Bmc Med
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Randomized Controlled Trial
Impact of medication nonadherence and drug-drug interaction testing on the management of primary care patients with polypharmacy: a randomized controlled trial.
Clinical management of patients with chronic cardiometabolic disease is complicated by polypharmacy. Consequently, when patients clinically deteriorate, physicians are challenged to distinguish both medication nonadherence and drug-drug interactions (DDI) from chronic disease progression. ⋯ Although intervention and control PCPs similarly detected and acted upon medication nonadherence and DDI at baseline, intervention PCPs' detection increased significantly after using the CDMT. Also, the clinical actions performed with CDMT support were more clinically rigorous. These outcomes support the clinical utility of CDMT in the management of symptomatic patients with cardiometabolic disease and polypharmacy.
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Randomized Controlled Trial Comparative Study
Comparison of MRI artificial intelligence-guided cognitive fusion-targeted biopsy versus routine cognitive fusion-targeted prostate biopsy in prostate cancer diagnosis: a randomized controlled trial.
Cognitive fusion MRI-guided targeted biopsy (cTB) has been widely used in the diagnosis of prostate cancer (PCa). However, cTB relies heavily on the operator's experience and confidence in MRI readings. Our objective was to compare the cancer detection rates of MRI artificial intelligence-guided cTB (AI-cTB) and routine cTB and explore the added value of using AI for the guidance of cTB. ⋯ AI-cTB effectively improved the csPCa detection rate. This study successfully integrated AI with TB in the routine clinical workflow and provided a research paradigm for prospective AI-integrated clinical studies.
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Randomized Controlled Trial Multicenter Study
Postoperative tumor bed radiation versus T-shaped field radiation in the treatment of locally advanced thoracic esophageal squamous cell carcinoma: a phase IIb multicenter randomized controlled trial.
Postoperative radiotherapy (PORT) is crucial for patients with thoracic locally advanced esophageal squamous cell carcinoma (LA-ESCC, pT3-4aN0-3M0) following esophagectomy. However, the appropriate radiation volume has not been well established. This study aimed to determine the optimal PORT volume for LA-ESCC patients. ⋯ Postoperative radiotherapy, with the specified radiation volume shows encouraging survival outcomes that are comparable to those of neoadjuvant chemoradiotherapy in patients with thoracic LA-ESCC. Both postoperative irradiation fields were found to be feasible and safe.
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Randomized Controlled Trial
Azithromycin in severe malaria bacterial co-infection in African children (TABS-PKPD): a phase II randomised controlled trial.
African children with severe malaria are at increased risk of non-typhoidal salmonellae co-infection. Broad-spectrum antibiotics are recommended by guidelines but the optimal class and dose have not been established. We investigated the optimal dose of oral dispersible azithromycin and whether simple clinical criteria and point-of-care biomarkers could target antibiotics to those at greatest risk of bacterial co-infection. ⋯ We found no evidence for an association between systemic azithromycin exposure and reduction in CRP. Further work is needed to better identify children at highest risk from bacterial co-infection.
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Randomized Controlled Trial
General health and social outcomes 50 years after exposure to antenatal betamethasone: follow-up of a randomised controlled trial.
Antenatal corticosteroids are recommended for women at risk of preterm birth from 24 to 34 weeks' gestation as they reduce neonatal morbidity and mortality, but evidence regarding their long-term effects on offspring is limited. This study assessed general health and social outcomes 50 years after antenatal exposure to corticosteroids. ⋯ There is no evidence that antenatal corticosteroids have clinically important effects on general health and social outcomes up to 50 years of age.