Articles: disease.
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Comparative Study Observational Study
The Agreement Between Diagnoses as Stated by Patients and Those Contained in Routine Health Insurance Data—Results of a Data Linkage Study.
The frequency of medical diagnoses is a figure of central importance in epidemiology and health services research. Prevalence estimates vary depending on the underlying data. For a better understanding of such discrepancies, we compared patients' diagnoses as reported by themselves in response to our questioning with their diagnoses as stated in the routine data of their health insurance carrier. ⋯ Diagnoses as stated by patients often differ from those found in routine health insurance data. Discrepancies that can be considered negligible were found for only two of the 11 diseases that we studied. Our investigation confirms that these two sources of data yield different estimates of prevalence. Age is a key factor; further reasons for the discrepancies should be investigated, and avoidable causes should be addressed.
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Cochrane Db Syst Rev · Mar 2024
ReviewExercise-based cardiac rehabilitation for adults with heart failure.
People with heart failure experience substantial disease burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous 2018 Cochrane review reported that exercise-based cardiac rehabilitation (ExCR) compared to no exercise control shows improvement in HRQoL and hospital admission amongst people with heart failure, as well as possible reduction in mortality over the longer term, and that these reductions appear to be consistent across patient and programme characteristics. Limitations noted by the authors of this previous Cochrane review include the following: (1) most trials were undertaken in patients with heart failure with reduced (< 45%) ejection fraction (HFrEF), and women, older people, and those with heart failure with preserved (≥ 45%) ejection fraction (HFpEF) were under-represented; and (2) most trials were undertaken in a hospital or centre-based setting. ⋯ This updated Cochrane review provides additional randomised evidence (16 trials) to support the conclusions of the previous 2018 version of the review. Compared to no exercise control, whilst there was no evidence of a difference in all-cause mortality in people with heart failure, ExCR participation likely reduces the risk of all-cause hospital admissions and heart failure-related hospital admissions, and may result in important improvements in HRQoL. Importantly, this updated review provides additional evidence supporting the use of alternative modes of ExCR delivery, including home-based and digitally-supported programmes. Future ExCR trials need to focus on the recruitment of traditionally less represented heart failure patient groups including older patients, women, and those with HFpEF.
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Randomized Controlled Trial
Omalizumab for the Treatment of Multiple Food Allergies.
Food allergies are common and are associated with substantial morbidity; the only approved treatment is oral immunotherapy for peanut allergy. ⋯ In persons as young as 1 year of age with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT03881696.).