Many practicing physicians struggle to properly evaluate clinical research studies - they either simply do not know them, regard the reported findings as 'truth' since they were reported in a 'reputable' journal and blindly implement these interventions, or they disregard them as having little pragmatic impact or relevance to their daily clinical work. Three aspects for the latter are highlighted: study populations rarely reflect their practice population, the absolute average benefits on specific outcomes in most controlled studies, while statistically significant, are so small that they are pragmatically irrelevant, and overall mortality between the intervention and control groups are unaffected. These observations underscore the need to rethink our research approaches in the clinical context - moving from the predominant reductionist to an eco-systemic research approach will lead to knowledge better suited to clinical decision-making for an individual patient as it takes into account the complex interplay of multi-level variables that impact health outcomes in the real-world setting.
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http://dx.doi.org/10.3389/fmed.2024.1377356 | DOI Listing |
J Neurosurg Pediatr
January 2025
1Neurotology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and.
Objective: The objective of this study was to discuss the characteristics of intracranial extension in patients with juvenile nasopharyngeal angiofibroma (JNA) and propose and an algorithm for its management.
Methods: A retrospective chart review of all patients with JNA who underwent operations between January 2013 and January 2023 was done, and those cases with intracranial extension categorized as stage IIIb, IVa, and IVb according to the Andrews modification of the Fisch staging classification were included in the study. Data were collected about age at presentation, symptoms, radiological findings, routes of intracranial extension, therapeutic management, and follow-up.
J Glob Health
January 2025
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Background: Approximately 70% of chronic obstructive pulmonary disease (COPD) is underdiagnosed worldwide. We aimed to develop and validate a COPD self-evaluation questionnaire (COPD-EQ) that is better suited for COPD screening in China.
Methods: We developed a primary version of COPD-EQ based on the Delphi method.
Sci Rep
January 2025
Brunel University of London, Uxbridge, UB8 3PH, UK.
Efficient energy management and maintaining an optimal indoor climate in buildings are critical tasks in today's world. This paper presents an innovative approach to surrogate modeling for predicting indoor air temperature (IAT) in buildings, leveraging advanced machine learning techniques. At the core of this study is the application of Long Short-Term Memory (LSTM) networks for time-series modeling, which significantly enhances the capture of temporal dependencies in temperature predictions.
View Article and Find Full Text PDFSci Rep
January 2025
School of Mechanical Engineering, Southwest Jiao Tong University, Chengdu, China.
In order to reduce turnout rail wear, the paper establishes a coupled dynamics model and a turnout rail wear model that consider the true profile of the turnout rail, the vehicle's continuous traction force while passing, and the operational resistance. Comparative analysis of various models for predicting turnout rail wear indicates that the wear energy model is better suited for this purpose. The ideal profile update step for the turnout rail is 0.
View Article and Find Full Text PDFPrev Med
December 2024
Department of Public Health Sciences, University of California Davis, Medical Sciences 1C, Davis, CA 95616, USA; UC Davis Comprehensive Cancer Center, 2279 45(th) Street, Sacramento, CA 95817, USA. Electronic address:
Objective: To observe stage at diagnosis and cancer-specific survival for common cancers among Armenians in California.
Methods: We used the Armenian Surname List and birthplace information in the California Cancer Registry to identify Armenians with stomach, lung, colorectal, and bladder cancers diagnosed during 1988-2019. We used multivariable logistic regression models to calculate odds of late-stage diagnoses among Armenian and non-Armenian, non-Hispanic White patients and examine the association of sociodemographic factors with late-stage diagnoses among the Armenian patient population.
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