Abstract:
OBJECTIVE:To design and evaluate a computer advisory system for the treatment of gestational trophoblastic tumour. DESIGN:A comparison of clinicians' treatment decisions with those of the computer system. Two datasets were used: one to calibrate the system and one to independently evaluate it. SETTING:Department of medical oncology. PATIENTS:Computerised records of 290 patients with low risk gestational trophoblastic tumour for whom the advisory system could predict the adequacy of treatment. The calibration set comprised patients admitted during 1979-86(227) and the test set patients during 1986-89(63). MAIN OUTCOME MEASURES:The system's accuracy in predicting need to change treatment compared with clinicians' actions. The mean time faster that the system was in predicting the need to change treatment. RESULTS:On the calibration dataset the system was 94% (164/174) accurate in predicting patients whose treatment was adequate, recommending change when none occurred in only 10 (6%) patients. In patients whose treatment was changed the system recommended change earlier than clinicians in 39/53 cases (74%), with a mean time advantage of 14.9 (SE 2.02) days. On the test dataset the system had an accuracy of 91% (31/34) in predicting treatment adequacy and a false positive rate of 9% (3/34). The system recommended change earlier than clinicians in 22/29 cases (76%), with a mean time advantage of 12.5 (2.22) days. CONCLUSIONS:The computer advisory system could improve patient management by reducing the time spent receiving ineffective treatment. This has implications for both patient time and clinical costs.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Leaning MS,Gallivan S,Newlands ES,Dent J,Brampton M,Smith DB,Bagshawe KDdoi
10.1136/bmj.305.6857.804keywords:
subject
Has Abstractpub_date
1992-10-03 00:00:00pages
804-7issue
6857eissn
0959-8138issn
1756-1833journal_volume
305pub_type
杂志文章abstract:OBJECTIVES:To investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery. DESIGN:Open, multicentre, randomised, controlled, non-inferiority trial. SETTING:Seven...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.m1309
更新日期:2020-05-13 00:00:00
abstract:OBJECTIVE:To examine the associations of a vegetarian diet and dietary fibre intake with risk of diverticular disease. DESIGN:Prospective cohort study. SETTING:The EPIC-Oxford study, a cohort of mainly health conscious participants recruited from around the United Kingdom. PARTICIPANTS:47,033 men and women living in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d4131
更新日期:2011-07-19 00:00:00
abstract:OBJECTIVE:To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. DESIGN:Prospective, operator blinded, randomised controlled trial. SETTING:General dental practice, London. PARTICIPANTS:100 adult smokers...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38621.463900.7C
更新日期:2005-10-29 00:00:00
abstract:OBJECTIVE:To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. DESIGN:Randomised double blind placebo controlled study. PARTICIPANTS:135 hospital patients (mean age 74) taking antibiotics. E...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39231.599815.55
更新日期:2007-07-14 00:00:00
abstract:OBJECTIVES:To investigate use of commodes and attitudes of users and carers to them. DESIGN:Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS:140 users of a commode and 105 of their carers. RESULTS:Main reasons for being supplied with a co...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6914.1258
更新日期:1993-11-13 00:00:00
abstract:OBJECTIVE:To investigate the results of resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire. DESIGN:Study of all such attempts at resuscitation over 32 months, based on the standard report form for each call made by the ambulance staff and the electrocardiogram tha...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6752.600
更新日期:1990-09-22 00:00:00
abstract::Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant scree...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g2253
更新日期:2014-05-27 00:00:00
abstract:OBJECTIVE:To compare the efficacy of surgery with disc prosthesis versus non-surgical treatment for patients with chronic low back pain. DESIGN:A prospective randomised multicentre study. SETTING:Five university hospitals in Norway. PARTICIPANTS:173 patients with a history of low back pain for at least one year, Osw...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.d2786
更新日期:2011-05-19 00:00:00
abstract:OBJECTIVE:To examine the association between intake of different types of alcoholic drinks and mortality. DESIGN:Prospective population study with baseline assessment of alcohol intake, smoking habit, income, education, and body mass index, and 10-12 years' follow up of mortality. SETTING:Copenhagen city heart study,...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6988.1165
更新日期:1995-05-06 00:00:00
abstract:OBJECTIVE:To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea. DESIGN:Prospective randomised allocation to one of three oral rehydration solutions (World Healt...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.308.6929.624
更新日期:1994-03-05 00:00:00
abstract::All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 3 1/2 years had a sensitivity of 45% for identifying the 103 ch...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6733.1177
更新日期:1990-05-05 00:00:00
abstract:OBJECTIVE:To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. DESIGN:Systematic review and meta-analysis of randomised trials, q...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.c2332
更新日期:2010-06-11 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of oral rehydration in children with moderate dehydration caused by gastroenteritis, and to compare the complications of oral and intravenous treatment. DESIGN:Randomised controlled trial. SETTING:Emergency department and infectious diseases ward in a large urban teaching hosp...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.303.6799.393
更新日期:1991-08-17 00:00:00
abstract:OBJECTIVE:To determine whether the increased iron demands of pregnancy could be met by increased absorption from dietary sources. DESIGN AND SETTING:Longitudinal prospective study in the research unit of a maternity hospital. SUBJECTS:12 normal pregnant women. INTERVENTIONS:At 12, 24, and 36 weeks' gestation (within...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6947.79
更新日期:1994-07-09 00:00:00
abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e1442
更新日期:2012-03-12 00:00:00
abstract:OBJECTIVES:To investigate the effectiveness of non-benzodiazepine hypnotics (Z drugs) and associated placebo responses in adults and to evaluate potential moderators of effectiveness in a dataset used to approve these drugs. DESIGN:Systematic review and meta-analysis. DATA SOURCE:US Food and Drug Administration (FDA)...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e8343
更新日期:2012-12-17 00:00:00
abstract:PROBLEM:Prophylactic treatment and follow-up after exposure to HIV, hepatitis B, and hepatitis C outside hospital needs to be improved. BACKGROUND AND SETTING:Until January 2000, people in Amsterdam could report exposure outside hospital to either a hospital or the municipal health service. If they reported to the mun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.330.7495.825
更新日期:2005-04-09 00:00:00
abstract:OBJECTIVE:To define the benefit of rice oral rehydration salts solution in relation to the glucose based World Health Organisation oral rehydration salts solution for treating and preventing dehydration in patients with severe dehydrating diarrhoea. DESIGN:Meta-analysis using data from 13 available randomised trials t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.304.6822.287
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To determine medical students' self awareness and ability to discriminate right from left; to identify characteristics associated with this ability; and to identify any techniques used to aid discrimination. DESIGN:Questionnaire and psychometric study. SETTING:Undergraduate medical school, Northern Ireland....
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.a2826
更新日期:2008-12-16 00:00:00
abstract::Cancer control encompasses the whole spectrum from prevention and early diagnosis to treatment and palliation. The key to the future of cancer control will be to establish multidisciplinary approaches to each type of cancer across this spectrum. For primary prevention this requires some understanding of the causes of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6952.449
更新日期:1994-08-13 00:00:00
abstract:OBJECTIVE:To determine whether cognitive therapy is effective in preventing the worsening of emerging psychotic symptoms experienced by help seeking young people deemed to be at risk for serious conditions such as schizophrenia. DESIGN:Multisite single blind randomised controlled trial. SETTING:Diverse services at fi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e2233
更新日期:2012-04-05 00:00:00
abstract:OBJECTIVE:To determine whether being overweight in childhood increases adult obesity and risk of disease. DESIGN:Prospective cohort study. SETTING:City of Newcastle upon Tyne. PARTICIPANTS:932 members of thousand families 1947 birth cohort, of whom 412 attended for clinical examination age 50. MAIN OUTCOME MEASURES...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.323.7324.1280
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To compare the effects of treatments for coronavirus disease 2019 (covid-19). DESIGN:Living systematic review and network meta-analysis. DATA SOURCES:WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, up to 3 December 2020 and six additional Chinese databases up to 12 ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m2980
更新日期:2020-07-30 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract::A 40 year old man presents with a 1 cm tender soft swelling in the lateral neck region. This developed seven days after the onset of a tonsillitis episode that has now resolved. He has a 20 pack-year smoking history and consumes minimal alcohol. Examination is otherwise normal. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f5473
更新日期:2013-10-28 00:00:00
abstract:OBJECTIVE:To evaluate the associations between personal use of permanent hair dyes and cancer risk and mortality. DESIGN:Prospective cohort study. SETTING AND PARTICIPANTS:117 200 women enrolled in the Nurses' Health Study, an ongoing prospective cohort study of female nurses in the United States. The women were free...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m2942
更新日期:2020-09-02 00:00:00
abstract:OBJECTIVE:To evaluate an experimental heroin maintenance programme. DESIGN:Randomised trial. SETTING:Outpatient clinic in Geneva, Switzerland. SUBJECTS:Heroin addicts recruited from the community who were socially marginalised and in poor health and had failed in at least two previous drug treatments. INTERVENTION:...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.317.7150.13
更新日期:1998-07-04 00:00:00
abstract:OBJECTIVES:To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. DESIGN:Prospective, randomized, 52 week, single blind comparative effec...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.k851
更新日期:2018-03-21 00:00:00
abstract::To study a range of possible risk factors for HIV among injecting drug user patients attending a clinic in London were interviewed from November 1986 to November 1987. Serum samples were tested for viral markers. Of 116 patients, 101 had shared injecting equipment, 75 on the first occasion of injecting and 76 during t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6680.1081
更新日期:1989-04-22 00:00:00
abstract:OBJECTIVE:To assess the safety and effectiveness of eflornithine as first line treatment for human African trypanosomiasis. DESIGN:Cohort study. SETTING:Control programme in Ibba, southern Sudan. PARTICIPANTS:1055 adults and children newly diagnosed with second stage disease in a 16 month period. MAIN OUTCOME MEASU...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39485.592674.BE
更新日期:2008-03-29 00:00:00