BMJ open
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Meta Analysis Comparative Study
Comparative efficacy of 13 immunosuppressive agents for idiopathic membranous nephropathy in adults with nephrotic syndrome: a systematic review and network meta-analysis.
This study aimed to compare the effectiveness of 13 types of immunosuppressive agents used to treat idiopathic membranous nephropathy (IMN) in adults with nephrotic syndrome. ⋯ CRD42018094228.
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Traditional early warning scores (EWSs) use vital sign derangements to detect clinical deterioration in patients treated on hospital wards. Combining vital signs with demographics and laboratory results improves EWS performance. We have developed the Hospital Alerting Via Electronic Noticeboard (HAVEN) system. HAVEN uses vital signs, as well as demographic, comorbidity and laboratory data from the electronic patient record, to quantify and rank the risk of unplanned admission to an intensive care unit (ICU) within 24 hours for all ward patients. The primary aim of this study is to find additional variables, potentially missed during development, which may improve HAVEN performance. These variables will be sought in the medical record of patients misclassified by the HAVEN risk score during testing. ⋯ Our study will use a clinical expert conducting a structured medical notes review to identify variables, associated with unplanned ICU admission, not included in the development of the HAVEN risk score. These variables will then be added to the risk score and evaluated for potential performance gain. To the best of our knowledge, this is the first study of this type. We anticipate that documenting the HAVEN development methods will assist other research groups developing similar technology.
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To evaluate the role of the European Union (EU) as a research collaborator in the UK's success as a global leader in healthcare research and innovation and quantify the impact that Brexit may have. ⋯ This study suggests what has long been argued, namely that the UK-EU research partnership has been mutually beneficial and that its continuation represents the best possible outcome for both negotiating parties. However, the uncertainties raised by Brexit necessitate looking beyond the EU for potential research partners. In the short term, the UK's best strategy might be to try and maintain its academic links with the EU. In the longer term, strategic relationships with research powerhouses, including the USA, China and India, are likely to be crucial for the UK to remain a global innovation leader.
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To evaluate the effects of anaesthesia on postoperative outcome in elderly patients who underwent hip fracture surgery. ⋯ RA was associated with better outcomes than GA, in terms of mortality, delirium, intensive care unit admission and ventilator care, in elderly patients who underwent hip fracture surgery.
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Multicenter Study Comparative Study
What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study.
Given the current excellent early mortality rates for paediatric cardiac surgery, stakeholders believe that this important safety outcome should be supplemented by a wider range of measures. Our objectives were to prospectively measure the incidence of morbidities following paediatric cardiac surgery and to evaluate their clinical and health-economic impact over 6 months. ⋯ Evaluation of postoperative morbidity is more complicated than measuring early mortality. However, tracking morbidity after paediatric cardiac surgery over 6 months offers stakeholders important data that are of value to parents and will be useful in driving future quality improvement.