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4.
Rev Med Suisse ; 15(664): 1699-1702, 2019 Sep 25.
Artigo em Francês | MEDLINE | ID: mdl-31553533

RESUMO

Case-reports, traditionally used in different medical specialties, allow to share important clinical information for the optimization of medical treatment of patients. They typically describe unusual or novel medical observations that may not have been previously reported in clinical studies. This article aims to resume the key aspects of the process of preparing and writing a good quality case-report in order to optimize its interest and its contribution to the medical knowledge. We will review the usefulness of this type of publication, its purpose and its major drawbacks. We will present the CARE guideline, established by a consensus of authors in 2013 in order to standardize the writing of case report studies and allow a qualitative comparison of these articles on objective bases.


Assuntos
Medicina , Relatório de Pesquisa/normas , Redação/normas , Consenso , Humanos
5.
Rev Med Suisse ; 15(664): 1703-1706, 2019 Sep 25.
Artigo em Francês | MEDLINE | ID: mdl-31553534

RESUMO

The scientific abstract is an essential part of an article. It resumes it clearly and synthetically in few sentences, while captivating the reader. Being the first paragraph, and sometimes the only one to be read, it should be comprehensive and needs to represent the paper as much as possible in order to motivate readers to continue reading if it corresponds to the subject of interest. It is also the only text to be submitted to conferences, and it is important in the process of application for research fundings too. In this article, we propose a practical guide to help you write a structured and accurate scientific abstract, with some practical tips.


Assuntos
Relatório de Pesquisa/normas , Redação/normas , Motivação , Leitura , Apoio à Pesquisa como Assunto
6.
BMJ ; 366: l5221, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533922

RESUMO

OBJECTIVE: To examine the design characteristics, risk of bias, and reporting adequacy of pivotal randomised controlled trials of cancer drugs approved by the European Medicines Agency (EMA). DESIGN: Cross sectional analysis. SETTING: European regulatory documents, clinical trial registry records, protocols, journal publications, and supplementary appendices. ELIGIBILITY CRITERIA: Pivotal randomised controlled trials of new cancer drugs approved by the EMA between 2014 and 2016. MAIN OUTCOME MEASURES: Study design characteristics (randomisation, comparators, and endpoints); risk of bias using the revised Cochrane tool (bias arising from the randomisation process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selection of the reported result); and reporting adequacy (completeness and consistency of information in trial protocols, publications, supplementary appendices, clinical trial registry records, and regulatory documents). RESULTS: Between 2014 and 2016, the EMA approved 32 new cancer drugs on the basis of 54 pivotal studies. Of these, 41 (76%) were randomised controlled trials and 13 (24%) were either non-randomised studies or single arm studies. 39/41 randomised controlled trials had available publications and were included in our study. Only 10 randomised controlled trials (26%) measured overall survival as either a primary or coprimary endpoint, with the remaining trials evaluating surrogate measures such as progression free survival and response rates. Overall, 19 randomised controlled trials (49%) were judged to be at high risk of bias for their primary outcome. Concerns about missing outcome data (n=10) and measurement of the outcome (n=7) were the most common domains leading to high risk of bias judgments. Fewer randomised controlled trials that evaluated overall survival as the primary endpoint were at high risk of bias than those that evaluated surrogate efficacy endpoints (2/10 (20%) v 16/29 (55%), respectively). When information available in regulatory documents and the scientific literature was considered separately, overall risk of bias judgments differed for eight randomised controlled trials (21%), which reflects reporting inadequacies in both sources of information. Regulators identified additional deficits beyond the domains captured in risk of bias assessments for 10 drugs (31%). These deficits included magnitude of clinical benefit, inappropriate comparators, and non-preferred study endpoints, which were not disclosed as limitations in scientific publications. CONCLUSIONS: Most pivotal studies forming the basis of EMA approval of new cancer drugs between 2014 and 2016 were randomised controlled trials. However, almost half of these were judged to be at high risk of bias based on their design, conduct, or analysis, some of which might be unavoidable because of the complexity of cancer trials. Regulatory documents and the scientific literature had gaps in their reporting. Journal publications did not acknowledge the key limitations of the available evidence identified in regulatory documents.


Assuntos
Antineoplásicos/uso terapêutico , Aprovação de Drogas/métodos , Neoplasias/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Viés , Estudos Transversais , Controle de Medicamentos e Entorpecentes , Humanos , Projetos de Pesquisa , Relatório de Pesquisa
8.
Stud Health Technol Inform ; 264: 883-887, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438051

RESUMO

Patient safety events (PSEs), or medical errors, are major impediments to healthcare system safety. Health information technology (HIT) is expected to promote quality of care. Nonetheless, HIT also creates unintended consequences that concern patient safety consolidating a high-quality database of HIT events is essential to understanding their nature. Previous studies demonstrated the potential to use FDA Manufacturer and User Facility Device Experience (MAUDE) database to extract HIT events. In this study, we utilized classic and CNN models to extract HIT events from MAUDE. Both individual and combined models were evaluated on the test set, where the best model identified HIT events with ~90% accuracy and achieved a ~.87 f1 score. This model was capable of identifying HIT events in an HIT-exclusive database and serving as a quality and error check tool during event reporting. Moreover, the strategy of HIT event identification may scale in developing other PSE subtype-specific databases.


Assuntos
Informática Médica , Bases de Dados Factuais , Humanos , Segurança do Paciente , Relatório de Pesquisa , Estados Unidos , United States Food and Drug Administration
9.
Stud Health Technol Inform ; 264: 1041-1045, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438083

RESUMO

Natural language processing (NLP) technologies have been successfully applied to cancer research by enabling automated phenotypic information extraction from narratives in electronic health records (EHRs) such as pathology reports; however, developing customized NLP solutions requires substantial effort. To facilitate the adoption of NLP in cancer research, we have developed a set of customizable modules for extracting comprehensive types of cancer-related information in pathology reports (e.g., tumor size, tumor stage, and biomarkers), by leveraging the existing CLAMP system, which provides user-friendly interfaces for building customized NLP solutions for individual needs. Evaluation using annotated data at Vanderbilt University Medical Center showed that CLAMP-Cancer could extract diverse types of cancer information with good F-measures (0.80-0.98). We then applied CLAMP-Cancer to an information extraction task at Mayo Clinic and showed that we can quickly build a customized NLP system with comparable performance with an existing system at Mayo Clinic. CLAMP-Cancer is freely available for academic use.


Assuntos
Armazenamento e Recuperação da Informação , Neoplasias , Registros Eletrônicos de Saúde , Humanos , Processamento de Linguagem Natural , Relatório de Pesquisa
11.
Nature ; 571(7763): 95-98, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31270483

RESUMO

The overwhelming majority of scientific knowledge is published as text, which is difficult to analyse by either traditional statistical analysis or modern machine learning methods. By contrast, the main source of machine-interpretable data for the materials research community has come from structured property databases1,2, which encompass only a small fraction of the knowledge present in the research literature. Beyond property values, publications contain valuable knowledge regarding the connections and relationships between data items as interpreted by the authors. To improve the identification and use of this knowledge, several studies have focused on the retrieval of information from scientific literature using supervised natural language processing3-10, which requires large hand-labelled datasets for training. Here we show that materials science knowledge present in the published literature can be efficiently encoded as information-dense word embeddings11-13 (vector representations of words) without human labelling or supervision. Without any explicit insertion of chemical knowledge, these embeddings capture complex materials science concepts such as the underlying structure of the periodic table and structure-property relationships in materials. Furthermore, we demonstrate that an unsupervised method can recommend materials for functional applications several years before their discovery. This suggests that latent knowledge regarding future discoveries is to a large extent embedded in past publications. Our findings highlight the possibility of extracting knowledge and relationships from the massive body of scientific literature in a collective manner, and point towards a generalized approach to the mining of scientific literature.


Assuntos
Mineração de Dados/métodos , Conhecimento , Ciência dos Materiais , Processamento de Linguagem Natural , Relatório de Pesquisa , Pesquisa , Terminologia como Assunto , Aprendizado de Máquina não Supervisionado , Condutividade Elétrica , Eletrodos , Ferro , Lítio , Magnetismo , Reprodutibilidade dos Testes , Semântica , Temperatura Ambiente
12.
Virchows Arch ; 475(5): 551-561, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31270615

RESUMO

Standardized structured reporting (SSR) enables high-quality pathology reporting, but implementing SSR is slow. The objective of this study is to identify both barriers and facilitators that pathologists encounter in SSR, in order to develop tailored implementation tools to increase SSR usage. We used a mixed method design: a focus group interview helped to identify barriers and facilitators in SSR. The findings were classified into the following domains: innovation, individual professional, social setting, organization, and economic and political context. We used a web-based survey among Dutch pathologists to quantify the findings. Ten pathologists participated in the focus group interview, and 97 pathologists completed the survey. The results of both showed that pathologists perceive barriers related to SSR itself. Particularly its incompatibility caused lack of nuance (73%, n = 97) in the standardized structured pathology report. Regarding the individual professional, knowledge about available SSR-templates was lacking (28%, n = 97), and only 44% (n = 94) of the respondents agreed that using SSR facilitates the most accurate diagnosis. Related to social setting, support from the multidisciplinary team members was lacking (45%, n = 94). At organization level, SSR leads to extra work (52%, n = 94) because of its incompatibility with other information systems (38%, n = 93). Main facilitators of SSR were incorporation of speech recognition (54%, n = 94) and improvement in communication during multidisciplinary team meetings (69%, n = 94). Both barriers and facilitators existed in various domains. These factors can be used to develop implementation tools to encourage SSR usage.


Assuntos
Fidelidade a Diretrizes , Patologia/normas , Relatório de Pesquisa/normas , Adulto , Comunicação , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Patologistas , Controle de Qualidade , Pesquisa , Inquéritos e Questionários
14.
Z Evid Fortbild Qual Gesundhwes ; 143: 1-7, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31296451

RESUMO

Reviews of primary research studies are becoming increasingly important as the concept of evidence-based practice in healthcare is gaining more and more influence and the number of research projects is increasing enormously. One of the less well-known types of review is the "scoping review." Scoping reviews are conducted when one first needs to take stock of the research literature. For example, scoping reviews are conducted in order to establish provisional working definitions or to define topics or subject areas conceptually. Preparing a scoping review also makes sense if the literature has not yet been comprehensively assessed or if it contains a complex or heterogeneous problem so that a more precise systematic review of the evidence is not appropriate. Scoping reviews can also serve to determine the scope and significance of a prospective classical systematic review. Finally, scoping reviews are also a good way to bundle and communicate research results, identify research gaps, and formulate recommendations for future research. This article explains the methodology of scoping reviews, their differences as compared to systematic reviews, and the reasons why they could be conducted. This guide to conducting scoping reviews is based on the methodology developed by the Joanna Briggs Institute (JBI).


Assuntos
Prática Clínica Baseada em Evidências , Relatório de Pesquisa , Literatura de Revisão como Assunto , Assistência à Saúde , Alemanha , Humanos , Estudos Prospectivos
15.
Gan To Kagaku Ryoho ; 46(Suppl 1): 110-112, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189830

RESUMO

A medical plan reflectsthe current state of a region. The purpose of thisres earch isto analyze medical plansby text mining and examine geographical features using a geographic information system. From the medical plans of 47 prefectures, nationwide, 6 regional divisions', and four age groups' text fileswere prepared. Further, wordswere extracted and subsequently, their relevance wasanalyzed. Additionally, we examined the geographical featuresus ing a color-dividing Japanese map by the word appearance rate of"Mitori"(end-of-life care), which is an important task. In the aggregate nationwide text files, 214,716 words were extracted. The top frequent words were medical care, home, support, nursing care, visit, medical treatment, and cooperation. In the co-occurrence network, medical care- home- nursing care- cooperation were connected with organization- construction. There was a link between human resources- training in Kanto and Kinki."Mitori"frequently occurred in areaswith a high aging rate, and there wasa human resources- training- securing connection in areas with a low aging rate. The frequency of"Mitori"was high in western Japan. The results suggested that collaboration between medical care and nursing care is emphasized in medical planning. Further,"Mitori"was emphasized in western Japan or areas with a high aging rate while human resourcesdevelopment wasemphas ized in areaswith a low aging rate.


Assuntos
Sistemas de Informação Geográfica , Serviços de Assistência Domiciliar , Mineração de Dados , Humanos , Japão , Relatório de Pesquisa
16.
Vet Clin Pathol ; 48(2): 259-269, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192474

RESUMO

BACKGROUND: A degree of uncertainty occurs with every measured laboratory result due to both analytical and biological variation. The tools of Total Observed error (TEO ) and dispersion based on biological variation have helped veterinary labs quantify the causes of variation that lead to measurement uncertainty (MU). International organizations recommend that the amount of MU in veterinary laboratory results be identified and communicated. The expanded measurement uncertainty (EMU), dispersion, and reporting interval adjustment have been recommended as tools to allow communication of MU to laboratory data users but are not commonly discussed in the veterinary literature. OBJECTIVE: Using the vocabulary of Total Observed error and biological variation and examples from veterinary medicine, a review of the theory and application of the EMU, dispersion, and the methods for deriving an appropriate reporting interval recommended by Hawkins and Badrick, is presented. CONCLUSIONS: By addressing the way that MU is communicated to users of laboratory results, the laboratory enables users to better understand the potential uncertainty associated with reported results, helps to prevent over and under-interpretation of data, and improves diagnostic accuracy and patient care.


Assuntos
Química Clínica/normas , Animais , Confiabilidade dos Dados , Erros de Diagnóstico/veterinária , Laboratórios , Valores de Referência , Relatório de Pesquisa , Incerteza
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