Efforts to improve interobserver agreement in histopathological grading.

The present study aimed to assess the interobserver variation in histopathological grading of 88 slides by four experienced pathologists who, before the start of the study, reached consensus about the method of grading through a joint session behind a discussion microscope. The results were compared with two previous studies, the first assessing the observer variation under normal conditions, the second doing the same after theoretical agreement about which morphological characteristics were relevant for grading. In the present study the pathologists first made a provisional diagnosis on low power view, followed by a final diagnosis on high power view, scoring various morphological characteristics as in the second study.

Measuring the functional status of patients with low back pain. Assessment of the quality of four disease-specific questionnaires.

Study Design: This study was a literature review of the quality of four disease-specific functional status questionnaires for patients with low back pain: Oswestry; Million; Roland; and Waddell disability questionnaire.

Objectives: The questionnaires were evaluated in terms of general description, scale structure, reliability, validity, responsiveness, and clinical research applications.

Summary Of Background Data: Functional status is an outcome of great interest for clinical trials of low back pain.

The efficacy of traction for lumbar back pain: design of a randomized clinical trial.

Objective: To present the design of a trial on the efficacy of lumbar traction.

Design: Randomized clinical trial.

Patients: Patients with a minimum of 6 wk, nonspecific low back pain.

The efficacy of traction for back and neck pain: a systematic, blinded review of randomized clinical trial methods.

Background And Purpose: The purpose of this study was to conduct a systematic analysis of the literature to assess the efficacy of traction for patients with neck or back pain.

Subjects: For this purpose, randomized clinical trials comparing traction with other treatments were selected.

Methods: A computer-aided search of the literature was conducted for relevant articles, followed by blinded assessment of the methods of the studies.

Treatment of depression in Parkinson's disease: a meta-analysis.

Despite a 40% prevalence of depression in idiopathic Parkinson's disease (PD), an extensive literature search found only 12 controlled studies of treatment efficacy. A meta-analysis of these was performed in pursuit of guidelines for pharmacological treatment. Articles were scored on a scale from 0 to 100 on a specially adapted list of methodological criteria.

The role of cigarette smoking in the etiology of cervical dysplasia.

We evaluated the effect of smoking on the risk of cervical dysplasia in a large case-control study, obtaining smoking information from a mail questionnaire. We observed higher risks with increasing numbers of cigarettes smoked, but not with longer duration of smoking. The risk for ex-smokers was between those of current smokers and nonsmokers and was lower for women who had stopped more than 10 years ago than for those who had quit more recently.

Risk factors for cervical dysplasia: implications for prevention.

This study assessed the aetiologic and public health importance of various risk factors for cervical dysplasia. A case-control design was used in which all cases had a histologically confirmed mild, moderate or severe cervical dysplasia. Controls were sampled from the general population.

The value of computed tomography in the diagnosis of grating scapula.

Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the kappa value as a measure of the interobserver agreement.

The role of sexual factors in the aetiology of cervical dysplasia.

The effect of sexual behavior on the risk for cervical dysplasia was evaluated in a case-control study. Cases (n = 257) had a histologically confirmed diagnosis of cervical dysplasia. Controls (n = 705) were sampled from the general population.

A randomized trial about the perceived informativeness of new empirical evidence. Does beta-carotene prevent (cervical) cancer?

The perceived informativeness of a publication can be assessed by measuring the change in belief it induces among the scientific public, regarding a certain hypothesis. In a randomized trial, we studied the effect of empirical evidence from a clinical experiment and a case-control study on the hypothesis that beta-carotene protects against (cervical) cancer. The study population consisted of first authors of recently published patient-oriented research papers.

Sources of interobserver variation in histopathological grading of cervical dysplasia.

The present study aimed to assess where the interobserver variation in grading cervical dysplasia stems from. Four experienced pathologists examined 93 histological slides, after they agreed on which morphological characteristics should be considered relevant for grading. They scored 6 morphological characteristics for each slide and assigned it to a degree of dysplasia.

The role of beta-carotene and other dietary factors in the aetiology of cervical dysplasia: results of a case-control study.

The effects of beta-carotene and several other dietary factors on the risk of cervical dysplasia were evaluated in a case-control study. Cases (n = 257) were the participants of a randomized trial assessing the effect of beta-carotene on cervical dysplasia. Controls (n = 705) were sampled from the general population.

[ Distribution of adipose tissue; a new risk indicator for hypertension].

A transverse patient-control study concerning a possible relationship between fat distribution and uncomplicated hypertension was carried out in two general practices. Of 92 patients with hypertension and of a control group of 92 patients from the same general practice matched for age and sex the circumferences of the middle, hip and thigh and the body weight were measured. Smoking habits, alcohol consumption, physical activity and obesity in the family were established in a structured interview.

The effect of beta-carotene on the regression and progression of cervical dysplasia: a clinical experiment.

In order to gain insight into the causality of the relation between beta-carotene and cancer, we performed a randomized placebo-controlled trial in which the effect of beta-carotene on the regression and progression rates of cervical dysplasia were examined. The experimental group (n = 137) received a supplemental dose of 10 mg of beta-carotene daily for 3 months. The control group (n = 141) received placebo capsules.

Interobserver variation in histopathological grading of cervical dysplasia.

In order to assess the variability among histopathologists in grading cervical dysplasia, four experienced histopathologists examined the same set of 106 biopsy specimens and assigned them to one of five diagnostic categories. These were: no dysplasia, mild dysplasia, moderate dysplasia, severe dysplasia and carcinoma in situ. The histopathologists did not discuss the grading criteria beforehand.

The puzzling role of vitamin A in cancer prevention (review).

This review focuses on the question of whether the cancer preventive effect of dietary vitamin A should be attributed to retinol or to carotene. Knowledge about the metabolism of retinol and carotene and results from epidemiological studies point to an effect of carotene. Studies on the mechanisms of the vitamin A effect and results of experimental studies in animals lend, at the same time, much support to an effect exerted by retinol.

Prescription sequence analysis: a new and fast method for assessing certain adverse reactions of prescription drugs in large populations.

Prescription sequence analysis (PSA) uses pharmacy-based prescription drug histories to detect a subset of drug effects: those that are themselves indications for changes in the prescribing of another drug. Dutch pharmacy practice ensures virtually complete drug histories. With a database of 25,000 patients, we used PSA to test an alleged link between the use of the anti-vertigo drug flunarizine and mental depression.

Dietary guidelines for cancer prevention: the etiology of a confused debate.

Several organizations in different countries have issued dietary guidelines for the public in order to reduce cancer incidence. Meanwhile, proponents and opponents of dietary guidelines disagree about their justification. Unfortunately, the discussion is confined to the question of whether or not present evidence is a firm enough base for recommendations.

An assessment of the relative validity of retrospective interviewing for measuring dietary intake.

The relative validity of a method for determining dietary intake four years previously was assessed. In May 1981, 79 people (46 women and 33 men, aged 29-69 years) were interviewed by use of the dietary history method concerning dietary intake in 1977. These results were compared with those obtained in this same group by means of a seven-day record in February 1977.