Quality indicators for the diagnosis and treatment of breast cancer integrated assistance: A critical appraisal.

Introduction: Quality indicators (QIs) are essential for adequate control of the health care management process, recognizing areas of improvement and providing solutions. We aimed to evaluate the Integrated Breast Cancer (BC) Care Process QIs.

Methods: We studied 487 consecutive BC cases diagnosed from November 1st, 2013, to November 30th, 2019, in a Spanish healthcare area, and we estimated the associated QIs.

Research integrity in randomized clinical trials: A scoping umbrella review.

Background: Randomized clinical trials (RCTs) are experiencing a crisis of confidence in their trustworthiness. Although a comprehensive literature search yielded several reviews on RCT integrity, an overarching overview is lacking.

Objectives: The authors undertook a scoping umbrella review of the research integrity literature concerning RCTs.

Decision Aids for Decision Making about Locally Advance Breast Cancer: A Systematic Review.

Locally advanced breast cancer (LABC) is a subset of breast cancer with locoregional progression without distant metastasis. The multimodality treatment (surgery, chemotherapy, radiotherapy, hormonal and targeted therapy if required) could significantly improve results in this specific group of patients. The complex and multiple options of treatment with similar mortality rates but different outcomes depending on the patient's desires, preferences and social environment require aid to facilitate the individual patient's decisions (e.

The transcriptional terminator XRN2 and the RNA-binding protein Sam68 link alternative polyadenylation to cell cycle progression in prostate cancer.

Alternative polyadenylation (APA) yields transcripts differing in their 3'-end, and its regulation is altered in cancer, including prostate cancer. Here we have uncovered a mechanism of APA regulation impinging on the interaction between the exonuclease XRN2 and the RNA-binding protein Sam68, whose increased expression in prostate cancer is promoted by the transcription factor MYC. Genome-wide transcriptome profiling revealed a widespread impact of the Sam68/XRN2 complex on APA.

DNA Damage Regulates the Functions of the RNA Binding Protein Sam68 through ATM-Dependent Phosphorylation.

Cancer cells frequently exhibit dysregulation of the DNA damage response (DDR), genomic instability, and altered RNA metabolism. Recent genome-wide studies have strongly suggested an interaction between the pathways involved in the cellular response to DDR and in the regulation of RNA metabolism, but the molecular mechanism(s) involved in this crosstalk are largely unknown. Herein, we found that activation of the DDR kinase ATM promotes its interaction with Sam68, leading to phosphorylation of this multifunctional RNA binding protein (RBP) on three residues: threonine 61, serine 388 and serine 390.

Clinical practice guidelines and consensus for the screening of breast cancer: A systematic appraisal of their quality and reporting.

Introduction: Clinical practice guidelines (CPGs) and consensus statements (CSs) are being promoted to provide high-quality healthcare guidance. This systematic review has assessed the breast cancer (BC) screening CPGs and CSs quality and reporting.

Methods: A search of bibliographic databases (MEDLINE, Embase, Web of Science, Scopus and CDSR), 12 guideline databases and 51 professional society websites was performed without language restrictions from January 2017 to June 2020, following prospective registration (Prospero no.

Shared decision making in breast cancer screening guidelines: a systematic review of their quality and reporting.

Background: Shared decision making (SDM) is a key component of evidence-based and patient-centred care. The aim of this study is to systematically review the quality of SDM proposals in clinical practice guidelines (CPGs) and consensus statements (CSs) concerning breast cancer (BC) screening.

Methods: Guidances were identified, without language restrictions, using a prospectively planned systematic search (MEDLINE, EMBASE, Web of Science, Scopus and guideline websites) from January 2010 to August 2020.

Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey.

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment.

Materials And Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale.

Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review.

Background: High-quality, well-reported clinical practice guidelines (CPGs) and consensus statements (CSs) underpinned by systematic reviews are needed. We appraised the quality and reporting of CPGs and CSs for breast cancer (BC) treatment.

Methods: Following protocol registration (Prospero n: CRD42020164801), CPGs and CSs on BC treatment were identified, without language restrictions, through a systematic search of bibliographic databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR) and online sources (12 guideline databases and 51 professional society websites) from January 2017 to June 2020.

Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review.

Background: It is not clear whether clinical practice guidelines (CPGs) and consensus statements (CSs) are adequately promoting shared decision making (SDM).

Objective: To evaluate the recommendations about SDM in CPGs and CSs concerning breast cancer (BC) treatment.

Search Strategy: Following protocol registration (Prospero no.

Accuracy of Onsite Tests to Detect Asymptomatic Bacteriuria in Pregnancy: A Systematic Review and Meta-analysis.

Objective: To estimate the accuracy of onsite tests to detect asymptomatic bacteriuria among pregnant women.

Data Sources: We searched MEDLINE, EMBASE, Web of Science, Scopus, and Latin-American Literature from inception until June 2015 without language restrictions. The ClinicalTrials.

Graphical displays for effective reporting of evidence quality tables in research syntheses.

Background: When generating guidelines, quality of the evidence is tabulated to capture its several domains, often using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We developed a graphic display to capture deficiencies, outliers and similarities across comparisons contained in GRADE tables.

Methods: Based on a systematic literature review capturing the effects of 32 different therapeutic comparisons on dysmenorrhoea, we synthesised evidence quality in tables and graphs.

Duration of treatment for asymptomatic bacteriuria during pregnancy.

Background: A previous Cochrane systematic review has shown that antibiotic drug treatment of asymptomatic bacteriuria in pregnant women substantially decreases the risk of pyelonephritis and reduces the risk of preterm delivery. However, it is not clear whether single-dose therapy is as effective as longer conventional antibiotic treatment.

Objectives: To assess the effects of different durations of treatment for asymptomatic bacteriuria in pregnancy.

Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi-country study.

Objective: To determine the relationship of interpregnancy interval with maternal and offspring outcomes.

Design: Retrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.

Setting: Latin America, 1990-2009.

Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis.

Background: Antenatal care of women with epilepsy is varied. The association of epilepsy and antiepileptic drug exposure with pregnancy outcomes needs to be quantified to guide management. We did a systematic review and meta-analysis to investigate the association between epilepsy and reproductive outcomes, with or without exposure to antiepileptic drugs.

Prediction of escape red blood cell transfusion in expectantly managed women with acute anaemia after postpartum haemorrhage.

Objective: To determine clinical predictors of escape red blood cell (RBC) transfusion in postpartum anaemic women, initially managed expectantly, and the additional predictive value of health-related quality of life (HRQoL) measures.

Design: Secondary analysis of women after postpartum haemorrhage, either randomly allocated to, or opting for expectant management.

Setting: Thirty-seven hospitals in the Netherlands.

Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

Background: Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered.

Objectives: To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies.

Search Strategy: An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies.

What do we know about tocolytic effectiveness and how do we use this information in guidelines? A comparison of evidence grading.

Background: Evidence summaries of tocolytic effectiveness assign quality levels based on a single dimension: the study design. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system takes into account several domains, including limitations of the study design and ranking the importance of outcomes.

Objectives: The aim of the study was to compare the quality of evidence according to GRADE with the quality as described by existing guidelines.

A case-control study of the risk of adverse perinatal outcomes due to tuberculosis during pregnancy.

We conducted a case-control study at three main inner-city hospitals in Birmingham, UK between 2004 and 2006, to determine the risk of adverse perinatal outcomes in pregnant women with tuberculosis (TB) (n = 24), compared with healthy pregnant controls (n = 72). The incidence of TB was 62/100,000 pregnancies, with 54.2% cases having pulmonary TB (41.

Duration of treatment for asymptomatic bacteriuria during pregnancy.

Background: A Cochrane systematic review has shown that drug treatment of asymptomatic bacteriuria in pregnant women substantially decreases the risk of pyelonephritis and reduces the risk of preterm delivery. However, it is not clear whether single-dose therapy is as effective as longer conventional antibiotic treatment.

Objectives: To assess the effects of different durations of treatment for asymptomatic bacteriuria in pregnancy.

Making GRADE accessible: a proposal for graphic display of evidence quality assessments.

When generating guidelines, quality of evidence is frequently reported in tabulated form capturing several domains, for example, study design, risk of bias and heterogeneity. Increasingly, this is done using the Grading of Recommendations Assessment, Development and Evaluation approach. As assimilating large amount of tabulated data across several comparisons and outcomes spread over many pages (sometimes hundreds) is not easy, there is a need to present evidence summaries in a more effective way.

Evidence summaries tailored to health policy-makers in low- and middle-income countries.

Objective: To describe how the SUPPORT collaboration developed a short summary format for presenting the results of systematic reviews to policy-makers in low- and middle-income countries (LMICs).

Methods: We carried out 21 user tests in six countries to explore users' experiences with the summary format. We modified the summaries based on the results and checked our conclusions through 13 follow-up interviews.

Misoprostol as an adjunct to standard uterotonics for treatment of post-partum haemorrhage: a multicentre, double-blind randomised trial.

Background: Post-partum haemorrhage is a leading cause of global maternal morbidity and mortality. Misoprostol, a prostaglandin analogue with uterotonic activity, is an attractive option for treatment because it is stable, active orally, and inexpensive. We aimed to assess the effectiveness of misoprostol as an adjunct to standard uterotonics compared with standard uterotonics alone for treatment of post-partum haemorrhage.

Episiotomy for vaginal birth.

Background: Episiotomy is done to prevent severe perineal tears, but its routine use has been questioned. The relative effects of midline compared with midlateral episiotomy are unclear.

Objectives: The objective of this review was to assess the effects of restrictive use of episiotomy compared with routine episiotomy during vaginal birth.