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Results for “methodological review”

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PubMed1994

Long-term neurobehavioral outcome in pediatric brain-tumor patients: review and methodological critique.

This paper provides an overview of pediatric brain tumors and reviews the literature on long-term neurobehavioral outcomes for these children. Progress in this area has been slow due to numerous methodological and practical complications. While some general conclusions can be drawn, the development of comprehensive models awaits more research into the multiplicity of biological and nonbiological events, and their interactions, potentially affecting outcome. Increased theoretical and methodological sophistication will be needed to address this complex classification of diseases. Barriers to research in this area are enumerated as are suggestions for future efforts.

Adolescent↗

PubMed2002

The assessment of bleeding patterns in postmenopausal women during continuous combined hormone replacement therapy: a review of methodology and recommendations for reporting of the data.

OBJECTIVES: To systematically review methods used to report data on bleeding patterns among postmenopausal women enrolled in clinical trials of continuous combined hormone replacement therapy (HRT); and to propose the use of standardized terms, definitions, and methods for collecting and reporting bleeding data in such trials. METHODS: A MEDLINE search identified 18 published reports of bleeding patterns among postmenopausal women enrolled in prospective clinical trials that included a continuous combined HRT treatment arm. Only two of these trials were not randomized. Methods for collecting and analyzing bleeding pattern data were collated from these published reports and examined for consistency. RESULTS: Comparisons across studies revealed little consistency in definitions and indices utilized to report bleeding patterns among postmenopausal women administered continuous combined HRT regimens in clinical trials. While a majority of the trials incorporated definitions established by the World Health Organization for the evaluation of bleeding with hormonal contraception, a number of the studies expanded on these definitions to reflect additional dimensions of bleeding such as volume. Indices calculated from daily bleeding data to describe bleeding patterns in treatment groups were highly variable among studies. CONCLUSION: Inconsistencies among clinical trials in bleeding pattern definitions and indices limit understanding and comparison of typical bleeding patterns with continuous combined HRT regimens. Standardized definitions, data collection procedures, and indices are proposed to enhance understanding of bleeding patterns with hormone therapy and enrich the quality of patient counselling on HRT.

Clinical Trials as Topic↗

PubMed1996

Computerization of Fujimori's method of waveform recognition. A review and methodological considerations for its application to all-night sleep EEG.

This article critically reviews 8 computer implementations of Fujimori's method for EEG waveform recognition, with methodological considerations for the application of this method to the analysis of all-night sleep EEG. Fujimori's method has been considered one of the most appropriate waveform analyses for EEG. This kind of analysis is advantageous for measuring frequency and amplitude of each EEG wave separately. However, current implementations have drawbacks which must be resolved before they can be used on all-night sleep EEG. An optimal sampling rate should be determined which is appropriate to the purpose of analysis. Amplitude thresholds for wave recognition, which are now set arbitrarily, should also be improved. Measurement of waves in higher orders of superimposition is also necessary, although existing systems are limited to the second order. Additional algorithms, such as for the separate detection of sleep slow waves, may be useful. Further applications for Fujimori's method are suggested.

Electroencephalography↗

PubMed2005

Review of methodologies and a protocol for the Agrobacterium-mediated transformation of wheat.

Since the first report of wheat transformation by Agrobacterium tumefaciens in 1997, various factors that influence T-DNA delivery and regeneration in tissue culture have been further investigated and modified. This paper reviews the current methodology literature describing Agrobacterium transformation of wheat and provides a complete protocol that we have developed and used to produce over one hundred transgenic lines in both spring and winter wheat varieties.

Journal Article↗

PubMed1980

The steroid-croup controversy: an analytic review of methodologic problems.

The reasons for the controversy regarding the use of corticosteroids to treat croup were reviewed by evaluating nine studies for their adequacy in meeting eight methodologic standards essential for reducing bias and distortion in clinical trials. Five studies employed diagnostic criteria for croup but none stratified patients with croup into acute laryngotracheitis and spasmodic croup, the two forms which account for the large majority of cases of croup. Only four studies used adequate doses of steroids, defined as 100 mg of cortisone or an equivalent. Only two studies developed clinically relevant choices for the outcome event. Although steroids may be helpful in certain types of croup, it is impossible to reach a definite conclusion about the efficacy of steroids, since all of the studies have major inadequacies in clinical trial design.

Adrenal Cortex Hormones↗

PubMed2000

Clinical tests of the sacroiliac joint.

In the literature many tests are described which are designed to provoke pain or detect joint mobility in the sacroiliac joint (SIJ). However, in part 1 of this review, the authors stated that there is little evidence of reliability of these tests. In this article, the authors describe the methodological review of 11 studies, which have dealt with the validity of SIJ tests. The methodological quality of the studies was tested by using a list of criteria that consisted of three categories: 1) study population, 2) test procedure and 3) test results. A weighting for each criterion was developed. The methodological score for the studies was, in general, disappointing and looked promising for only two out of 11 studies (58 and 64 points). Four authors drew conclusions of positive validity from the tests they studied but other authors did not confirm these results. The conclusion of this methodological review is that there is no evidence to support the inclusion of mobility and pain provocation tests for the SIJ in clinical practice. Three major problems have been identified in validating SIJ dysfunction tests. Firstly, poor reliability of SIJ dysfunction tests exists, which may be improved by multiple test scores as postulated in part 1 of this review. Secondly, the methodological quality of validity studies needs to be developed to a much higher level with special consideration paid to sensitivity, specificity, confidence intervals and likelihood ratio values. And finally, there is a need for the proper use of a gold standard in assessing the validity of SIJ tests.

Humans↗

PubMedDate not supplied

Review of methodologies for the determination of nonvolatile N-nitroso compounds in foods.

An attempt has been made to briefly review methods available for the determination of total N-nitroso compounds, N-nitrosamides, N-nitrosamino acids, and miscellaneous other nonvolatile N-nitroso compounds in foods and beverages, giving special emphasis to the progress made during the past five years. It appears that a wide variety of acceptable methods are available for N-nitrosamino acids and simple hydroxylated N-nitrosamines, but none of them has yet been adequately validated. Only limited progress has been made for the analysis of N-nitrosamides, N-nitroso sugar amino acids, and other N-nitroso compounds. Various mass spectrometric methods available for the determination and confirmation of these compounds are also discussed.

Food Analysis↗

PubMed2004

How reliable are reliability studies of fracture classifications? A systematic review of their methodologies.

Two independent reviewers performed a search in MEDLINE and EMBASE for fracture classification reliability studies. Data were obtained on classifications, image modalities, fracture selection processes, sample sizes and their justification, type and number of raters, practical issues for the classification sessions, statistical methods, and results. A 10-item checklist was devised for quality assessment of methodologies. 44 studies assessing 32 fracture classification systems were included. We found a wide variation of methodologies. For instance, the median number of raters was 5 (2-36) and the median number of fractures was 50 (10-200). This selection was considered representative in 17/44 of the studies. The true distribution of classification categories was estimated in 9 studies. The kappa coefficient was mostly used (39/44) to quantify the raters' agreement. Methodological issues are discussed. Given limitations in the use and interpretation of kappa coefficients, investigators should consider alternative methods that focus upon the accuracy of the classification systems. The development and adoption of a systematic methodological approach to the development and validation of fracture classification systems is needed.

Fractures, Bone↗

PubMedDate not supplied

Psychiatric morbidity following motor vehicle accidents: a review of methodological issues.

Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.

Accidents, Traffic↗

PubMed1997

Estimating the economic costs of the abuse of tobacco, alcohol and illicit drugs: a review of methodologies and Canadian data sources.

The study of economic costs of substance abuse, namely, abuse of tobacco, alcohol and illicit drugs, can provide important information for setting good public health policies. This review paper provides a list of previous cost studies of substance abuse, compares the cost categories considered by various methodologies and describes an inventory of data sources for obtaining relevant information for cost studies. Investigators will find this paper useful as an introduction to the literature in this area, for designing a list of cost categories to consider in a particular study and for identifying relevant data sources.

Alcoholism↗

PubMed2002

Pharmacokinetics of ethanol: a review of the methodology.

This paper reviews current concepts on tools for studying the pharmacokinetics of alcohol. It has been known that ethanol metabolism occurs mainly in the liver via alcohol dehydrogenase and an accessory microsomal pathway. The contribution of each pathway has been examined by administration of metabolic inhibitors. The role of gastric alcohol dehydrogenase in the first-pass effects of ethanol has been speculative and may be relatively low. Some pharmacokinetic approaches with mathematical models have elucidated the role of gastric alcohol dehydorgenase, hepatic alcohol dehydrogenase and cytochrome P450 2E1 in ethanol elimination. The scale-up of ethanol elimination kinetics has enabled extrapolation from animal models to human kinetics. The clarification of the pharmacokinetics of ethanol is very important for estimating the effects of ethanol on biological events.

Alcohol Dehydrogenase↗

PubMed2004

Quantitative proteomics: a review of different methodologies.

The present review attempts to cover the vast array of methods which have appeared in the last few years for performing quantitative proteome analysis. These methods are divided into two classes: those applicable to conventional two-dimensional map analysis, coupling orthogonally a charge-based step (isoelectric focusing) to a size-based separation [sodium dodecylsulfate (SDS)-electrophoresis] and those applicable to two-dimensional chromatographic protocols. The first method, although being by and large the most popular approach, can offer differential display of paired samples with relatively few methods, the oldest one being based on statistical analysis performed on sets of gels via powerful software packages, such as the MELANIE, PDQuest, Z3 and Z4000, Phoretix and Progenesis. Recent developments comprise analysis performed on a single gel containing mixed samples differentially labeled, either with fluorophors (Cy3 and Cy5) or with d(0)/d(3) acrylamide. Conversely, chromatographic approaches, which mostly rely on analysis not of intact proteins but of their tryptic digests, offer a panoply of differential labeling protocols, most of which rely on stable isotope tagging. Essentially, all possible reactions have been described, such as those involving Lys, Asp, Glu, Cys residues, as well as a number of methods exploiting differential derivatization of amine and carboxyl groups generated during proteolysis. All such methods are described and evaluated.

Amino Acid Sequence↗

PubMed2004

Design and analysis of group-randomized trials: a review of recent methodological developments.

We review recent developments in the design and analysis of group-randomized trials (GRTs). Regarding design, we summarize developments in estimates of intraclass correlation, power analysis, matched designs, designs involving one group per condition, and designs in which individuals are randomized to receive treatments in groups. Regarding analysis, we summarize developments in marginal and conditional models, the sandwich estimator, model-based estimators, binary data, survival analysis, randomization tests, survey methods, latent variable methods and nonlinear mixed models, time series methods, global tests for multiple endpoints, mediation effects, missing data, trial reporting, and software. We encourage investigators who conduct GRTs to become familiar with these developments and to collaborate with methodologists who can strengthen the design and analysis of their trials.

Cluster Analysis↗

PubMed2004

Systematic review: the methodological quality of trials affects estimates of treatment efficacy in functional (non-ulcer) dyspepsia.

AIM: To evaluate treatment efficacy using objective quality criteria. METHODS: A systematic review was performed of randomized controlled trials of endoscopically investigated dyspepsia (1979-2003) using the Jadad score and Rome II guidelines. The Jadad score differentiated studies as 'high quality' (score 4-5/5) vs. 'poor quality' (score 1-3/5). Three key Rome II guidelines on study design (cut-off of 0/3 or > 0/3) were also compared with the Jadad score. RESULTS: Poor quality trials suggested a benefit of prokinetic therapy [relative risk (RR) of remaining dyspeptic, 0.47; 95% confidence interval (CI), 0.39-0.56), which was not confirmed in high quality trials (RR, 1.0; 95% CI, 0.84-1.19). There was a marked benefit of H2-receptor antagonist therapy in poor quality trials (RR, 0.68; 95% CI, 0.61-0.76), but a marginal benefit in good quality trials (RR, 0.87; 95% CI, 0.79-0.97). Trial quality did not affect the small statistically significant benefit seen with Helicobacter pylori eradication. Two high quality trials suggested a limited benefit with the use of proton pump inhibitors, with no poor quality trials to provide a comparison. Separation of the studies by the Rome II criteria had a similar impact on the calculated treatment estimates. CONCLUSIONS: The magnitude of benefit of prokinetic and H2-receptor antagonist therapies reported in previous meta-analyses has been over-estimated. The quality of trials has an impact on the efficacy estimates of treatment. The Rome II criteria for study methodology may be appropriate for judging study quality.

Dyspepsia↗

PubMed2006

Impact of neglect on functional outcome after stroke: a review of methodological issues and recent research findings.

PURPOSE: This study provides an update on recent research findings concerning neglect and its impact on functional outcome. The review covers studies published during the past ten years. METHODS: A systematic review was carried out on reports drawn from electronic databases (MEDLINE and PSYCHLIT, January 1996 - August 2005) and identified from the lists of references in these reports. Unpublished reports, articles in other than the English language, and studies with non-human and non-adult subjects were excluded. The selection criteria were met by 26 articles. RESULTS: 15 of the 26 studies recruited heterogeneous patient groups (patients with right and left and/or unspecified lesions). The results from homogeneous groups (right hemisphere patients) were more consistent, emphasizing neglect as an independent predictor of functional outcome. Studies with homogeneous patient groups used consecutive series of patients, standardized measures of neglect, and a broader concept of functional outcome (both motor and cognitive items) than those with heterogeneous patient groups. Follow-ups longer than one year were very rare. CONCLUSIONS: Neglect has a significant negative impact on functional outcome, either as an independent predictive factor or in connection with other variables. The results, however, are inevitably affected by differences in patient samples and in the methods used in assessing neglect and functional outcome. Research focusing on homogeneous patient groups and especially on left hemisphere patients is needed. Neglect should be assessed with a standardized test battery rather than a single test, and functional outcome should be measured with scales consisting of cognitive, social and motor items. Also longer follow-ups are needed to verify the long-term functional outcome of neglect patients.

Aged↗

PubMedDate not supplied

Parent participation. 1: Literature review and methodology.

A qualitative exploratory study was undertaken to examine parents' views and experiences of participation in the care of their child in hospital and to identify factors that inhibit or facilitate participation. Parents of children aged 2-5 years of age were interviewed within 2 months of discharge, using tape-recorded, semi-structured interviews. The findings demonstrate that parents clearly wish to participate in their children's care at a level of their own choosing. However, they preferred professionals to be responsible for their children's clinical care, while they continue to be responsible for the children's normal day-to-day care. Problems were identified in the area of relationships between parents and professionals, centred on communication and the continuing paternalistic nature of these relationships. Parents of children who experienced single, short hospital admissions found involvement in their children's care particularly difficult. Guidelines were developed from the results, to facilitate parent participation in the care of children in this age group.

Child↗

PubMed1989

Nursing turnover: literature review and methodological critique.

Turnover represents a major problem for nursing and health care in terms of cost, the ability to care for patients and the quality of care given. As a result, turnover has been the subject of a large number of investigations, both in nursing and non-nursing fields. However, many of the articles published report conflicting findings. A further complication is the variety of methodologies researchers have used; there has been little agreement on definition, measurement or reporting strategies. This has led to considerable confusion when attempting to compare studies. This article reviews what is currently understood about nursing turnover from an organizational perspective, and examines some of the methodological considerations surrounding the study of nursing turnover. Historically, nursing turnover research appears to have relied heavily on studies conducted in non-nursing areas for methodological guidance. References to non-nursing studies are therefore important and are reported where appropriate.

Humans↗

PubMedDate not supplied

Residential environment and health: a review of methodological and conceptual issues.

Geographic patterns of poor health and mortality risk are found in most countries. Important health effects at the neighborhood level are mortality, general health, illness and disabilities, mental health, and healthcare utilization. Awareness of the influence of social class on health has been growing during the last decades. Studies show that individuals with lower socioeconomic status (SES) have a shorter life expectancy than do their 'well-off' counterparts. Yet SES-related health inequalities cannot be fully explained by individual characteristics, and environmental qualities should be taken into account. Many aspects of local areas that might be related to health or access to opportunities to live healthily are systematically poorer in socially disadvantaged areas. Such factors have the potential to explain health differences between deprived and prosperous neighborhoods. Investigating health differences at the neighborhood level implies conceptual as well as methodological issues pertaining to selection, accumulation, multiple level measurement, objective features versus perceptions, and time dynamic aspects. This article reviews such issues and evaluates several exemplary theoretical approaches from the fields of public health and environmental health in their ability to overcome such problems.

Environment↗