SEARCH · PubMed Health

Results for “Meta- analysis”

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 919 records · Page 51Linked to original sources

PubMed2006

Meta-analysis of inoperable pancreatic cancer: gemcitabine combined with cisplatin versus gemcitabine alone.

OBJECTIVES: To compare the therapeutic effects of gemcitabine (GEM) monotherapy with GEM-cisplatin (DDP) combination chemotherapy in patients with advanced stage pancreatic cancer (APCa) through meta-analysis. METHODS: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-DDP combination chemotherapy and GEM alone in APCa. A quantitative meta-analysis using updated information based on inclusion criteria from all available RCTs was carried out by two reviewers. The primary meta-analysis involved the overall survival (OS), objective remission rate (ORR) and toxicity. RESULTS: The meta-analysis included six RCTs. There was no significant advantage for the GEM-DDP combination group in 6-month survival rate (P = 0.24) or clinical benefit rate (P = 0.58). There was a marginal significant improvement for the GEM-DDP combination group in ORR (RD = 6%, P = 0.05; RD, risk difference = risk in the GEM-DDP combination group - risk in the GEM alone group). Moreover, there was a significant improvement for the combination group in 6-month TTP/TTF (RD = 9%, P = 0.02). WHO grade 3-4 toxicity was higher for the GEM-DDP combination group in terms of neutropenia (RD = 6%, P = 0.08), thrombocytopenia (RD = 8%, P = 0.17) and vomiting/nausea (RD = 11%, P = 0.07); none reached significant difference. CONCLUSION: GEM-DDP combination should not be recommended and GEM monotherapy remains the standard treatment for patients with APCa.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Perinatel outcomes of singleton pregnancies achieved by in vitro fertilization: a systematic review and meta-analysis.

OBJECTIVE: To determine whether the incidence of adverse obstetric outcomes is higher in singleton pregnancies achieved by in vitro fertilization (IVF) than in spontaneously conceived singletons matched for maternal age. METHODS: We used comprehensive search strategies to search MEDLINE and EMBASE databases. We selected case-control and cohort studies that compared singleton pregnancies conceived by IVF or intracytoplasmic sperm injection (ICSI) with spontaneously conceived singletons (matched for maternal age [case-control studies] or controlled for maternal age [cohort studies]). Two reviewers independently assessed titles, abstracts, and study quality and extracted data. Statistical analysis was performed with Review Manager for Windows (Version 4.2, Oxford, UK). We performed meta-analysis of dichotomous data, using odds ratios (ORs) as measures of effect size, with a random effects model. We followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines for meta-analysis of observational studies. RESULTS: Singleton pregnancies resulting from IVF have increased rates of poor obstetric outcome, compared with spontaneously conceived singletons matched for maternal age, with increases in perinatal mortality (OR 2.40; 95% confidence interval [CI] 1.59-3.63), preterm birth at < 33 weeks' gestation (OR 2.99; 95% CI 1.54-5.80), preterm birth at < 37 weeks' gestation (OR 1.93; 95% CI 1.36-2.74), very low birth weight (< 1500 g) (OR 3.78; 95% CI 4.29-5.75), small for gestational age (OR 1.59; 95% CI 1.20-2.11), and congenital malformations (OR 1.41; CI 1.06-1.88). CONCLUSIONS: IVF singleton pregnancies have increased rates of poor obstetric outcome, compared with spontaneously conceived singletons matched for maternal age.

Case-Control Studies↗

PubMed2006

Meta-analysis on inoperable pancreatic cancer: a comparison between gemcitabine-based combination therapy and gemcitabine alone.

AIM: To compare gemcitabine-based combination therapy and gemcitabine (GEM) alone in patients with advanced pancreatic cancer (APCa) through meta-analysis. METHODS: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-based combination therapy and GEM alone for APCa. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The meta-analysis involved overall survival (OS), objective remission rate (ORR), clinical benefit rate (CBR), time to progress/progress free survival (TTP/PFS) and toxicity. RESULTS: The meta-analysis included 22 RCTs. There was significant improvement in the GEM combination group with regard to the 6-mo survival rate (RD = 0.04, 95% CI 0.01-0.06, P = 0.008), 1-year survival rate (RD = 0.03, 95% CI 0.01-0.05, P = 0.01), ORR (RD = 0.04, 95% CI 0.01-0.07, P = 0.02), CBR (RD = 0.10, 95% CI 0.02-0.17, P = 0.01) and 6-mo TTP/PFS (RD = 0.07, 95% CI 0.04-0.10, P < 0.00001). However, the Grade 3-4 toxicity set by WHO was higher for the GEM combination group for neutropenia (RD = 0.05, 95% CI 0.01-0.10, P = 0.02), thrombocytopenia (RD = 0.05, 95% CI 0.02-0.08, P = 0.002) and vomiting/nausea (RD = 0.03, 95% CI 0.00-0.05, P = 0.02). CONCLUSION: GEM-based combination therapy may improve the overall survival and palliation in optimal patients with APCa as compared with GEM alone.

Antimetabolites, Antineoplastic↗

PubMed2005

Meta-analysis of the brief psychiatric rating scale factor structure.

A meta-analysis (N=17,620; k=26) of factor analyses of the Brief Psychiatric Rating Scale (BPRS) was conducted. Analysis of the 12 items from Overall et al.'s (J. E. Overall, L. E. Hollister, & P. Pichot, 1974) 4 subscales found support for his 4 subscales. Analysis of all 18 BPRS items found 4 components similar to those of Overall et al. In a 5-component solution, a 5th activation component emerged but was best supported among samples of schizophrenic patients. The first 4 components appear to form the core of the BPRS factor structure. Results of the meta-analysis suggest 5 subscales (with items in parentheses): Affect (anxiety, guilt, depression, somatic); Positive Symptoms (thought content, conceptual disorganization, hallucinatory behavior, grandiosity); Negative Symptoms (blunted affect, emotional withdrawal, motor retardation); Resistance (hostility, uncooperativeness, suspiciousness); and Activation (excitement, tension, mannerisms-posturing).

Brief Psychiatric Rating Scale↗

PubMed2003

Meta-analysis and decision analysis bridge research and practice.

Research synthesis methods provide meaningful quantitative data through systematic review of the research literature and translation of these findings into practice implications. Meta-analysis has been the gold standard for translation of research findings into practice. Decision analysis has emerged as an alternative to and extension of meta-analysis. Examples, contrasting the application of meta-analysis and decision analysis, are presented and discussed in relation to its relevance in providing clinical direction. The methods are points along the continuum of translating research findings into practice. Meta-analytic studies provide an essential foundation for estimating and assigning the probabilities used in decision analysis, whereas the outcomes of decision analysis provide data for estimating the cost effectiveness of different interventions or treatment options. Decision analysis can assist in bridging the research-practice gap. Nurse researchers are urged to collaborate with other disciplines that have used these methods to refine translation and use of research findings in practice.

Decision Making↗

PubMed2003

Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair.

BACKGROUND: The aim was to conduct a meta-analysis of the randomized evidence to determine the relative merits of laparoscopic (LIHR) and open (OIHR) inguinal hernia repair. METHODS: A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified all randomized clinical trials that compared OIHR and LIHR and were published in the English language between January 1990 and the end of October 2000. The meta-analysis was prepared in accordance with the Quality of Reporting of Meta-analyses (QUOROM) statement. The six outcome variables analysed were operating time, time to discharge from hospital, return to normal activity and return to work, postoperative complications and recurrence rate. Random effects meta-analyses were performed using odds ratios and weighted mean differences. RESULTS: Twenty-nine trials were considered suitable for meta-analysis. Some 3017 hernias were repaired laparoscopically and 2972 hernias were repaired using an open method in 5588 patients. For four of the six outcomes the summary point estimates favoured LIHR over OIHR; there was a significant reduction of 38 per cent in the relative odds of postoperative complications (odds ratio 0.62 (95 per cent confidence interval (c.i.) 0.46 to 0.84); P = 0.002), 4.73 (95 per cent c.i. 3.51 to 5.96) days in time to return to normal activity (P < 0.001), 6.96 (95 per cent c.i. 5.34 to 8.58) days in time to return to work (P < 0.001) and 3.43 (95 per cent c.i. 0.35 to 6.50) h in time to discharge from hospital (P = 0.029). There was a significant increase of 15.20 (95 per cent c.i. 7.78 to 22.63) min in the mean operating time for LIHR (P < 0.001). The relative odds of short-term recurrence were increased by 50 per cent for LIHR compared with OIHR, although this result was not statistically significant (odds ratio 1.51 (95 per cent c.i. 0.81 to 2.79); P = 0.194). CONCLUSION: LIHR was associated with earlier discharge from hospital, quicker return to normal activity and work, and significantly fewer postoperative complications than OIHR. However, the operating time was significantly longer and there was a trend towards an increase in the relative odds of recurrence after laparoscopic repair.

Hernia, Inguinal↗

PubMed1996

New meta-analysis of treatment trials of hypertension: improving the estimate of therapeutic benefit.

The objectives of this sub group meta-analysis on the treatment of hypertension was to: (1) high-light specific results of well-designed trials; (2) group trials according to their specific clinical context; (3) express results of the meta-analysis in absolute reduction terms; and (4) estimate the bias of withdrawal because of blood pressure increase. This meta-analysis is based on summarised published results from randomised controlled trials, comparing a drug treatment versus placebo or no treatment, with morbi-mortality as the principle outcome. The following data were analysed: (1) total mortality; (2) cardiovascular mortality; (3) stroke; (4) major coronary events; and (5) congestive heart failure. The treatment significantly reduced the incidence of all outcomes in trials involving older patients, avoiding up to nine strokes (OR = 0.66, 95% Cl: 0.56-0.77) and four major coronary events (OR = 0.79, 95% Cl: 0.68-0.92) every 1000 patient-years when the bias of withdrawal was taken into account. The only outcome significantly influenced by treatment in younger patients with mild-to-moderate hypertension was stroke, with one stroke avoided every 1000 patient-years (OR = 0.51, 95% Cl: 0.39-0.66). There was insufficient statistical power in the trials which enrolled patients with non-moderate hypertension to reach clinical significance, except for the reduction in the incidence of congestive heart failure. However, the results indicated a trend towards greater absolute benefit under treatment. Trials enrolling patients with post-stroke hypertension also had insufficient power, but suggested benefit by the reduction of the incidence of stroke recurrence and congestive heart failure under treatment. In conclusion, the most constant treatment benefit concerned stroke, although the absolute reduction was very modest in younger patients with mild-to-moderate hypertension. Only the results from trials in older patients showed a significant reduction of major coronary events. Such results need further analyses, ideally based on individual patient data.

Adult↗

PubMedDate not supplied

Dietary beta-carotene intake and the risk of epithelial ovarian cancer: a meta-analysis of 3,782 subjects from five observational studies.

OBJECTIVE: The etiology of epithelial ovarian cancer is unknown. Prior work suggests that high dietary beta-carotene intake is associated with a decreased risk of this tumor although this association remains speculative. A meta-analysis was performed to evaluate this suspected relationship. METHODS: Using previously described methods, a protocol was developed for a meta-analysis examining the association between high dietary beta-carotene intake versus low intake and the risk of epithelial ovarian cancer. Literature search techniques, study inclusion criteria and statistical procedures were prospectively defined. Data from observational studies were pooled using a general variance based meta-analytic method employing confidence intervals previously described by Greenland. The outcome of interest was a summary relative risk (RRs) reflecting the risk of ovarian cancer associated with high beta-carotene intake versus low dietary intake. Sensitivity analyses were performed when necessary to evaluate any observed statistical heterogeneity. RESULTS: Five observational studies enrolling 3,782 subjects were initially pooled in a meta-analysis subsequent to an analysis showing a lack of statistical heterogeneity. The meta-analysis showed a summary relative risk of 0.84 with a 95% confidence interval of 0.75-0.94, a statistically significant result. These data suggest that high (versus low) dietary intake of beta-carotene is associated with a sixteen percent decrease in ovarian cancer risk. Sensitivity analyses showed no impact of study design or differences in quantitative measure of beta-carotene intake across studies on the summary relative risk. CONCLUSIONS: High dietary intake of beta-carotene appears to represent a protective factor for the development of ovarian cancer although its magnitude is modest. Further work is needed to clarify factors that may modify the effects of beta-carotene in vivo.

Adult↗

PubMed1998

Meta-analysis of the ACE gene in ischaemic stroke.

OBJECTIVES: The angiotensin-1 converting enzyme (ACE) gene is known to have two polymorphic alleles I/D. People with the DD genotype have been shown to be at greater risk of myocardial infarction, but only in some studies. Similar studies in stroke patients also show inconsistent results, but most of these studies have been underpowered to detect a small contribution to stroke risk from the ACE gene. A meta-analysis was undertaken using all known publications of the ACE polymorphism in ischaemic stroke. METHODS: Two computerised databases were searched for all publications relating to case-control studies using the ACE I/D variant in human ischaemic stroke. Seven association studies were identified and a meta-analysis was conducted using the Mantel-Haenszel estimate for odds ratio (OR) to determine whether the DD genotype predicted outcome in either a genetically dominant or recessive model. RESULTS: 1918 white subjects (1196 cases and 722 controls) were used in the meta-analysis. There was no difference in ACE genotype (chi2=2.92, p>0.05) or I/D allele frequency (chi2=3.28, p>0.05) in cases or controls. The overall OR for the D allele as an independent risk factor in ischaemic stroke was 1.31 (95% confidence interval (95% CI): 1.06-1.62, p=0.01) under a recessive model, and 1.14 (95% CI: 0.91-1.44, p=0.26) under a dominant model. CONCLUSIONS: This meta-analysis shows that the the D allele, acting recessively, is a modest but independent risk factor for ischaemic stroke onset. Meta-analysis may usefully be employed in allelic association studies for detecting small attributable risks of candidate genes in polygenic disorders.

Aged↗

PubMed2005

Tumor risk in Beckwith-Wiedemann syndrome: A review and meta-analysis.

Beckwith-Wiedemann syndrome (BWS) is an overgrowth syndrome associated with macroglossia, abdominal wall defects, ear anomalies, and an increased risk for embryonic tumors. Reported tumor risk estimates vary between 4% and 21%. It has been hypothesized that tumor predisposition in BWS is related to the imprinting status of the H19 and LIT1 genes on chromosome 11p15. A loss of imprinting (LOI) of H19 implies a higher tumor risk. However, a systematic analysis of available data is lacking. Therefore, we performed a review and meta-analysis of reported associations between the imprinting status of the LIT1 and H19 genes and the risk for tumor development in BWS. Five publications suitable for meta-analysis were identified by electronic database searches. Sufficient data were available for 402 out of 520 patients. Patients were divided into four groups based on the imprinting status of H19 and LIT1: group I with LOI of LIT1 (45%); group II with LOI of H19 (9%); group III with LOI of LIT1 and LOI of H19 (21%); and group IV with normal imprinting patterns (26%). Differences in tumor risk between groups were studied with random effects meta-analysis. Tumors occurred in 55 patients. The odds of tumor development was significantly lower in group I when compared to group II (OR=0.06; 95% CI: 0.02-0.21) and group III (OR=0.12; 95% CI: 0.04-0.37). Tumor risk did not differ significantly between groups II and III (OR=1.40; 95% CI: 0.56-3.50). Compared to group IV, tumor risk was significantly lower in group I (OR=0.33; 95% CI: 0.12-0.87) and higher in groups II (OR=4.0; 95% CI: 1.5-10.4) and III (OR=2.6; 95% CI: 1.2-5.7). Tumor incidence rate for group IV was 10.6% (95% CI: 3.6-17.7). Calculated absolute risks were 3% for group I, 43% for group II, and 28% for group III, respectively. No Wilms tumor was seen in group I. In total, other tumors were seen with comparable frequencies in groups I-III. The results show a strong association between a LOI of H19 and especially Wilms tumor development in BWS.

Beckwith-Wiedemann Syndrome↗

PubMed2004

Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children.

OBJECTIVE: To conduct a meta-analysis of randomized, controlled trials of cephalosporin versus penicillin treatment of group A beta-hemolytic streptococcal (GABHS) tonsillopharyngitis in children. METHODOLOGY: Medline, Embase, reference lists, and abstract searches were conducted to identify randomized, controlled trials of cephalosporin versus penicillin treatment of GABHS tonsillopharyngitis in children. Trials were included if they met the following criteria: patients <18 years old, bacteriologic confirmation of GABHS tonsillopharyngitis, random assignment to antibiotic therapy of an orally administered cephalosporin or penicillin for 10 days of treatment, and assessment of bacteriologic outcome using a throat culture after therapy. Primary outcomes of interest were bacteriologic and clinical cure rates. Sensitivity analyses were performed to assess the impact of careful clinical illness descriptions, compliance monitoring, GABHS serotyping, exclusion of GABHS carriers, and timing of the test-of-cure visit. RESULTS: Thirty-five trials involving 7125 patients were included in the meta-analysis. The overall summary odds ratio (OR) for the bacteriologic cure rate significantly favored cephalosporins compared with penicillin (OR: 3.02; 95% confidence interval [CI]: 2.49-3.67, with the individual cephalosporins [cephalexin, cefadroxil, cefuroxime, cefpodoxime, cefprozil, cefixime, ceftibuten, and cefdinir] showing superior bacteriologic cure rates). The overall summary OR for clinical cure rate was 2.33 (95% CI: 1.84-2.97), significantly favoring the same individual cephalosporins. There was a trend for diminishing bacterial cure with penicillin over time, comparing the trials published in the 1970s, 1980s, and 1990s. Sensitivity analyses for bacterial cure significantly favored cephalosporin treatment over penicillin treatment when trials were grouped as double-blind (OR: 2.31; 95% CI: 1.39-3.85), high-quality (OR: 2.50; 95% CI: 1.85-3.36) trials with well-defined clinical status (OR: 2.12; 95% CI: 1.54-2.90), with detailed compliance monitoring (OR: 2.85; 95% CI: 2.33-3.47), with GABHS serotyping (OR: 3.10; 95% CI: 2.42-3.98), with carriers eliminated (OR: 2.51; 95% CI: 1.55-4.08), and with test of cure 3 to 14 days posttreatment (OR: 3.53; 95% CI: 2.75-4.54). Analysis of comparative bacteriologic cure rates for the 3 generations of cephalosporins did not show a difference. CONCLUSIONS: This meta-analysis indicates that the likelihood of bacteriologic and clinical failure of GABHS tonsillopharyngitis is significantly less if an oral cephalosporin is prescribed, compared with oral penicillin.

Anti-Bacterial Agents↗

PubMed1999

Explaining heterogeneity in meta-analysis: a comparison of methods.

Exploring the possible reasons for heterogeneity between studies is an important aspect of conducting a meta-analysis. This paper compares a number of methods which can be used to investigate whether a particular covariate, with a value defined for each study in the meta-analysis, explains any heterogeneity. The main example is from a meta-analysis of randomized trials of serum cholesterol reduction, in which the log-odds ratio for coronary events is related to the average extent of cholesterol reduction achieved in each trial. Different forms of weighted normal errors regression and random effects logistic regression are compared. These analyses quantify the extent to which heterogeneity is explained, as well as the effect of cholesterol reduction on the risk of coronary events. In a second example, the relationship between treatment effect estimates and their precision is examined, in order to assess the evidence for publication bias. We conclude that methods which allow for an additive component of residual heterogeneity should be used. In weighted regression, a restricted maximum likelihood estimator is appropriate, although a number of other estimators are also available. Methods which use the original form of the data explicitly, for example the binomial model for observed proportions rather than assuming normality of the log-odds ratios, are now computationally feasible. Although such methods are preferable in principle, they often give similar results in practice.

Bayes Theorem↗

PubMed2002

Meta-analysis: the efficacy of intravenous H2-receptor antagonists in bleeding peptic ulcer.

BACKGROUND: Although a previous meta-analysis found that intravenous H2-receptor antagonists were only weakly beneficial in bleeding gastric ulcer and of no benefit in bleeding duodenal ulcer, patients with ulcer bleeding continue to receive such treatment. AIM: To re-evaluate the efficacy of intravenous H2-receptor antagonists in ulcer re-bleeding, surgery and mortality by updating the previous meta-analysis. METHODS: After two independent literature searches, randomized, placebo-controlled trials of intravenous H2-receptor antagonists in bleeding ulcer published between 1984 and 2000 were added to those from the initial meta-analysis. Pooled rates of re-bleeding, surgery and death were re-calculated, together with the relative risk reduction, absolute risk reduction, number needed to treat and Mantel-Haenszel odds ratio. RESULTS: Intravenous H2-receptor antagonists did not significantly reduce re-bleeding, surgery or death in bleeding duodenal ulcer. There were small but significant reductions in re-bleeding, surgery and death in bleeding gastric ulcer; the absolute risk reductions were 7.2%, 6.7% and 3.2%, respectively. CONCLUSIONS: Intravenous H2-receptor antagonists are of no value in bleeding duodenal ulcer, although they may be mildly beneficial in bleeding gastric ulcer. Because proton pump inhibitors have a greater inhibitory effect on gastric acid secretion than H2-receptor antagonists, they may be more effective in ulcer bleeding and should be further evaluated for that indication.

Histamine H2 Antagonists↗

PubMed1991

Aminoglycoside combinations versus beta-lactams alone for penetrating abdominal trauma: a meta-analysis.

Despite several small comparative clinical trials, controversy persists over the best choice of antimicrobial therapy for penetrating abdominal trauma. Some still question whether single drug regimens are as effective as the traditional combinations containing an aminoglycoside. A meta-analysis was performed to address this issue. Meta-analysis is a relatively new statistical tool whereby data from a number of clinical trials is analyzed and pooled to produce useful and more reliable data. In this study, a meta-analysis of 17 published randomized trials was performed to assess the effectiveness of single beta-lactam antimicrobials versus combinations containing aminoglycoside when used for penetrating abdominal trauma. The overall summary odds ratio of the pooled results of these trials was 0.96 (p = 0.833) with a 95% confidence interval of 0.30-3.05. Since not significantly different from unity (1.0), we conclude that single beta-lactam antimicrobials are as effective as traditional combinations containing aminoglycoside in this setting.

Abdominal Injuries↗

PubMedDate not supplied

A meta-analysis of utility estimates for HIV/AIDS.

The authors performed a meta-analysis to derive pooled utilities for HIV/AIDS and to assess the relative importance of study design characteristics in predicting utilities. Twenty-five articles were identified reporting 74 unique utilities elicited from 1956 respondents. The authors used a hierarchical linear model to perform the meta-analysis, with disease stage, elicitation method, respondent type, and the upper-bound and lower-bound labels for the utility scale as the independent variables. Disease stage (P = 0.016) and respondent type (P = 0.014) were significant predictors of utility. Elicitation method was of marginal significance (P = 0. 052). Bounds were not significant. Pooling utilities, the authors estimate a utility of 0.70 for AIDS, 0.82 for symptomatic HIV and 0.94 for asymptomatic HIV when the time tradeoff method is used to elicit utilities from patients and the scale ranges from death to perfect health. The pooled utilities reported here should be of great use to researchers performing cost-utility analyses of interventions for HIV/AIDS.

Cost-Benefit Analysis↗

PubMed2001

Height outcome in congenital adrenal hyperplasia caused by 21-hydroxylase deficiency: a meta-analysis.

OBJECTIVE: To investigate adult heights attained by patients with 21-hydroxylase deficiency and to perform a meta-analysis of height outcomes reported in this population. STUDY DESIGN: A retrospective chart review of our patients >5 years of age (n = 65) who were followed up from 1978 to 1998 for 21-hydroxylase deficiency was conducted. Final height (FH) SD scores and target height (TH) SD scores were determined. The impact of sex, time of diagnosis, and compliance was assessed. Meta-analysis of results from 18 studies was performed; TH was available for 204 of 561 patients. RESULTS: Mean FH SD score-TH SD score for our 65 patients was -1.03. For the meta-analysis, mean weighted FH SD score for all 561 patients was -1.37, whereas weighted mean FH SD score-TH SD score for the 204 patients for whom TH was available was -1.21. No difference in outcome was seen for males compared with females, although a statistically significant difference was seen for patients identified early versus late. CONCLUSIONS: Adult height in patients with 21-hydroxylase deficiency is often within 1 SD of TH. Early diagnosis and good compliance appear to improve the outcome. Rather than pursuing alternate therapies for congenital adrenal hyperplasia, efforts may instead be focused on early detection and improved compliance with traditional medical therapy.

Adrenal Hyperplasia, Congenital↗

PubMed1996

Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials.

Meta-analysis of four double-blind, randomized, placebo-controlled trials of oral acyclovir (800 mg five times daily) for the treatment of herpes zoster was conducted to provide definitive assessments of the effect of acyclovir on the resolution of zoster-associated pain. The studies involved a total of 691 patients, and the analysis was performed on an intent-to-treat basis. A range of milestones of pain cessation were evaluated by means of Cox regression models with adjustment for relevant prognostic factors. The proportion of patients with postherpetic neuralgia at 3 and 6 months was also determined. Advancing age and more severe pain at presentation were associated with more prolonged pain. Acyclovir was clearly shown to accelerate pain resolution by all of the measures employed. Benefit was especially evident in patients 50 years of age or older. Fewer acyclovir recipients had postherpetic neuralgia at 3 or 6 months. Overall, the reductions of pain duration and prevalence were approximately twofold.

Acyclovir↗

PubMed2001

A refined method for the meta-analysis of controlled clinical trials with binary outcome.

For the meta-analysis of controlled clinical trials with binary outcome a test statistic for testing an overall treatment effect is proposed, which is based on a refined estimator for the variance of the treatment effect estimator usually used in the random-effects model of meta-analysis. In simulation studies it is shown that the proposed test keeps the prescribed significance level much better than the commonly used tests in the fixed-effects and random-effects model, respectively. Moreover, when using the test it is not necessary to choose between fixed effects and random effects approaches in advance. The proposed method applies in the same way to the analysis of a controlled multi-centre study with binary outcome, including a possible interaction between drugs and centres.

Cisapride↗