Bmc Med
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A tumour biomarker is a characteristic that is objectively measured and evaluated in tumour samples as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. The development of a biomarker contemplates distinct phases, including discovery by hypothesis-generating preclinical or exploratory studies, development and qualification of the assay for the identification of the biomarker in clinical samples, and validation of its clinical significance. ⋯ In the process of validation of a biomarker assay, a key point is the validation of the methodology. Here we discuss the challenges for the technical validation of immunohistochemical and gene expression assays to detect tumour biomarkers and provide suggestions of pragmatic solutions to address these challenges.
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Prescription of non-steroidal anti-inflammatory drugs (NSAIDs) should be based on the assessment of both gastrointestinal (GI) and cardiovascular (CV) risk for the individual patient. We aimed to assess the GI/CV risk profile and the pharmacological management of patients with osteoarthritis (OA) in clinical practice. ⋯ Over 90% of patients with OA are at increased GI and/or CV risk. In over half of these patients, the prescription of NSAIDs was not in accordance with current guidelines or recommendations made by regulatory agencies.
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Biguanides have been developed for the treatment of hyperglycemia and type 2 diabetes. Recently, metformin, the most widely prescribed biguanide, has emerged as a potential anticancer agent. ⋯ Moreover, metformin may exhibit direct inhibitory effects on cancer cells by inhibiting mammalian target of rapamycin (mTOR) signaling and protein synthesis. The evidence supporting a role for metformin in cancer therapy and its potential molecular mechanisms of action are discussed.
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A study conducted by Lai and colleagues, published this week in BMC Medicine, suggests that more guidance might be required for interpreting systematic review (SR) results. In the study by Lai and colleagues, positive (or favorable) results were influential in changing participants' prior beliefs about the interventions presented in the systematic review. Other studies have examined the relationship between favorable systematic review results and the publication of systematic reviews. ⋯ In addition, using guidance from the Preferred Items for Systematic Reviews and Meta-analyses (PRISMA: http://www.prisma-statement.org/) Statement and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE: http://www.gradeworkinggroup.org/) approach can also be used to improve the interpretation of systematic reviews. In this commentary, we highlight important methodological issues related to the conduct and reporting of systematic reviews and also present our own guidance on interpreting systematic reviews. Please see Research article: http://www.biomedcentral.com/1741-7015/9/30/.
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Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown. ⋯ Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care.