BMJ : British medical journal
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Randomized Controlled Trial Multicenter Study Comparative Study
Biopsy and selective recall compared with immediate large loop excision in management of women with low grade abnormal cervical cytology referred for colposcopy: multicentre randomised controlled trial.
To compare the effectiveness of punch biopsy and selective recall for treatment versus a policy of immediate treatment by large loop excision in the management of women with low grade abnormal cervical cytology referred for colposcopy. ⋯ A policy of targeted punch biopsies with subsequent treatment for cervical intraepithelial neoplasia grade II or III and cytological surveillance for grade I or less provides the best balance between benefits and harms for the management of women with low grade abnormal cytology referred for colposcopy. Immediate large loop excision results in overtreatment and more after effects and should not be recommended.
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Randomized Controlled Trial Multicenter Study
Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing: a cluster randomised controlled trial.
To establish whether an interactive booklet on respiratory tract infections in children reduces reconsultation for the same illness episode, reduces antibiotic use, and affects future consulting intentions, while maintaining parental satisfaction with care. ⋯ Use of a booklet on respiratory tract infections in children within primary care consultations led to important reductions in antibiotic prescribing and reduced intention to consult without reducing satisfaction with care.
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Randomized Controlled Trial Multicenter Study
Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial.
To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. ⋯ Telephone based peer support can be effective in preventing postnatal depression among women at high risk.
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Randomized Controlled Trial Multicenter Study
Video decision support tool for advance care planning in dementia: randomised controlled trial.
To evaluate the effect of a video decision support tool on the preferences for future medical care in older people if they develop advanced dementia, and the stability of those preferences after six weeks. ⋯ Older people who view a video depiction of a patient with advanced dementia after hearing a verbal description of the condition are more likely to opt for comfort as their goal of care compared with those who solely listen to a verbal description. They also have more stable preferences over time.
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Multicenter Study
Preserving professional credibility: grounded theory study of medical trainees' requests for clinical support.
To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor. ⋯ Trainees consider not only clinical implications but also professional credibility when requesting support from clinical supervisors. Exposing the complexity of this process provides the opportunity to make changes to training programmes to promote timely supervision and provides a framework for further exploration of the impact of clinical training on quality of care of patients.