Journal of comparative effectiveness research
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Evaluation of: Mol F, van Mello NM, Strandell A et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet 383(9927), 1483-1439 (2014). ⋯ To date, there is a wealth of data establishing laparoscopic treatment as the 'gold standard'; however, paradoxically, the evidence behind choosing the two main treatment methods of salpingotomy and salpingectomy, especially with regards to future fertility potential, remain unclear. This article is a summary of a randomized controlled trial of salpingotomy versus salpingectomy in patients with an apparent contralateral healthy tube and the impact on future fertility. It attempts to answer the clinical question whether preservation of tube by salpingotomy increases the futures chances of natural conception as opposed to salpingectomy.
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Editorial Randomized Controlled Trial Multicenter Study
Accelerated versus standard care in hip fracture patients: does speed save lives?
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The intense competition that accompanied the growth of internet-based companies ushered in the era of 'big data' characterized by major innovations in processing of very large amounts of data and the application of advanced analytics including data mining and machine learning. Healthcare is on the cusp of its own era of big data, catalyzed by the changing regulatory and competitive environments, fueled by growing adoption of electronic health records, as well as efforts to integrate medical claims, electronic health records and other novel data sources. ⋯ For life science companies, this will impact the entire pharmaceutical value chain from early research to postcommercialization support. More generally, this will revolutionize comparative effectiveness research.
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Chronic conditions are the most important cause of morbidity, mortality and health expense in the USA. Comparative effectiveness research (CER) seeks to provide evidence supporting the relative value of alternative courses of action. This research often concludes with estimates of the likelihood of desirable and undesirable outcomes associated with each option. ⋯ In these ways, SDM and CER are interrelated. SDM translates CER into patient-centered practice, while CER provides the backbone evidence about options and outcomes in SDM interventions. In this review, we explore the potential for a SDM-CER synergy in improving healthcare for patients with chronic conditions.