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Interest of conflict AND patients

Christine Grady
Measuring the quality and performance of IRBs requires clarity about what IRBs are supposed to do. Although many agree that IRBs are supposed to protect the rights and welfare of human subjects, exactly how review by an IRB contributes to protection is not always clear. Originally, ethics review was instituted as a way to check the interests, possible conflicts, and enthusiasm of investigators whose relationship to participants is different from physicians' relationship to patients. IRB performance might include evaluating how well IRBs do this...
March 21, 2019: Journal of Empirical Research on Human Research Ethics: JERHRE
Z Li, A Y Wang, M Bowman, K Hammarberg, C Farquhar, L Johnson, N Safi, E A Sullivan
STUDY QUESTION: What is the cumulative live birth rate following a 'freeze-all' strategy compared with a 'fresh-transfer' strategy? SUMMARY ANSWER: The 'freeze-all' strategy resulted in a similar cumulative live birth rate as the 'fresh-transfer' strategy among high responders (>15 oocytes retrieved) but did not benefit normal (10-15 oocytes) and suboptimal responders (<10 oocytes). WHAT IS KNOWN ALREADY: Frozen-thawed embryo transfer is associated with a decreased risk of adverse obstetric and perinatal outcomes compared with fresh embryo transfer...
2019: Human Reproduction Open
L E E van der Houwen, M C I Lier, A M F Schreurs, M van Wely, P G A Hompes, A E P Cantineau, R Schats, C B Lambalk, V Mijatovic
STUDY QUESTIONS: The primary objective is to investigate if continuous use of oral contraceptives is non-inferior compared to long-term pituitary desensitization with a GnRH agonist prior to IVF/ICSI in patients with moderate to severe endometriosis with regard to treatment efficacy. Secondary objectives concern treatment safety and cost-effectiveness. WHAT IS KNOWN ALREADY: Long-term pituitary desensitization with a GnRH agonist for 3-6 months prior to IVF/ICSI improves clinical pregnancy rates in women suffering from endometriosis...
2019: Human Reproduction Open
N E van Hoogenhuijze, J C Kasius, F J M Broekmans, J Bosteels, H L Torrance
STUDY QUESTION: What is the effect of endometrial scratching in patients with or without prior failed ART cycles on live birth (LBR) and clinical pregnancy rates (CPR)? SUMMARY ANSWER: It remains unclear if endometrial scratching improves the chance of pregnancy and, if so, for whom. WHAT IS KNOWN ALREADY: Endometrial scratching is hypothesized to improve embryo implantation in ART. Multiple studies have been published, but it remains unclear if endometrial scratching actually improves pregnancy rates and, if so, for which patients...
2019: Human Reproduction Open
P Burkoň, M Slavik, T Kazda, P Pospíšil, T Prochazka, M Vrzal, P Šlampa
BACKGROUND: Stereotactic body radiotherapy (SBRT) is used to treat localized tumor lesions and consists of applying high doses of radiation to a small number of fractions using specially equipped linear accelerators, modern immobilization devices, and imaging methods, which are considered special, advanced techniques in modern day radiotherapy. SBRT is a very well tolerated, non-invasive, short-term treatment that does not require hospitalization or any complicated preparation. Compared to standard radiotherapy techniques, SBRT allows, due to its precision, significantly higher doses to be applied to the target with less damage to surrounding healthy tissues...
2019: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Celeste Tavolaro, Samia Ghaffar, Haitao Zhou, Quynh Nguyen, Carlo Bellabarba, Richard Bransford
BACKGROUND: Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although CT is usually the initial imaging modality, MRI has been proposed as mandatory to help identify spinal injuries in ASD patients with unexplained neck or back pain or known injuries to help identify non-contiguous fractures...
March 16, 2019: Spine Journal: Official Journal of the North American Spine Society
Patricia M Herman, Nicholas Broten, Tara A Lavelle, Melony E Sorbero, Ian D Coulter
BACKGROUND CONTEXT: The US National Pain Strategy focused attention on high-impact chronic pain and its restrictions. Although many interventions have been studied for chronic low-back pain, results are typically reported for heterogeneous samples. To better understand chronic pain and target interventions to those who most need care, more granular classifications recognizing chronic pain's impact are needed. PURPOSE: To test whether chronic pain impact levels can be identified in chronic low-back pain clinical trial samples, examine the baseline patient mix across studies, and evaluate the construct validity of high-impact chronic pain...
March 15, 2019: Spine Journal: Official Journal of the North American Spine Society
Joseph Lopez, Bilal A Naved, Tejus Pradeep, Kevin Pineault, Taylor Purvis, Alexandra Macmillan, Sheri Slezak, James W May, Amir H Dorafshar
BACKGROUND: The purpose of this study was to evaluate patients' views of conflicts of interest (COI) and their comprehension of recent legislation known as the Physician Payments Sunshine Act. This report constitutes the first evaluation of plastic surgery patients' views on COI and the government-mandated Sunshine Act. METHODS: This cross-sectional study invited patients at an academic, general plastic surgery outpatient clinic to complete an anonymous survey. The survey contained 25 questions that assessed respondents' perceptions of physician COI and awareness of the Sunshine Act...
March 12, 2019: Annals of Plastic Surgery
Niko Amend, Horst Thiermann, Franz Worek, Timo Wille
The global use of organophosphorus compounds (OP) for pest control and nerve agents being used in military conflicts and for assassinations renders intoxications by these agents a public health concern. OP-poisoned patients often suffer from dysrhythmias which may ultimately result in death. In this study, human-induced pluripotent stem cells derived cardiomyocytes were exposed to OP compounds in a microelectrode array system (MEA). The MEA system is widely accepted to assess the proarrhythmic properties of (candidate) drugs...
March 8, 2019: Toxicology Letters
Yanling Gou, Xue Li, Peiling Li, Hongyan Zhang, Tenghan Xu, Hao Wang, Beidi Wang, Xuesong Ma, Xue Jiang, Zongfeng Zhang
STUDY QUESTION: How is the activation of estrogen receptor β (ERβ) in endometriotic stromal cells (ESCs) involved in macrophage recruitment to promote the pathogenesis of endometriosis? SUMMARY ANSWER: ERβ modulates the production of C-C motif chemokine ligand 2 (CCL2) via nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling in ESCs and thus recruits macrophages to ectopic lesions to promote pathogenesis. WHAT IS KNOWN ALREADY: Macrophages are mainly recruited to the peritoneal cavity to promote the pathogenesis of endometriosis...
March 6, 2019: Human Reproduction
K Stocking, J Wilkinson, S Lensen, D R Brison, S A Roberts, A Vail
STUDY QUESTION: How much statistical power do randomised controlled trials (RCTs) and meta-analyses have to investigate the effectiveness of interventions in reproductive medicine? SUMMARY ANSWER: The largest trials in reproductive medicine are unlikely to detect plausible improvements in live birth rate (LBR), and meta-analyses do not make up for this shortcoming. WHAT IS KNOWN ALREADY: Effectiveness of interventions is best evaluated using RCTs...
March 6, 2019: Human Reproduction
Laura Hawryluck, Csilla Kalocsai, Joe Colangelo, James Downar
An unexplored aspect of conflicts and conflict resolution in the ICU at EOL is the role of advocacy in both medicine and law. GOAL: Qualitative study to explore perspectives of SDM/patient lawyers on issues of advocacy at EOL to better understand conflicts and resolution processes. METHODS: Purposive sampling with criterion and snowball techniques were used to recruit 11 experienced lawyers for semi-structured interviews. Interviews explored respondents' beliefs, views, and experiences with conflicts; were audio-recorded, coded inductively and iteratively following interpretive analysis...
February 10, 2019: Journal of Critical Care
Ashley L Stephens, Courtenay R Bruce, Andrew Childress, Janet Malek
Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers for critical care patients...
February 28, 2019: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
Gang Huang, Juan Qin, Xuejun Deng, Guiquan Luo, Dongmei Yu, Mei Zhang, Shiheng Zhou, Lei Wang
BACKGROUND: Conflicting results have been reported on the prognostic significance of serum uric acid (SUA) in patients with acute heart failure (AHF). This meta-analysis aimed to determine the prognostic significance of SUA level in patients with AHF. METHODS: We made a comprehensive literature search in Pubmed and Embase databases from inception to April 6, 2018. All available observational studies or post hoc analysis of randomized controlled trial that evaluated the prognostic value of SUA level in patients with AHF were eligible...
February 2019: Medicine (Baltimore)
Ben Goldacre, Carl Reynolds, Anna Powell-Smith, Alex J Walker, Tom A Yates, Richard Croker, Liam Smeeth
OBJECTIVES: Approximately one in eight practices in primary care in England are 'dispensing practices' with an in-house dispensary providing medication directly to patients. These practices can generate additional income by negotiating lower prices on higher cost drugs, while being reimbursed at a standard rate. They, therefore, have a potential financial conflict of interest around prescribing choices. We aimed to determine whether dispensing practices are more likely to prescribe high-cost options for four commonly prescribed classes of drug where there is no evidence of superiority for high-cost options...
February 5, 2019: BMJ Open
Xiao Sun, Xiaobin Zhou, Yuan Zhang, Haihua Liu
OBJECTIVE: The aim of this study was to evaluate the reporting characteristics as well as the methodological quality of systematic reviews (SRs) and meta-analyses (MAs) of nursing interventions in patients with Alzheimer's disease and determine potential factors for high quality. METHODS: Following the inclusion and exclusion criteria, we searched the databases PubMed, EMBASE, and The Cochrane Library from inception through October 1, 2017. Two reviewers independently selected articles and extracted data...
February 25, 2019: Journal of Nursing Scholarship
Lucile Ferreux, Amira Sallem, Ahmed Chargui, Anne-Sophie Gille, Mathilde Bourdon, Chloé Maignien, Pietro Santulli, Jean Philippe Wolf, Catherine Patrat, Khaled Pocate-Cheriet
STUDY QUESTION: Did the revised Alpha/ESHRE consensus (Vienna, 2017) bring a real answer on managing oocytes with aggregates of smooth endoplasmic reticulum (SERa)? SUMMARY ANSWER: According to the currently available literature, a case by case approach on the time of injecting/inseminating SERa+ oocytes may be not helpful for embryologists making a decision, so we suggest fertilizing both SERa+ and SERa- oocytes and prioritizing embryos derived from SERa- oocytes...
February 26, 2019: Human Reproduction
Lauren M Maloney, Mark B Mycyk
Patients, clinicians, and policymakers need to trust that conflicts of interest (COI) are appropriately disclosed in all forms of disseminated science, whether it's in the form of a research study, an expert editorial, a review article, or a meeting presentation. Recent high-profile events have renewed the public's attention to the basic procedure and reasons for disclosing COI.1 Honest and mutually-beneficial partnerships with industry or other funding agencies are vital for the advancement of medicine. Conflicts are inevitable and "could never possibly be eliminated" according to Jeffrey Flier,2 but a better understanding of the procedure for disclosing COI could reduce misunderstandings associated with COI and change the perception that COI is a dirty word...
February 25, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Aakash Garg, Amit Rout, Raj Tayal, Abhishek Sharma, Sahil Agrawal, John B Kostis, Marc Cohen, Samin Sharma, Najam Wasty
Randomized controlled trials comparing drug eluting stents (DES) with bare-metal stents (BMS) for saphenous vein graft (SVG) interventions have shown conflicting results. We conducted this meta-analysis to evaluate the cumulative evidence for long-term efficacy and safety of DES vs BMS in SVG lesions. A systematic search was conducted of Randomized controlled trials comparing DES vs BMS in patients undergoing percutaneous interventions for SVG lesions. End-points of interest were all-cause death, cardiac death, myocardial infarction, target lesion revascularization and target vessel revascularization at longest available follow-up...
January 8, 2019: Current Problems in Cardiology
Soraia Sousa, Tracey Hilder, Christopher Burdess, Philippa Bolton
This study focused on an evaluation over 2.5 years to establish if a frequent attenders' service in an Emergency Department (ED) impacted on the overall number of patients attending as well as the numbers of their attendances. For this, three patient lists from April-September 2015 and three lists from a matched period in 2017 were randomly selected and the two samples compared. Results showed both a reduction in the number of total patients identified as frequent attenders as well as a reduction on the number of attendances to ED...
February 20, 2019: BJPsych Bulletin
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