The Medical journal of Australia
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Meta Analysis
Automatic external defibrillators: changing the way we manage ventricular fibrillation.
To discuss recent developments in automatic defibrillation and to review the evidence that first-responders equipped with automatic external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrest. ⋯ Meta-analysis suggests that equipping first-responders with AEDs increases the probability of survival to hospital discharge after out-of-hospital cardiac arrest (odds ratio, 1.74; 95% CI, 1.27-2.38; P < 0.001). However, most of the studies lacked sufficient power to draw definitive conclusions. Until the impact of wide deployment of AEDs is fully understood, first-responder defibrillation in Australia should only occur as part of coordinated multicentre research studies.
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To assess whether there is evidence that the surgeon is a prognostic factor in the treatment of colorectal cancer. ⋯ The current data strongly suggest that the surgeon is an important prognostic factor in the treatment of colorectal cancer.
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To develop evidence-based guidelines for the treatment of proximal femoral fractures to optimise functional outcome while minimising length of stay in hospital. ⋯ Randomised controlled trial evidence (NHMRC Levels I and II) exists for many, but not all, aspects of hip fracture treatment. There is a need for changes to be made to some aspects of practice in accordance with evidence-based guidelines.
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Meta Analysis
Mammographic screening trials for women aged under 50. A quality assessment and meta-analysis.
To carry out a systematic quality review and meta-analysis of all randomised trials of mammographic screening that included women aged under 50 years. ⋯ These analyses suggest little, if any, benefit for women under 50 years of age. The results are not explained by the quality of the trials or the radiology. We recommend that women in this age group intending to be screened should be fully informed of these results.