Abstract:
:Randomized clinical trials (RCTs) have been used to assess interventions affecting health since biblical times. They provide the most valid means of measuring the true effects of intervention compared with no treatment or placebo. Although they can also be used to assess the value of diagnostic tests, this article focuses on randomized trials in the context of treatment. Key elements of an RCT include: the explicit definition of a clinically relevant question; the identification of an appropriate sample of patients; a clearly defined and reproducible intervention; an appropriate intervention and comparator; clinically relevant, measurable outcomes; and appropriate tools for measurement and analysis. It is also essential to establish that the question posed is ethical, the methods of study are valid, and that follow-up is complete, with an "intent to treat" analysis. Results are best presented using both proportions and absolute numbers. By providing clinical decision-makers with numbers needed to treat or harm, decisions may be better informed and easier to understand, than if proportions alone are used.
journal_name
Semin Reprod Medjournal_title
Seminars in reproductive medicineauthors
Hughes EGdoi
10.1055/s-2003-39995keywords:
subject
Has Abstractpub_date
2003-02-01 00:00:00pages
55-64issue
1eissn
1526-8004issn
1526-4564journal_volume
21pub_type
杂志文章,评审abstract::Research translation and evaluation are often underconsidered in research design and implementation thus limiting research benefit to the end user. In this article, we first describe a best practice approach to evaluation, for a center of research excellence in polycystic ovary syndrome. Within this, we outline a comp...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0038-1667308
更新日期:2018-01-01 00:00:00
abstract::Over the past decade there has been a resurgence of interest in the culture media used in clinical in vitro fertilization. Unfortunately, during this time more confusion than consensus appears to have developed regarding the composition of these media. In order to facilitate a clearer understanding of this field, it i...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2000-12559
更新日期:2000-01-01 00:00:00
abstract::The maternal-fetal environment plays an important role in developmental programming of adult disease. Metabolic and hormonal dysfunction during human fetal development accompanies gestational diabetes as a common occurrence in mothers with polycystic ovary syndrome (PCOS), while human fetal androgen excess from congen...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1371087
更新日期:2014-05-01 00:00:00
abstract::The reproductive organs in both males and females consist of gonads, internal ductal structures, and external genitalia. Normal sexual differentiation is dependent on the genetic sex determined by the presence or absence of the Y chromosome at fertilization. Testes develop under the influence of the Y chromosome and o...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-815593
更新日期:2003-11-01 00:00:00
abstract::Estrogens are frequently used in reproductive medicine. The Women's Health Initiative trial found that the risks of menopausal hormone therapy (MHT) exceed the benefits. The estrogens in MHT, however, were introduced prior to our understanding of the mechanism of action of estrogens. Estrogen signaling is highly compl...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1299593
更新日期:2012-01-01 00:00:00
abstract::In recent years, there has been increasing concern regarding the safety of in vitro fertilization (IVF) because of the potential health impact on these infants. Multiple pregnancy contributes the vast majority of morbidity associated with IVF and, initially, many thought that adverse outcomes after IVF were solely att...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1087108
更新日期:2008-09-01 00:00:00
abstract::Assisted reproductive techniques have revolutionized the treatment of male reproductive failure, allowing biological fatherhood to be achieved by many men that nature would have never permitted. As we are able to help more and more couples with our therapies, the genetic basis of the man's spermatogenic, anatomical, o...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1307418
更新日期:2012-04-01 00:00:00
abstract::HOX genes, encoding homeodomain transcription factors, are dynamically expressed in endometrium, where they are necessary for endometrial growth, differentiation, and implantation. In human endometrium, the expression of HOXA10 and HOXA11 is driven by sex steroids, with peak expression occurring at time of implantatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1242996
更新日期:2010-01-01 00:00:00
abstract::Primary ovarian insufficiency (POI) compromises a woman's chance of conceiving with her own oocytes. Although biomarkers such as serum follicle-stimulating hormone, serum antimüllerian hormone, and assessment of antral follicle count by transvaginal ultrasound can give some general idea about ovarian activity and perh...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1280921
更新日期:2011-07-01 00:00:00
abstract::Women with polycystic ovary syndrome (PCOS) most often seek treatment for reduction of hair growth and/or acne, restoration of menstrual cyclicity, and infertility. In addition, these patients are increasingly seeking advise and treatment for the metabolic abnormalities related to PCOS (e.g., insulin resistance and ty...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2003-43305
更新日期:2003-08-01 00:00:00
abstract::During most of gestation, the fetal adrenal gland is almost solely dedicated to the production of dehydroepiandrosterone sulfate (DHEA-S). This specialized ability of the fetal adrenal is unique to primates and occurs because of a specialized fetal zone that composes the bulk of the fetal adrenal gland. Morphologicall...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-861549
更新日期:2004-11-01 00:00:00
abstract::The constructs and the provision of preconception and obstetrical care have historically been based on the assumption of heterosexuality, and have often excluded lesbian women. However, due to significant strides in lesbian, gay, bisexual, transgender, and queer (LGBTQ) civil rights, more lesbian women desire to creat...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1606385
更新日期:2017-09-01 00:00:00
abstract::The human uterus mainly consists of two layers: an inner endometrium and an outer layer, the myometrium, made of smooth muscle. The uterus is characterized by its unique capacity for regeneration. This capacity permits cyclical regeneration and remodeling of the tissue over the course of a woman's reproductive life. D...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1331801
更新日期:2013-01-01 00:00:00
abstract::Endometriosis is a common cause of pelvic pain in women of reproductive age. Traditional medical therapies are hormonal in nature, including estrogen-progestin contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) agonists. Other hormonal options are androgens and aromatase inhibitors, with research al...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1597308
更新日期:2017-01-01 00:00:00
abstract::The number of women in the U.S. military is dramatically increasing. Similarly, the roles of active-duty women are greatly expanding, thus exposing them to new occupational risks. Determining the impact of pregnancy outcomes for women while in the military is difficult due to changing exposures over time, difficulty i...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0040-1712929
更新日期:2019-09-01 00:00:00
abstract::Subclinical hypothyroidism has been found to be associated with adverse reproductive outcomes, such as infertility, miscarriage, preterm birth, and complications of pregnancy. Multiple studies have investigated the relationships between thyroid function, thyroid antibodies, fertility, and pregnancy. Thyroid autoimmuni...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1593487
更新日期:2016-11-01 00:00:00
abstract::Successful in utero stem cell transplantations with hematopoietic or other stem cells should represent a major step forward in the management of patients with congenital, hematological, metabolic, and immunological disorders. The possibility of performing cell transplantations with stem cells across histoincompatibili...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-952156
更新日期:2006-11-01 00:00:00
abstract::Despite the critical role the placenta plays in governing the outcome of pregnancy, a great deal remains to be learned about this transient organ. Several factors have contributed to our relative lack of knowledge. For example, most of the placenta's development, which precedes that of the embryo or fetus, occurs duri...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2000-12569
更新日期:2000-01-01 00:00:00
abstract::Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) share a common receptor in gonadal cells; however, the presence of these receptors has also been detected in several nongonadal but reproduction-associated tissues of pig, human, and other species. There are no data about the ontogeny of the human LH/hCG ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2001-13907
更新日期:2001-01-01 00:00:00
abstract::The contribution of embryo cryopreservation to the birth rate per in vitro fertilization cycle has escalated from a rare subsidy to a vital tool that is called upon to augment the cycle outcome. Embryology laboratories must identify the embryo stage, quality criteria and methodology that will optimize their ability to...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1546826
更新日期:2015-03-01 00:00:00
abstract::Intraperitoneal adhesions remain a costly, long-term sequela of abdominal surgery. They cause significant postoperative morbidity and difficult reoperative surgery. Although adhesions have been recognized for more than 250 years, a uniformly effective method of adhesion prevention does not exist. In recent years, rese...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1082391
更新日期:2008-07-01 00:00:00
abstract::Since 2004, assisted conception is encompassed by the European Directive on the Quality and Safety of Tissues and Cells (2004/23/EC). The aim of a standard for quality and safety is to minimize risks of errors, contamination, and accidents and to maximize efficiency of use. This article presents a case study of the im...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0032-1311521
更新日期:2012-06-01 00:00:00
abstract::Prior to the advent of modern minimally invasive surgery techniques, the primary surgical management of symptomatic leiomyomata for women desiring future fertility or uterine conservation was through laparotomy. Today, many cases of intramural and subserous leiomyomata are managed with laparoscopic myomectomy and sele...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-828621
更新日期:2004-05-01 00:00:00
abstract::Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1361822
更新日期:2014-01-01 00:00:00
abstract::Gonadotropin-releasing hormone agonist (GnRHa) administration for the induction of oocyte maturation during in vitro fertilization treatment is effective in the prevention of ovarian hyperstimulation syndrome (OHSS). However, some studies have reported a lower ongoing pregnancy rate after GnRHa trigger. The excellent ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1265678
更新日期:2010-11-01 00:00:00
abstract::Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe fo...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0030-1248135
更新日期:2010-03-01 00:00:00
abstract::Leptin is a circulating protein produced by adipocytes that has been implicated in control of body weight through appetite regulation and control of reproduction, most likely through an effect on the central nervous system. From studies in mice, it is clear that the genetic background of the animal on which the mutati...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2002-32506
更新日期:2002-05-01 00:00:00
abstract::Intrauterine insemination (IUI) is a widely used fertility treatment for couples with male and/or non-male factor infertility and is a relatively simple and inexpensive procedure. When used for unexplained infertility, IUI combined with ovarian stimulation increases the pregnancy rates, but evidence does not support t...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1375183
更新日期:2014-07-01 00:00:00
abstract::Gonadotropins cross the vascular endothelial barrier to reach their target organs. Hormone concentrations in blood are very low and fluctuate rapidly to give sharp biological effects. Nonspecific transendothelial transport mechanisms are slow and markedly concentration dependent. There is thus a need for specific tran...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2001-13916
更新日期:2001-01-01 00:00:00
abstract::Although the genetic origin of many human diseases and phenotypes has been long and widely recognized, identification of the causative gene alleles has been limited, slow, and cumbersome. This has changed substantially with the introduction of genome-wide association studies (GWASs) a decade ago, fueled by studies and...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0036-1585406
更新日期:2016-07-01 00:00:00