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Cochrane Collaboration
Nonprofit•Oxford, United Kingdom•
About: Cochrane Collaboration is a nonprofit organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Systematic review & Randomized controlled trial. The organization has 1995 authors who have published 3928 publications receiving 382695 citations.
Papers published on a yearly basis
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TL;DR: None of the three studies found that medication prior to transfusion reduces NHTR, and a better-powered RCT is necessary to evaluate the role of pretransfusion medication in the prevention of NHTR.
Abstract: Background
Allergic and febrile non-haemolytic transfusion reactions (NHTRs) are the two most common forms of transfusion reaction. Pretransfusion medication with anti-inflammatory drugs is used in NHTR prevention, however its efficacy and safety remains unclear.
Objectives
To assess the clinical effects and safety of pharmacological interventions for preventing NHTR in patients with and without a history of transfusion reactions.
Search methods
The search strategy included The Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 4, 2008), Cochrane Injuries Group's Specialised Register (December 17, 2008), MEDLINE (1950 to November (week 3) 2008), EMBASE (1988 to November (week 3) 2008), LILACS (1982 to January 12, 2009), CINAHL (1982 to December 2008), ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED): 1970 to December 2008). There was no language restriction.
Selection criteria
Randomised controlled trials (RCTs) assessing the effectiveness of interventions for the prevention of NHTR.
Data collection and analysis
Authors independently selected studies, assessed the risks of bias and extracted data. Relative risks (RR) were estimated in RCTs with parallel design (PD). Odds ratio (OR) was estimated for one RCT with crossover design (CD). No meta-analysis was attempted due to differences in the pharmacotherapy of pre-transfusion medication and methodology between the studies; a per-protocol analysis was used.
Main results
This review includes three RCTs (two PD and one CD). The PD-RCTs employed disparate units of randomisation (UofR); patient or transfusion, while the CD-RCT applied the patient as the UofR. The PD-RCTs administered leukodepleted blood products. Both PD-RCTs compared acetaminophen plus diphenhydramine (ApD) at different regimens with placebo, while the CD-RCT contrasted hydrocortisone pharmacotherapy with diphenhydramine. Both PD-RCTs found no statistically significant difference in allergic reactions (RR 0.13, 95% confidence interval (CI) 0.01 to 2.39, RR 1.46, 95% CI 0.78 to 2.73) and febrile reactions (RR 0.52, 95% CI 0.22 to 1.26). The CD-RCT found a statistically significant difference in the odds of febrile reactions (OR 2.38, 95% CI 1.07 to 5.27). The trials did not report anaphylactic reactions, deaths related to transfusion reactions or other adverse events.
Authors' conclusions
None of the three studies found that medication prior to transfusion reduces NHTR. This applied regardless of the patient's history of NHTR and the use of leukodepleted blood products in the transfusion. However, this conclusion is based on three trials of moderate to low quality. A better-powered RCT is necessary to evaluate the role of pretransfusion medication in the prevention of NHTR. Inclusion criteria should be restricted to patients at high risk of developing NHTR, with no restriction by age, history of transfusion reactions and type of blood products (leukodepleted or not).
60 citations
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McMaster University1, University of Chile2, University of Amsterdam3, University of Missouri–Kansas City4, Utrecht University5, Cochrane Collaboration6, University of Helsinki7, Liverpool School of Tropical Medicine8, University of Aberdeen9, American University of Beirut10, Ottawa Hospital Research Institute11
TL;DR: Adhering to the general and GRADE domain-specific guidance should improve the quality of explanations associated with GRADE evidence tables, assist authors of systematic reviews, HTA reports, or guidelines with information that they can use in other parts of their evidence synthesis.
60 citations
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TL;DR: It is shown that antibiotics may significantly delay, but might not prevent, preterm birth for women with preterm prelabour rupture of membranes; there is insufficient evidence to show the absolute efficacy of cerclage and bed rest in preventing pre term birth; the use of progesterone appears promising; and the possible benefits of certain tocolytics need to be reliably measured against the possible adverse effects when used in preventingPreterm birth.
59 citations
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TL;DR: The authors' qualitative review provides a comprehensive picture of medical students’ attitudes towards family practice in the available literature, and in general, although some students find family medicine appealing, it is regarded as a career of low interest and prestige.
Abstract: During the last decade medical students from most Western countries have shown little interest in family practice. Understanding the factors that influence medical students to choose family medicine is crucial. To systematically review and synthesize published evidence about medical students’ attitudes and perceptions towards family practice. A qualitative systematic review. The literature search was undertaken in July 2010 in PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Science Citation Index (SSCI), and ProQuest Dissertations & Theses. Two authors independently selected the studies for their inclusion and assessed their quality. The selected studies were thoroughly read. Key themes and categories were identified. A matrix was created for allowing the comparison of each theme across studies. Ten studies were finally included. Seven broad themes were identified across them: 1) Scope and context of practice was a broad theme comprising linked sub-themes: perception of a varied specialty, broad practice, holistic perspective and flexibility that allows having a family; 2) Lower interest or intellectually less challenging: treating common disease, repetitive, quasi administrative job; 3) Influence of role models, either positive and negative, and society: negative comments from other professionals, peers and family; 4) Lower prestige; 5) Poor remuneration; 6) Medical school influences, being important both the length and quality of the exposure; 7) Post graduate training, where the shorter duration and the lower intensity were perceived as positive aspects. After identifying these seven key themes, were also looked into patterns in the distribution of these themes among studies. Our qualitative review provides a comprehensive picture of medical students’ attitudes towards family practice in the available literature. In general, although some students find family medicine appealing, it is regarded as a career of low interest and prestige. More research is needed on the influence of role models, medical school and post graduate training.
59 citations
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TL;DR: The CPI-based crash prediction model can correctly identify the crash and non-crash cases at higher accuracy than the other crash prediction models based on detectors and shows that rear-end collision risk is lower for heavy vehicles than cars in the crash case due to their shorter reaction time and lower speed when spacing is shorter.
59 citations
Authors
Showing all 2000 results
Name | H-index | Papers | Citations |
---|---|---|---|
Douglas G. Altman | 253 | 1001 | 680344 |
John P. A. Ioannidis | 185 | 1311 | 193612 |
Jasvinder A. Singh | 176 | 2382 | 223370 |
George A. Wells | 149 | 941 | 114256 |
Shah Ebrahim | 146 | 733 | 96807 |
Holger J. Schünemann | 141 | 810 | 113169 |
Paul G. Shekelle | 132 | 601 | 101639 |
Peter Tugwell | 129 | 948 | 125480 |
Jeremy M. Grimshaw | 123 | 691 | 115126 |
Peter Jüni | 121 | 593 | 99254 |
John J. McGrath | 120 | 791 | 124804 |
Arne Astrup | 114 | 866 | 68877 |
Mike Clarke | 113 | 1037 | 164328 |
Rachelle Buchbinder | 112 | 613 | 94973 |
Ian Roberts | 112 | 714 | 51933 |