This document outlines the steps for critically appraising a research article on prognosis using the Sudan Evidence-Based Medicine Association template. It includes developing a well-built clinical question using PICO (Patient, Intervention, Comparison, Outcome), outlining the current knowledge and selecting a research article to appraise. Key steps are summarizing the article, assessing validity and applying an appraisal scheme to evaluate relevance, validity, results and applicability of the research. The template provides guidance on critically evaluating different aspects of the study to determine the strength and potential limitations.
Quality assessment in systematic literature reviewJingjing Lin
This tutorial is to introduce the definition, process, and tools of quality assessment in the systematic literature review.
If you are new to my channel, you can check out the previous events together with this one to get started with the systematic literature review as a research approach.
EP11 Systematic Literature Review Planning: workflow, literature scoping, and review protocol (https://youtu.be/qukb-VytjxQ)
EP12 Develop search strategy: fishing relevant literature for your research (https://youtu.be/9cH5I03jbg0)
EP13 Literature screening: inclusion and exclusion
(https://youtu.be/BCdveqka-E4)
You can browse other previous research sharing in this YouTube list of mine (https://www.youtube.com/playlist?list...)
Please kindly subscribe if you want to be reminded when I have new videos published on YouTube.
Quality assessment in systematic literature reviewJingjing Lin
This tutorial is to introduce the definition, process, and tools of quality assessment in the systematic literature review.
If you are new to my channel, you can check out the previous events together with this one to get started with the systematic literature review as a research approach.
EP11 Systematic Literature Review Planning: workflow, literature scoping, and review protocol (https://youtu.be/qukb-VytjxQ)
EP12 Develop search strategy: fishing relevant literature for your research (https://youtu.be/9cH5I03jbg0)
EP13 Literature screening: inclusion and exclusion
(https://youtu.be/BCdveqka-E4)
You can browse other previous research sharing in this YouTube list of mine (https://www.youtube.com/playlist?list...)
Please kindly subscribe if you want to be reminded when I have new videos published on YouTube.
"Hierarchies of Evidence" is an important but problematic concept for medical professionals to understand as it underpins their capacity to be effective practitioners and researchers.
Presented as part of the Capacity Building in Policy Briefs Development Workshop conducted by Research Chair for Evidence-Based Health Care and Knowledge Translation
In collaboration with World Health Organization, Regional Office for the Eastern Mediterranean in King Saud University 2019.
"Hierarchies of Evidence" is an important but problematic concept for medical professionals to understand as it underpins their capacity to be effective practitioners and researchers.
Presented as part of the Capacity Building in Policy Briefs Development Workshop conducted by Research Chair for Evidence-Based Health Care and Knowledge Translation
In collaboration with World Health Organization, Regional Office for the Eastern Mediterranean in King Saud University 2019.
My presentation to medical faculty re:
Upon completion of this session, you will:
1. Explain the role of objectives in teaching
2. List 1 objective applicable to your practice for each of the 7 CanMed Roles.
A presentation on what is a Medical Journal Club and its value in clinical and academic training with the headings necessary for inclusion in a PowerPoint presentation.
Also contains Hyperlinks to useful CAT sites.
Comparing research designs fw 2013 handout versionPat Barlow
This is an updated version of my Comparing Research Designs lecture, which now includes discussions on: (1) common considerations with research design such as bias, reliability, validity, and confounding; and (2) expanded discussion of RCT designs including factorial and cross-over designs.
How to scientifically conduct a clinical professional research trial? In the current era of Collaborate or parish, we need to keep this design in our mind.
Enjoy
@copyLeft
Introduces Value-based Healthcare, an important concept for transforming healthcare making it more cost-effective, sustainable, and patient-centered. Strategically, it makes the healthcare providers accountable to the desired patient and health system "valued" outcomes.
https://youtu.be/-oOuJfpRFpY
Strategies to fix healthcare systems v1Imad Hassan
3. Names the essential and strategic concepts that leaders in healthcare need to master. They need to be incorporated into any modern healthcare system to make it successful, sustainable and highly-responsive. Around 6 minutes.
https://youtu.be/KQRxbNORHF8
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
JC SEBMA Prognosis Appraisal Template V1
1. Journal Club: Critical Appraisal of an Article on
Prognosis
Sudan Evidence-Based Medicine Association Template
Developed by:
Dr. Imad Salah Ahmed Hassan
MD (UK) FACP FRCPI MemAcadMEd (UK) MSc (UK) MBBS (U of K)
7. Select a Reasonable Piece of
Research
Tip:
Paste the title, authors, journal details
here
Type of Study: RCT Retrospective Cohort Case-Control
Other:
Tip: Study Strength: RCT>cohort>case control>case series
Date published:
Number of Pages:
Quality of journal i.e. impact factor (get from Google!)
Linked-In: Author Details/Picture
8. Reason(s) for Selecting this Piece of
Research
Tip: Common Reasons
Answers my QUESTION
Free article
Recent Article
Reputable Journal
Other
9. Summarize the Results of your
Article
Tip: Paste the Abstract/Conclusion from the
Abstract here
Paste Abstract here: use several slides if it is
long-remember the 6X6 rule in power-point
presentations!
10. My Appraisal Map
Appropriateness of chosen Title?
Trustworthy Authors?
Truthful Abstract?
Comprehensiveness of Introduction section?
Relevance: Importance for Practice
Validity: Appropriate Methodology (Validity:
Internal)?
Results: Trustworthy Results?
Applicability?
Impact of Findings on Current Practice and
Future Recommendations?
11. Apply Your Appraisal Scheme
Tip: Use the RVRA Scheme: Based on the National & Gulf
Center for Evidence-based Health Practice
Relevance
Validity
Results
Applicability
12. Apply Your Appraisal Scheme
Tip: Use the RVRA Scheme
Relevance Personal Knowledge
Validity Methods Section
Results
(Impact)
Results Section
Applicability Personal
Interpretation/
Experience
13. Apply Your Appraisal Scheme
Relevance
Does the study
address a
common
problem in your
practice?
Does the study
address an
important
outcome to you
or to your
patient? (DOE
vs. POEM)
Assuming that
the study
conclusion is
true; would it
14. Apply Your Appraisal Scheme
Validity
Describe the Research
Design
Tip:
Name the Study Design
15. Apply Your Appraisal Scheme
Validity
Recruitment: Was the
defined representative
sample of patients
assembled at a common
(usually early) point in
the course of their
disease i.e.
homogeneous sample?
Tip:
Selection and Sampling: )-----
‘‘Referral Bias’’: Primary vs Tertiary
Centres (Severity),
“Inception Bias”/ “Lead-time Bias”:
Timing of Inclusion/Homogeneous
Sample
Find me in the Methods Section:
Selection of Patients
Copy the Inclusion &
Exclusion Criteria
Copy the Study Flow Chart to
your Presentation
16. Apply Your Appraisal Scheme
Validity
Copy the Inclusion &
Exclusion Criteria
Inclusion Criteria: Exclusion Criteria:
17. Apply Your Appraisal Scheme
Validity
Maintenance: Was the
follow-up of these
patients sufficiently
long and complete?
Follow-up –Attrition
Bias: >20% loss of
follow-up: Non-
dependable Results
will vary depending on
the outcome (e.g., for
pregnancy outcomes,
nine months; for cancer,
many years)
Find me in the Results
Section.
18. Apply Your Appraisal Scheme
Validity
Outcome Measures:
Primary & Secondary
Detection Bias (Failure of Blinding): Objective
(Death, amputation, infection rates etc.) or strictly
defined Subjective outcomes (quality of life, pain,
dependence) PLUS Blinding (to clinical and
prognostic characteristics of the patients)
Find me in the Methods or Results Section.
Primary: Secondary:
19. Apply Your Appraisal Scheme
Validity
Measurement
(Objective & Blinded):
Were objective and
unbiased outcome
criteria clearly defined?
Consider: Did the
individual assessing the
outcome criteria know
whether or not the
patient had a potential
prognostic factor, i.e.
were they blinded?
20. Apply Your Appraisal Scheme
Validity
Adjustment: Was there
adjustment for
important prognostic
factors?
Consider:
Was there
standardization for
potentially important
prognostic factors e.g.
age?
Were different sub-
groups compared?
21. Apply Your Appraisal Scheme
Validity
Validation: Was there
validation in an
independent group
("test-set") of
patients?
Was there validation in an independent
group of patients?
Adjustment Bias: If the patient
groups are clinically dissimilar.
?Regression Analysis
Find me in the Methods or Results
Section.
Test vs Development Group in
Adjustment Bias
The most effective way to do this is to
create a second group, called the test
group, to analyze the results, that is
different from the first group (the
development group) and that is used
for determining the factors in question.
This eliminates the possibility that
chance was responsible for the initial
identification of prognostic factors.
If this second study effectively validates
25. Results
Results clinical significance (in MP : Magnitude &
Precision)
Precision of the
effect: How
precise was the
estimate of the
treatment effect?
Confidence intervals? Narrow or Wide
Statistical vs. Clinical Significance
26. Summarize the Study Biases
Selection, Attrition, Performance,
Detection Biases, Conflict of
Interest etc.
27. Summarize the Study Strength
Tip: From the Discussion or
Letter to the Editor/Editorial
Comment etc.
E.G.: Number of Patients, Randomization Method,
Least Biases, Statistical Tests used, Outcome
Measures, Ascertainment, Drop-outs, Length of
Follow-up etc.
28. Summarize the Study
Weaknesses
Tip: From the Discussion or
Letter to the Editor/Editorial
Comment etc.
E.G.: Number of Patients, Randomization Method,
Least Biases, Statistical Tests used, Outcome
Measures, Ascertainment, Drop-outs, Length of
Follow-up etc.
30. Unanswered Questions from the
Study
Tip: From the Discussion or
Letter to the Editor/Editorial
Comment etc.
31. Applicability
Applicability I (in IPPP: Intervention – Population -
Preferences-Potential Benefits - Harm
Applicability (External Validity): Can the results be applied to my patients?
Guide Tip Answer
Were the study patients
similar to this patient?
Article should list the patients’ important
clinical characteristics, along with the
definitions used for these characteristics
Will the results lead
directly to selecting or
avoiding a treatment?
Prognostic data often provide the basis for
sensible decisions about therapy
Are the results useful for
reassuring or counseling
my patient?
Will the evidence make a clinically
important impact on your conclusions
about what to offer or tell this patient?
Uniformly good prognosis –
Reassuring
Uniformly poor prognosis -
Counseling
Can the results be used
in my clinical practice?
Availability of diagnostic tests,
treatments, Cost etc.
Additional Points
33. Resolution of your PICO
Question
Narrate/Write your PICO Question & Why is
it important.
Summarize the Study Findings
Summarize the weaknesses, biases,
Survival, Prediction Rule etc.
Indicate the Level of Evidence & whether
you are going to apply the findings to your
patient:
34. Resolution of your PICO Question:
Recommendations
New Research: Is there a need to do more
research of the subject? Y□ N □
Suggested research if the answer is yes:
Audit: Is there a need to audit your practice?
Y□ N □
Suggest an audit cycle.
Publication: Is it worth publishing your Journal
Club presentation in an EBM CAT journal or
website? May be start your own JC website?