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Specialty: General Medicine
Management: National Institute for Health Research (NIHR)

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Total 12 results found since Jan 2013.

Surgical implementation gap: an interrupted time series analysis with interviews examining the impact of surgical trials on surgical practice in England
Conclusion While practice does not always change in the direction indicated by clinical trials, our results suggest that individuals, official committees and professional societies do assimilate trial evidence. Decision-makers seem to respond to the totality of evidence such that there are often plausible reasons for not adopting the evidence of any one trial in isolation.
Source: BMJ Quality and Safety - May 18, 2023 Category: General Medicine Authors: Schmidtke, K. A., Evison, F., Grove, A., Kudrna, L., Tucker, O., Metcalfe, A., Bradbury, A. W., Bhangu, A., Lilford, R. Tags: Open access, Editor's choice Original research Source Type: research

Prevalence of atrial fibrillation in Northern Sri Lanka: a study protocol for a cross-sectional household survey
This study was approved by the Ethics Review Committee of Faculty of Medicine at University of Jaffna. Written informed consent will be obtained from all participants. Findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences. The findings will enable early treatment for new AF diagnoses and inform interventions to improve community-based management of AF in LMICs.
Source: BMJ Open - November 23, 2022 Category: General Medicine Authors: Kanesamoorthy, S., Sheron, V. A., Uruthirakumar, P., Kodippily, C., Kumarendran, B., Gooden, T. E., Thomas, G. N., Nirantharakumar, K., Lip, G. Y. H., Guruparan, M., Haniffa, R., Surenthirakumaran, R., Beane, A., Subaschandran, K., on behalf of the NIHR G Tags: Open access, Diagnostics Source Type: research

Exploring the experiences of stroke survivors, informal caregivers and healthcare providers in Sierra Leone: a qualitative study protocol
This study has received ethical approval from the Sierra Leone Ethics and Scientific Review Committee (8 December 2020) and the KCL Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference: HR-20/21-21050). The findings of the study and learning in terms of the process of coproduction and involvement of stroke survivors will be disseminated via peer-reviewed publications, conferences, media and lay reports.
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: O'Hara, J., Thompson, M., Deen, G., Leather, A. J. M., Youkee, D., Wall, J., Sackley, C., Parmar, D., McKevitt, C., NIHR Global Health Research Group at Kings College London, Wolfe, Langhorne, Lisk, Deen, McKevitt, Watkins, Leather, Prince, Youkee, Wang, Tags: Open access, Qualitative research Source Type: research

Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials
Publication date: 2–8 February 2019Source: The Lancet, Volume 393, Issue 10170Author(s): Jane Armitage, Colin Baigent, Elizabeth Barnes, D John Betteridge, Lisa Blackwell, Michael Blazing, Louise Bowman, Eugene Braunwald, Robert Byington, Christopher Cannon, Michael Clearfield, Helen Colhoun, Rory Collins, Björn Dahlöf, Kelly Davies, Barry Davis, James de Lemos, John R Downs, Paul Durrington, Jonathan EmbersonSummaryBackgroundStatin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We u...
Source: The Lancet - February 2, 2019 Category: General Medicine Source Type: research

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial
Publication date: Available online 5 December 2018Source: The LancetAuthor(s): Martin Dennis, Gillian Mead, John Forbes, Catriona Graham, Maree Hackett, Graeme J Hankey, Allan House, Stephanie Lewis, Erik Lundström, Peter Sandercock, Karen Innes, Carol Williams, Jonathan Drever, Aileen Mcgrath, Ann Deary, Ruth Fraser, Rosemary Anderson, Pauli Walker, David Perry, Connor McgillSummaryBackgroundResults of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.MethodsFOCUS was a pragmatic, multicentre, parallel group, double-b...
Source: The Lancet - December 5, 2018 Category: General Medicine Source Type: research

Adverse outcomes after arthroscopic partial meniscectomy: a study of 700 000 procedures in the national Hospital Episode Statistics database for England
Publication date: Available online 24 September 2018Source: The LancetAuthor(s): Simon G F Abram, Andrew Judge, David J Beard, Andrew J PriceSummaryBackgroundArthroscopic partial meniscectomy is one of the most common orthopaedic procedures worldwide. Clinical trial evidence published in the past 6 years, however, has raised questions about the effectiveness of the procedure in some patient groups. In view of concerns about potential overuse, we aimed to establish the true risk of serious complications after arthroscopic partial meniscectomy.MethodsWe analysed national Hospital Episode Statistics data for all arthroscopic ...
Source: The Lancet - October 5, 2018 Category: General Medicine Source Type: research

Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials
Publication date: Available online 17 July 2018Source: The LancetAuthor(s): Peter M Rothwell, Nancy R Cook, J Michael Gaziano, Jacqueline F Price, Jill F F Belch, Maria Carla Roncaglioni, Takeshi Morimoto, Ziyah MehtaSummaryBackgroundA one-dose-fits-all approach to use of aspirin has yielded only modest benefits in long-term prevention of cardiovascular events, possibly due to underdosing in patients of large body size and excess dosing in patients of small body size, which might also affect other outcomes.MethodsUsing individual patient data, we analysed the modifying effects of bodyweight (10 kg bands) and height (10 cm ...
Source: The Lancet - July 18, 2018 Category: General Medicine Source Type: research

Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599  912 current drinkers in 83 prospective studies
Publication date: 14–20 April 2018 Source:The Lancet, Volume 391, Issue 10129 Author(s): Angela M Wood, Stephen Kaptoge, Adam S Butterworth, Peter Willeit, Samantha Warnakula, Thomas Bolton, Ellie Paige, Dirk S Paul, Michael Sweeting, Stephen Burgess, Steven Bell, William Astle, David Stevens, Albert Koulman, Randi M Selmer, W M Monique Verschuren, Shinichi Sato, Inger Njølstad, Mark Woodward, Veikko Salomaa, Børge G Nordestgaard, Bu B Yeap, Astrid Fletcher, Olle Melander, Lewis H Kuller, Beverley Balkau, Michael Marmot, Wolfgang Koenig, Edoardo Casiglia, Cyrus Cooper, Volker Arndt, Oscar H Franco, Patrik Wennberg, Jo...
Source: The Lancet - April 13, 2018 Category: General Medicine Source Type: research

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study
Publication date: Available online 13 June 2017 Source:The Lancet Author(s): Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell Background Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70–90%, uptake is low and guidelines are conflicti...
Source: The Lancet - June 15, 2017 Category: General Medicine Source Type: research

Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials
Publication date: Available online 18 May 2016 Source:The Lancet Author(s): Peter M Rothwell, Ale Algra, Zhengming Chen, Hans-Christoph Diener, Bo Norrving, Ziyah Mehta Background Aspirin is recommended for secondary prevention after transient ischaemic attack (TIA) or ischaemic stroke on the basis of trials showing a 13% reduction in long-term risk of recurrent stroke. However, the risk of major stroke is very high for only the first few days after TIA and minor ischaemic stroke, and observational studies show substantially greater benefits of early medical treatment in the acute phase than do longer-term trials. ...
Source: The Lancet - May 19, 2016 Category: Journals (General) Source Type: research

Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis
Publication date: Available online 24 December 2015 Source:The Lancet Author(s): Dena Ettehad, Connor A Emdin, Amit Kiran, Simon G Anderson, Thomas Callender, Jonathan Emberson, John Chalmers, Anthony Rodgers, Kazem Rahimi Background The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established. However, the extent to which these effects differ by baseline blood pressure, presence of comorbidities, or drug class is less clear. We therefore performed a systematic review and meta-analysis to clarify these differences. Method For this systematic review and meta-ana...
Source: The Lancet - December 25, 2015 Category: Journals (General) Source Type: research

Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial
This study assessed the effectiveness of antibiotic prophylaxis for reducing pneumonia in patients with dysphagia after acute stroke. Methods We did a prospective, multicentre, cluster-randomised, open-label controlled trial with masked endpoint assessment of patients older than 18 years with dysphagia after new stroke recruited from 48 stroke units in the UK, accredited and included in the UK National Stroke Audit. We excluded patients with contraindications to antibiotics, pre-existing dysphagia, or known infections, or who were not expected to survive beyond 14 days. We randomly assigned the units (1:1) by computer to ...
Source: The Lancet - September 5, 2015 Category: Journals (General) Source Type: research