Investigator-led clinical trials are pragmatic trials that aim to investigate the benefits and harms of treatments in routine clinical practice. These much-needed trials represent the majority of all trials currently conducted. They are however threatened by the rising costs of clinical research, which are in part due to extensive trial monitoring processes that focus on unimportant details. Risk-based quality management focuses, instead, on "things that really matter". We discuss the role of central statistical monitoring as part of risk-based quality management. We describe the principles of central statistical monitoring, provide examples of its use, and argue that it could help drive down the cost of randomized clinical trials, especially investigator-led trials, whilst improving their quality.
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http://dx.doi.org/10.1007/s10147-020-01726-6 | DOI Listing |
BMC Psychiatry
January 2025
Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Background: During adolescence, a critical developmental phase, cognitive, psychological, and social states interact with the environment to influence behaviors like decision-making and social interactions. Depressive symptoms are more prevalent in adolescents than in other age groups which may affect socio-emotional and behavioral development including academic achievement. Here, we determined the association between depression symptom severity and behavioral impairment among adolescents enrolled in secondary schools of Eastern and Central Uganda.
View Article and Find Full Text PDFBMC Public Health
January 2025
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Qiaokou District, Wuhan City, 430030, China.
Objective: Understanding healthcare-seeking propensity is crucial for optimizing healthcare utilization, especially for patients with chronic conditions like hypertension or diabetes, given their substantial burden on healthcare systems globally. This study aims to evaluate hypertensive or diabetic patients' healthcare-seeking propensity based on the severity of symptoms, categorizing symptoms as either major or minor. It also explores factors influencing healthcare-seeking propensity and examines whether healthcare-seeking propensity affects healthcare utilization and preventable hospitalizations.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
January 2025
ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 FenYang Road, Shanghai, 200031, China.
Background: Vocal fold leukoplakia (VFL), a precancerous lesion of the larynx, is characterized by white plaques on the vocal fold mucous membrane. Currently, there are no reliable biomarkers to predict the recurrence and malignant transformation of VFL. Considering chondroitin sulfate proteoglycan 4 (CSPG4) as a biomarker for malignant tumors such as laryngeal squamous cell carcinoma (LSCC), we conducted this cohort study to evaluate the prognostic influence of CSPG4 expression on VFL patients.
View Article and Find Full Text PDFStroke Vasc Neurol
January 2025
Jizhou Clinical College, Tianjin Medical University, Tianjin, China
Background: Cognitive decline is a significant concern for stroke survivors, affecting their quality of life and increasing their burden on the healthcare system. DL-3-n-butylphthalide (butylphthalide) has shown efficacy in the short-term treatment of various cognitive impairments. This study evaluated the efficacy of butylphthalide in preventing cognitive decline over a 12-month period in patients with ischaemic stroke.
View Article and Find Full Text PDFAnaesth Crit Care Pain Med
January 2025
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada; Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada.
Background: Pharmacological sedation and analgesia are used to alleviate discomfort during awake medical procedures but can cause adverse effects like apnea and hypoxemia, increasing the need for airway management and prolonging recovery. Virtual reality (VR) has emerged as a non-pharmacological intervention to reduce the need for procedural sedatives and analgesics.
Methods: A systematic review and meta-analysis were conducted, assessing the impact of VR immersion on intraprocedural sedation and analgesia usage in adults (≥ 18 years).
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