is essential in helping the investigator refine the questions and design of his or her study. The retrieval and use of available literature for use in a study proposal is outlined here.

Bibliographies as Topic↗

The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force.

Clinical outcome assessment in Multiple Sclerosis (MS) is challenging due to the diversity and fluctuating nature of MS symptoms. Traditional clinical scales such as the EDSS are inadequate in their assessment of key clinical dimensions of MS (e.g. , cognitive function), and they have psychometric limitations as well. Based on analyses of pooled data from natural history studies and from placebo groups in clinical trials, the National MS Society's Clinical Outcomes Assessment Task Force recently proposed a new multidimensional clinical outcome measure, the MS Functional Composite (MSFC). The MSFC comprises quantitative functional measures of three key clinical dimensions of MS: leg function/ambulation, arm/hand function, and cognitive function. Scores on component measures are converted to standard scores (z-scores), which are averaged to form a single MSFC score. Preliminary analyses confirm that: (1) the three clinical dimensions of the MSFC are relatively independent; (2) the MSFC is sensitive to clinical changes over 1- and 2-year intervals; and (3) the MSFC has acceptable criterion validity (i.e., predicts both concurrent and subsequent EDSS change). The advantages and potential limitations of incorporating quantitative functional outcome measures such as the MSFC into collaborative databases are discussed.

Clinical Trials as Topic↗

AIDS information from the National Library of Medicine.

As part of a U.S government effort to combat AIDS, the National Library of Medicine (NLM) is expanding its information services in this area. In response to the Health Omnibus Program Extension Act of 1988, NLM has expanded its AIDS Bibliography, enhanced its DIRLINE file with AIDS-related organizations, and developed three new online MEDLARS (Medical Literature Retrieval and Analysis System) databases: AIDSLINE, AIDSTRIALS, and AIDSDRUGS. NLM's AIDS-related programs and services are discussed.

Acquired Immunodeficiency Syndrome↗

Evidence-based pain management and palliative care in issues three and four for 2003 of The Cochrane Library.

The Cochrane Library of systematic reviews is published quarterly. Issue 3 for 2003 of the library was published in May 2003. That issue contains 3058 reviews of which 1754 are in full text. The issue contains 85 new reviews and four of those are directly relevant to pain management and palliative care. Annotated bibliographies for those seven reviews are provided. Issue 4 for 2003 of The Cochrane reviews and 1344 protocols. The Cochrane trials database now stands at over at over 378,000 records with an additional 4626 summaries of non-Cochrane systematic reviews published in the general medical literature [(Database of abstracts of reviews of effectiveness (DARE)].

Clinical Trials as Topic↗

The European Multiple System Atrophy-Study Group (EMSA-SG).

Introduction. The European Multiple System Atrophy-Study Group (EMSA-SG) is an academic network comprising 23 centers across Europe and Israel that has constituted itself already in January 1999. This international forum of established experts under the guidance of the University Hospital of Innsbruck as coordinating center is supported by the 5th framework program of the European Union since March 2001 (QLK6-CT-2000-00661). Objectives. Primary goals of the network include (1) a central Registry for European multiple system atrophy (MSA) patients, (2) a decentralized DNA Bank, (3) the development and validation of the novel Unified MSA Rating Scale (UMSARS), (4) the conduction of a Natural History Study (NHS), and (5) the planning or implementation of interventional therapeutic trials. Methods. The EMSA-SG Registry is a computerized data bank localized at the coordinating centre in Innsbruck collecting diagnostic and therapeutic data of MSA patients. Blood samples of patients and controls are recruited into the DNA Bank. The UMSARS is a novel specific rating instrument that has been developed and validated by the EMSA-SG. The NHS comprises assessments of basic anthropometric data as well as a range of scales including the UMSARS, Unified Parkinson's Disease Rating Scale (UPDRS), measures of global disability, Red Flag list, MMSE (Mini Mental State Examination), quality of live measures, i.e. EuroQoL 5D (EQ-5D) and Medical Outcome Study Short Form (SF-36) as well as the Beck Depression Inventory (BDI). In a subgroup of patients dysautonomic features are recorded in detail using the Queen Square Cardiovascular Autonomic Function Test Battery, the Composite Autonomic Symptom Scale (COMPASS) and measurements of residual urinary volume. Most of these measures are repeated at 6-monthly follow up visits for a total study period of 24 months. Surrogate markers of the disease progression are identified by the EMSA-SG using magnetic resonance and diffusion weighted imaging (MRI and DWI, respectively). Results. 412 patients have been recruited into the Registry so far. Probable MSA-P was the most common diagnosis (49% of cases). 507 patients donated DNA for research. 131 patients have been recruited into the NHS. There was a rapid deterioration of the motor disorder (in particular akinesia) by 26.1% of the UMSARS II, and - to a lesser degree - of activities of daily living by 16.8% of the UMSARS I in relation to the respective baseline scores. Motor progression was associated with low motor or global disability as well as low akinesia or cerebellar subscores at baseline. Mental function did not deteriorate during this short follow up period. Conclusion. For the first time, prospective data concerning disease progression are available. Such data about the natural history and prognosis of MSA as well as surrogate markers of disease process allow planning and implementation of multi-centre phase II/III neuroprotective intervention trials within the next years more effectively. Indeed, a trial on growth hormone in MSA has just been completed, and another on minocycline will be completed by the end of this year.

Animals↗

The Internet for the medical and scientific community.

With the explosion of data coming out from the international scientific community, researchers can now locate and manipulate data of interest quickly and easily on the Internet. The scope of this review is to focus on some of the recent developments of the Internet that are specially relevant to health scientists. The review also provides the medical and scientific community with a selection of sites to visit on the Internet, dealing with clinical and laboratory aspects of science.

Bibliographies as Topic↗

Assessing the use of retrospective databases in conducting economic evaluations of drugs: the case of asthma.

When evaluating drug substances, the traditional clinical study setting does not allow scope for observing real-life behaviour since all alternative actions are determined beforehand. However, a study based on prospective or retrospective databases containing real-life data can examine how patients and physicians behave in a real-world setting and can investigate the relationship between the introduction of a drug and the amount of healthcare used in actual practice. We reviewed the quality and potential policy application of published retrospective database studies in which an economic evaluation of the use of drugs in asthma was conducted. A search in literature databases found 16 such studies, which were reviewed and evaluated according to a published checklist. No article fulfilled all the criteria for a 'good' economic evaluation. The results of many of the evaluations may be informative, but not transparent enough to deliver policy conclusions. This may limit the use of the currently published retrospective database studies as a base for policy decision, compared with randomised controlled trials, despite the additional value of these database analyses when well conducted. A greater transparency when presenting material and results is therefore called for, to increase the usefulness of database studies.

Anti-Asthmatic Agents↗