JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Effect of endoscopic sphincterotomy for suspected sphincter of Oddi dysfunction on pain-related disability following cholecystectomy: the EPISOD randomized clinical trial.
Abdominal pain after cholecystectomy is common and may be attributed to sphincter of Oddi dysfunction. Management often involves endoscopic retrograde cholangiopancreatography (ERCP) with manometry and sphincterotomy. ⋯ In patients with abdominal pain after cholecystectomy undergoing ERCP with manometry, sphincterotomy vs sham did not reduce disability due to pain. These findings do not support ERCP and sphincterotomy for these patients.
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Randomized Controlled Trial Multicenter Study
Two-year outcome of a randomized trial comparing second-generation drug-eluting stents using biodegradable or durable polymer.
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Little is known regarding the durability of clinical practice guideline recommendations over time. ⋯ The durability of class I cardiology guideline recommendations for procedures and treatments promulgated by the ACC/AHA varied across individual guidelines and levels of evidence. Downgrades, reversals, and omissions were most common among recommendations not supported by multiple randomized studies.