Victor M Montori

..In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice...

..This systematic review and meta-analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes...

..abstract:..

..The aim of STOPIT-2 is to determine the magnitude and determinants of possible bias introduced by stopping RCTs early for benefit...

..CONCLUSION: Normalization Process Theory has been developed through procedures that were properly sceptical and critical, and which were opened to review at each stage of development. The theory has been shown to merit formal testing...

..This approach provides a potential solution to both the statistical and interpretational problems of existing methods...

..Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information...

..An area not covered by a DA is the decision of a patient with chronic obstructive pulmonary disease (COPD) to use inhaled steroids which requires balancing the benefits and downsides of therapy...

..The literature postulates that patient and clinician preferences may explain this low utilization...

..Niacin is widely available over the counter (OTC). We sought to determine the safety of 500 mg immediate release niacin, when healthy individuals use them as directed...

..In the last 10 years, evidence-based medicine has matured as a philosophy of clinical care and medical education. An appraisal of its role in endocrinology awaits the pervasion of its principles into all of endocrine practice...

..In the last section of the paper, we explore potential healthcare system barriers to STDM in chronic care delivery. Throughout the discussion we identify areas for further research...

..The impact of contraindications on treatment decisions remains unexplored...

..Our objective was to determine the extent to which systematic reviews are clustered in a large collection of clinical journals and whether review type (narrative or systematic) affects citation counts...

..We sought to systematically ascertain the quality of randomized controlled trials (RCTs) in diabetes...

..Until such reporting occurs, clinicians will be left with uncertainty about the validity of RCTs that guide their clinical practice...

..In this commentary, we review these trials, their methods, results, and implications for practice. We finish by formulating a recommended approach to the contemporary evidence-based management of patients with type 2 diabetes...

..We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits...

..We judged it unlikely that patient preferences were driving the decision to obtain stress testing...

..To describe the process used to develop a medication choice decision aid (DA) for patients with type 2 diabetes...

..Poor adherence to therapy, perhaps related to unaddressed patient preferences, limits the effectiveness of osteoporosis treatment in at-risk women. A parallel patient-level randomized trial in primary care practices was performed...

..The aims of this study are (1) to develop a decision aid (CHEST PAIN CHOICE) that communicates the short-term risk of ACS and (2) to evaluate the impact of the decision aid on patient participation in decision-making and resource use...

..To conduct a systematic review and meta-analysis of randomized trials that assessed the effect of testosterone use on cardiovascular events and risk factors in men with different degrees of androgen deficiency...

..Vitamin D affects bone and muscle health and likely reduces the risk of falls in the elderly...

..Patient involvement in the choice of antihyperglycemic agents could improve adherence and optimize glycemic control in patients with type 2 diabetes mellitus...

..To assess the effect of a specialist telemedicine intervention for improving diabetes care using the chronic care model (CCM)...

..In this review, we synthesize the available evidence to determine to what extent proactive vascular access monitoring affects the incidence of AV access thrombosis and abandonment compared with clinical monitoring...

..We sought to determine the impact of a decision aid to help patients with diabetes decide about statins (Statin Choice) on patients' trust in the clinician...

..We conducted a systematic review to summarize the best available evidence comparing the two accesses types in terms of patient-important outcomes...

..Statin Choice is a decision aid about taking statins. The optimal mode of delivering Statin Choice (or any other decision aid) in clinical practice is unknown...

..Insulin sensitizers, including metformin and thiazolidinediones (TZDs), improve hyperinsulinemia and reproductive dysfunctions in some women with hyperandrogenism. The extent to which these agents improve hirsutism remains unclear...

..The natural history of pituitary incidentalomas (PIs) and nonfunctioning pituitary adenomas (NFPAs) remains poorly understood...

..Specifically, do patients prefer trials to focus on patient-important outcomes (vs. surrogate outcomes) and provide practical/pragmatic answers (vs. mechanistic/explanatory answers)?..

..The risks of testosterone therapy in men remain poorly understood...

..Osteoporosis and osteopenia are associated with increased fracture incidence...

..However, little is known about translating the findings from CER into routine practice such that it provides value to the patients, clinicians, and the healthcare system...

..Poor quality of information transfer about the benefits and risks of statin drug use may result in patients not making informed decisions that they can act on in a timely fashion...

..The accuracy of intraoperative periprosthetic frozen section histologic evaluation in predicting a diagnosis of periprosthetic joint infection prior to microbiologic culture results is unknown...

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..To compare health care consumers' understanding, evaluations, and preferences for symbols vs. numbers and letters for the representation of strength of recommendations (SOR) and quality of evidence (QOE)...

..However, little is known regarding the factors associated with 30-day readmission after PCI...

..We seek to identify patients at low short-term risk for a cardiac event for whom additional ED investigations might be unnecessary...

..Author contact can enhance the quality of systematic reviews. We conducted a systematic review of the practice of author contact in recently published systematic reviews to characterize its prevalence, quality, and results...

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..Adherence to evidence-based medications after myocardial infarction is associated with improved outcomes. However, long-term data on factors affecting medication adherence after myocardial infarction are lacking...

..To conduct a systematic review and meta-analysis of randomized placebo-controlled trials to measure the effect of testosterone use on sexual function in men with sexual dysfunction and varying testosterone levels...

..Prenatal treatment with dexamethasone to prevent virilization in pregnancies at risk for classical congenital adrenal hyperplasia (CAH) remains controversial...

..The efficacy of treatments for pediatric obesity remains unclear...

..Hypoglycemia limits the efficacy of intensive insulin therapy. The extent to which continuous insulin infusion (CSII) overcomes this limitation is unclear...

..Existing literature on patient complexity has mainly identified its components descriptively and in isolation, lacking clarity as to their combined functions in disrupting care or to how complexity changes over time...

..Understanding the predictors of adherence may inform quality improvement processes aimed at optimizing disease prevention...

..The effect of intensive therapy to achieve tight glycemic control in patients hospitalized in non-critical care settings is unclear...

..Yet a recent systematic review demonstrated large heterogeneity among results from individual studies. Our purpose is to describe the variation in configurations, instructional methods and presentation formats in WBL...

..A comprehensive synthesis of research investigating how to improve IBL is needed. This systematic review sought to provide such a synthesis...

..Dehydroepiandrosterone (DHEA) has been studied as an agent to improve HRQOL in these patients...

..To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients...

..The efficacy of lifestyle interventions to encourage healthy lifestyle behaviors to prevent pediatric obesity remains unclear...

..Several studies found association between vitamin D levels and hypertension, coronary artery calcification, and heart disease...

..We conducted a systematic review and meta-analysis to determine the efficacy of nonantigen-based immunotherapeutic approaches for preservation of beta-cell function in patients with type 1 diabetes...

..e., absence of contamination) of patient-level randomization (vs. cluster randomization) in pilot trials of decision aid efficacy...

..Testing men at increased risk for osteoporotic fractures has been recommended...

..To summarise the evidence about the efficacy and safety of using GH in adults with GH deficiency focusing on quality of life and body composition...

..We also discuss potential future efforts needed to maximize the quality, adoption, and application of the clinical recommendations...

..Several treatment options exist for varicose veins. In this review we summarize the available evidence derived from comparative studies about the relative safety and efficacy of these treatments...

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..This review was conducted to determine the optimal timing for referring patients with end-stage renal disease to vascular surgery for access placement...

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..The diagnostic accuracy of tests used to diagnose GH deficiency (GHD) in adults is unclear...

..Economic evaluation remains an understudied aspect of lower extremity vascular reconstructions. This study reviewed the economic-based literature with respect to open and endovascular treatment of peripheral arterial disease...

..Optimal identification of the best translation of evidence to diabetes practice will require longer follow-up or new care-delivery models...

..In this review, we synthesize the available evidence regarding the complications associated with LSA coverage...

..We therefore sought to determine if the effect of aspirin for primary prevention of cardiovascular events and mortality differs between patients with and without diabetes...

..We sought to expand the clinical application of the TIMI risk score by assessing its prognostic accuracy in patients in the emergency department with potential acute coronary syndromes...

..The purpose of this study was to determine the extent to which diabetes education encounters include evidence-based content aimed at reducing the risk of cardiovascular disease...

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..To summarize the available evidence on the cardiovascular effects of cross-sex steroid use in transsexuals...

..Drug-induced hypoglycemia is a significant adverse effect that may cause important morbidity...

..Its extent is unknown. We studied author self-citation, choosing the major clinical field of diabetes mellitus to represent the general medical literature...

..Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear...

..In our experience, estimation of risk using this tool, when done with patients, can further patients' insight into their risk of coronary events, often leading to enlightened discussions about modification of Individual risk factors...

..CONCLUSION: The PSI is a reliable and preliminarily valid instrument for measuring provider satisfaction with diabetes care. Use in research and quality improvement activities awaits further validation...

..The value of redesigning the consultation room to accommodate these changes and the effect of a redesign on patient-clinician interaction are unclear...

..The purpose of this research was to assess the association between the metabolic syndrome (MetSyn) and cardiovascular events and mortality by meta-analyses of longitudinal studies...

..Health-care providers have neither evidence summaries nor evidence-based guidelines to assist them in treating patients who use spit tobacco...

..We sought to quantify the effect of survivor bias on the association between valve surgery and mortality in infective endocarditis (IE)...

..Examples of research in Alzheimer's disease are presented to illustrate how evidence is produced, appraised and utilized...

..This article will highlight the evolution of industry relationships and conflict of interest over time, discuss methods by which industry can potentially exert effects and propose new directions for the future...

..We systematically reviewed the literature to summarize the available evidence regarding the benefits and harms of plasma transfusion in common clinical settings...

..The goal is to provide tips for educators interested in replicating this educational model...

..This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition...

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..The goal of this systematic review and meta-analysis is to evaluate the effect of surgery on mortality, surgical complications, pituitary function and vision...

..We assess the methodological quality and prognostic accuracy of clinical decision rules in emergency department (ED) syncope patients...

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..We performed a meta-analysis of prospective cohort studies to examine the association between penicillin resistance and short-term all-cause mortality for pneumococcal pneumonia...

..To determine the prevalence and characteristics of endocrinopathies at diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome...

..Risk difference (RD) is often estimated from relative association measures generated by meta-analysis and a particular group's baseline risk. We describe a problematic situation in using this approach...