- 1、本文档共58页,可阅读全部内容。
- 2、有哪些信誉好的足球投注网站(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
- 3、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载。
- 4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
查看更多
Compression Fractures Welcome UNC 椎体压缩性骨折欢迎北课件
Complications… ?adjacent vertebral fractures (probable) Most studies show increased risk Problem: patients with compression fractures have high probability of future fractures (25%/year) Confounding: Those with worse disease more likely to have VP/KP and more likely to have future fractures Concerns about the Validity of most recently reported studies… Outpatients (inpatients may have more severe pain) Patients received 4 weeks of medical treatment – patients on average had 9-16 weeks of symptoms in the 2 recent VP studies (compared to 6 weeks for the Lancet KP study) Counter: no difference in subgroup analysis between patients with less than or more than 6 weeks of symptoms Jewitt Brace The RCT… 1930: Sollman suggests approach to problem of investigator bias: use of blinded observer and a placebo control 1932-1937: Harry Gold at Cornell refines the double blind method and use of placebo 1935: Ronald Fisher’s “The Design of Experiments” argues for use of strictly randomized allocation The RCT Randomization made test groups more comparable and “ethical” 1947: limited supply of streptomycin for British patients, Bradford Hill in the BMJ pushed for studies with a randomized design: “precluded the biases introduced by our personal idiosyncracies, consciously or unconsciusly applied, or lack of judgment” RCT… 1960s: increase value on statistical evidence in interpreting evidence 1990s: Evidence Based Medicine… Won’t get fooled again… Hip protectors and decreased hip fractures… Estrogen use in postmenopausal women decreases the risk of CAD (women on estrogens live 1.5 years longer than those not…) Early coronary intervention must be good for patients with diabetes and evidence for significant but asymptomatic coronary disease on angiography Maybe trephination…. Problems with prior studies looking at VP and KP Not blinded Bias on part of investigators (evidence that it“works”) Bias of participants (advertised “evidence” that this works) Underestimated placebo
您可能关注的文档
- KIDNEY 异位肾课件.ppt
- KIDNEY(Nephroptosis)异位肾课件.ppt
- Carcinoid and Pancreatic Neuroendocrine Cancer 下载类癌和胰腺神经内分泌癌课件.ppt
- 233 syndrome myasthenia gravis吉兰巴雷和 233综合征重症肌无力课件.ppt
- 急性有机磷杀虫课件.ppt
- Pheonix India嗜铬细胞瘤凤凰印度课件.ppt
- Management Review MyAAPCR疟疾和管理审查课件.ppt
- 肱二头肌桡骨囊滑囊炎课件.ppt
- 直接接触电击防护课件.ppt
- Weebly百日咳 课件.ppt
- 英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料伴你成长---高二新世纪上---第三单元.doc
- 英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料伴你成长---高二新世纪上---第七单元.doc
- 英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料伴你成长---高二新世纪上---第六单元.doc
- 英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料伴你成长---高二新世纪上---第二单元.doc
- 英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料英语文档资料伴你成长---高二新世纪上---第八单元.doc
- 2023-2024年瑞安市环境影响评价技术评估服务项目招标文件.pdf
- 2017内科主治医师考试重要考点.docx
- 学校校长述职报告汇总7篇.doc
- 摔跤吧-爸爸-观后感-.doc
- 节约用水人人有责的演讲稿范文.doc
文档评论(0)