CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Meta Analysis
Diagnostic accuracy of the TIMI risk score in patients with chest pain in the emergency department: a meta-analysis.
The Thrombolysis in Myocardial Infarction (TIMI) risk score uses clinical data to predict the short-term risk of acute myocardial infarction, coronary revascularization or death from any cause. It was originally developed for use in patients with unstable angina or non-ST-elevation myocardial infarction. 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. ⋯ Although the TIMI risk score is an effective risk stratification tool for patients in the emergency department with potential acute coronary syndromes, it should not be used as the sole means of determining patient disposition.
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Meta Analysis Comparative Study
Comparison of cardiovascular risk profiles among ethnic groups using population health surveys between 1996 and 2007.
Although people of South Asian, Chinese and black ethnic backgrounds represent about 60% of the world's population, most knowledge of cardiovascular risk is derived from studies conducted in white populations. We conducted a large, population-based comparison of cardiovascular risk among people of white, South Asian, Chinese and black ethnicity living in Ontario, Canada. ⋯ Ethnic groups living in Ontario had striking differences in cardiovascular risk profiles. Awareness of these differences may help in identifying priorities for the development of cardiovascular disease prevention programs for specific ethnic groups.
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Meta Analysis
The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis.
The prevention of head injuries in alpine activities has focused on helmets. However, no systematic review has examined the effect of helmets on head and neck injuries among skiers and snowboarders. ⋯ Our findings show that helmets reduce the risk of head injury among skiers and snowboarders with no evidence of an increased risk of neck injury.
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Review Meta Analysis
Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis.
Erythropoiesis-stimulating agents are used to treat anemia in patients with cancer. However, their safety and effectiveness is controversial. We did a systematic review of the clinical efficacy and harms of these agents in adults with anemia related to cancer or chemotherapy. ⋯ Use of erythropoiesis-stimulating agents in patients with cancer-related anemia improved some disease-specific measures of quality of life and decreased the use of blood transfusions. However, it increased the risk of death and serious adverse events. Our findings suggest that such therapy not be used routinely as an alternative to blood transfusion in patients with anemia related to cancer.
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Review Meta Analysis
Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data.
Hyperglycemia is associated with increased mortality in critically ill patients. Randomized trials of intensive insulin therapy have reported inconsistent effects on mortality and increased rates of severe hypoglycemia. We conducted a meta-analysis to update the totality of evidence regarding the influence of intensive insulin therapy compared with conventional insulin therapy on mortality and severe hypoglycemia in the intensive care unit (ICU). ⋯ Intensive insulin therapy significantly increased the risk of hypoglycemia and conferred no overall mortality benefit among critically ill patients. However, this therapy may be beneficial to patients admitted to a surgical ICU.