The Experts below are selected from a list of 14880 Experts worldwide ranked by ideXlab platform
Thomas A Trikalinos - One of the best experts on this subject based on the ideXlab platform.
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prevention and treatment of tympanostomy tube otorrhea a meta analysis
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Children with tympanostomy tubes often develop ear discharge. OBJECTIVE: Synthesize evidence about the need for water precautions (ear plugs or swimming avoidance) and effectiveness of topical versus oral antibiotic treatment of otorrhea in children with tympanostomy tubes. DATA SOURCES: Searches in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Excerpta Medica Database, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles independently screened by 2 investigators. DATA EXTRACTION: 25 articles were included. RESULTS: One randomized controlled trial (RCT) in children assigned to use ear plugs versus no precautions reported an odds ratio (OR) of 0.68 (95% confidence Interval, 0.37–1.25) for >1 episode of otorrhea. Another RCT reported an OR of 0.71 (95% confidence Interval, 0.29–1.76) for nonswimmers versus swimmers. Network meta-analyses suggest that, relative to oral antibiotics, topical antibiotic–glucocorticoid drops were more effective: OR 5.3 (95% Credible Interval, 1.2–27). The OR for antibiotic-only drops was 3.3 (95% Credible Interval, 0.74–16). Overall, the topical antibiotic–glucocorticoid and antibiotic-only preparations have the highest probabilities, 0.77 and 0.22 respectively, of being the most effective therapies. LIMITATIONS: Sparse randomized evidence (2 RCTs) and high risk of bias for nonrandomized comparative studies evaluating water precautions. Otorrhea treatments include non–US Food and Drug Administration approved, off-label, and potentially ototoxic antibiotics. CONCLUSIONS: No compelling evidence of a need for water precautions exists. Cure rates are higher for topical drops than oral antibiotics.
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Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. OBJECTIVES: The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. DATA SOURCES: Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles were independently screened by 2 investigators. DATA EXTRACTION: A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. RESULTS: Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% Credible Interval: −14.0 to −3.4) at 1 to 3 months and 0.0 (95% Credible Interval: −4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. LIMITATIONS: Sparse evidence is available, applicable only to otherwise healthy children. CONCLUSIONS: Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events.
Kate Emary - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard
The American journal of tropical medicine and hygiene, 2013Co-Authors: Catrin E. Moore, Wirichada Pan-ngum, Lalith Wijedoru, Soeng Sona, Tran Vu Thieu Nga, Pham Thanh Duy, Phat Voong Vinh, Kheng Chheng, Varun Kumar, Kate EmaryAbstract:Rapid diagnostic tests are needed for typhoid fever (TF) diagnosis in febrile children in endemic areas. Five hundred children admitted to the hospital in Cambodia between 2009 and 2010 with documented fever (≥ 38°C) were investigated using blood cultures (BCs), Salmonella Typhi/Paratyphi A real-time polymerase chain reactions (PCRs), and a Typhoid immunoglobulin M flow assay (IgMFA). Test performance was determined by conventional methods and Bayesian latent class modeling. There were 32 cases of TF (10 BC- and PCR-positive cases, 14 BC-positive and PCR-negative cases, and 8 BC-negative and PCR-positive cases). IgMFA sensitivity was 59.4% (95% confidence Interval = 41–76), and specificity was 97.8% (95% confidence Interval = 96–99). The model estimate sensitivity for BC was 81.0% (95% Credible Interval = 54–99). The model estimate sensitivity for PCR was 37.8% (95% Credible Interval = 26–55), with a specificity of 98.2% (95% Credible Interval = 97–99). The model estimate sensitivity for IgMFA (≥ 2+) was 77.9% (95% Credible Interval = 58–90), with a specificity of 97.5% (95% Credible Interval = 95–100). The model estimates of IgMFA sensitivity and specificity were comparable with BCs and better than estimates using conventional analysis.
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EVALUATION TYPHOID IGM FLOW ASSAY, CAMBODIA Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard
2013Co-Authors: Catrin E. Moore, Wirichada Pan-ngum, Lalith Wijedoru, Soeng Sona, Pham Thanh Duy, Phat Voong Vinh, Kheng Chheng, Varun Kumar, Thieu Nga, Kate EmaryAbstract:Rapid diagnostic tests are needed for typhoid fever (TF) diagnosis in febrile children in endemic areas. Five hundred children admitted to the hospital in Cambodia between 2009 and 2010 with documented fever (38°C) were investigated using blood cultures (BCs), Salmonella Typhi/Paratyphi A real-time polymerase chain reactions (PCRs), and a Typhoid immunoglobulin M flow assays (IgMFAs). Test performance was determined by conventional methods and Bayesian latent class modeling. There were 32 cases of TF (10 BC- and PCR-positive cases, 14 BC-positive and PCR-negative cases, and 8 BCnegative and PCR-positive cases). IgMFA sensitivity was 59.4% (95% confidence Interval = 41–76), and specificity WAS 97.8% (95% confidence Interval = 96–99). The model estimate sensitivity for BC was 81.0% (95% Credible Interval = 54–99). The model estimate sensitivity for PCR was 37.8% (95% Credible Interval = 26–55), with a specificity of 98.2% (95% Credible Interval = 97–99). The model estimate sensitivity for IgMFA (2+) was 77.9% (95% Credible Interval = 58–90), with a specificity of 97.5% (95% Credible Interval = 95–100). The model estimates of IgMFA sensitivity and specificity were comparable with BCs and better than estimates using conventional analysis.
Dale W. Steele - One of the best experts on this subject based on the ideXlab platform.
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prevention and treatment of tympanostomy tube otorrhea a meta analysis
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Children with tympanostomy tubes often develop ear discharge. OBJECTIVE: Synthesize evidence about the need for water precautions (ear plugs or swimming avoidance) and effectiveness of topical versus oral antibiotic treatment of otorrhea in children with tympanostomy tubes. DATA SOURCES: Searches in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Excerpta Medica Database, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles independently screened by 2 investigators. DATA EXTRACTION: 25 articles were included. RESULTS: One randomized controlled trial (RCT) in children assigned to use ear plugs versus no precautions reported an odds ratio (OR) of 0.68 (95% confidence Interval, 0.37–1.25) for >1 episode of otorrhea. Another RCT reported an OR of 0.71 (95% confidence Interval, 0.29–1.76) for nonswimmers versus swimmers. Network meta-analyses suggest that, relative to oral antibiotics, topical antibiotic–glucocorticoid drops were more effective: OR 5.3 (95% Credible Interval, 1.2–27). The OR for antibiotic-only drops was 3.3 (95% Credible Interval, 0.74–16). Overall, the topical antibiotic–glucocorticoid and antibiotic-only preparations have the highest probabilities, 0.77 and 0.22 respectively, of being the most effective therapies. LIMITATIONS: Sparse randomized evidence (2 RCTs) and high risk of bias for nonrandomized comparative studies evaluating water precautions. Otorrhea treatments include non–US Food and Drug Administration approved, off-label, and potentially ototoxic antibiotics. CONCLUSIONS: No compelling evidence of a need for water precautions exists. Cure rates are higher for topical drops than oral antibiotics.
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Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. OBJECTIVES: The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. DATA SOURCES: Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles were independently screened by 2 investigators. DATA EXTRACTION: A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. RESULTS: Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% Credible Interval: −14.0 to −3.4) at 1 to 3 months and 0.0 (95% Credible Interval: −4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. LIMITATIONS: Sparse evidence is available, applicable only to otherwise healthy children. CONCLUSIONS: Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events.
Catrin E. Moore - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard
The American journal of tropical medicine and hygiene, 2013Co-Authors: Catrin E. Moore, Wirichada Pan-ngum, Lalith Wijedoru, Soeng Sona, Tran Vu Thieu Nga, Pham Thanh Duy, Phat Voong Vinh, Kheng Chheng, Varun Kumar, Kate EmaryAbstract:Rapid diagnostic tests are needed for typhoid fever (TF) diagnosis in febrile children in endemic areas. Five hundred children admitted to the hospital in Cambodia between 2009 and 2010 with documented fever (≥ 38°C) were investigated using blood cultures (BCs), Salmonella Typhi/Paratyphi A real-time polymerase chain reactions (PCRs), and a Typhoid immunoglobulin M flow assay (IgMFA). Test performance was determined by conventional methods and Bayesian latent class modeling. There were 32 cases of TF (10 BC- and PCR-positive cases, 14 BC-positive and PCR-negative cases, and 8 BC-negative and PCR-positive cases). IgMFA sensitivity was 59.4% (95% confidence Interval = 41–76), and specificity was 97.8% (95% confidence Interval = 96–99). The model estimate sensitivity for BC was 81.0% (95% Credible Interval = 54–99). The model estimate sensitivity for PCR was 37.8% (95% Credible Interval = 26–55), with a specificity of 98.2% (95% Credible Interval = 97–99). The model estimate sensitivity for IgMFA (≥ 2+) was 77.9% (95% Credible Interval = 58–90), with a specificity of 97.5% (95% Credible Interval = 95–100). The model estimates of IgMFA sensitivity and specificity were comparable with BCs and better than estimates using conventional analysis.
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EVALUATION TYPHOID IGM FLOW ASSAY, CAMBODIA Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard
2013Co-Authors: Catrin E. Moore, Wirichada Pan-ngum, Lalith Wijedoru, Soeng Sona, Pham Thanh Duy, Phat Voong Vinh, Kheng Chheng, Varun Kumar, Thieu Nga, Kate EmaryAbstract:Rapid diagnostic tests are needed for typhoid fever (TF) diagnosis in febrile children in endemic areas. Five hundred children admitted to the hospital in Cambodia between 2009 and 2010 with documented fever (38°C) were investigated using blood cultures (BCs), Salmonella Typhi/Paratyphi A real-time polymerase chain reactions (PCRs), and a Typhoid immunoglobulin M flow assays (IgMFAs). Test performance was determined by conventional methods and Bayesian latent class modeling. There were 32 cases of TF (10 BC- and PCR-positive cases, 14 BC-positive and PCR-negative cases, and 8 BCnegative and PCR-positive cases). IgMFA sensitivity was 59.4% (95% confidence Interval = 41–76), and specificity WAS 97.8% (95% confidence Interval = 96–99). The model estimate sensitivity for BC was 81.0% (95% Credible Interval = 54–99). The model estimate sensitivity for PCR was 37.8% (95% Credible Interval = 26–55), with a specificity of 98.2% (95% Credible Interval = 97–99). The model estimate sensitivity for IgMFA (2+) was 77.9% (95% Credible Interval = 58–90), with a specificity of 97.5% (95% Credible Interval = 95–100). The model estimates of IgMFA sensitivity and specificity were comparable with BCs and better than estimates using conventional analysis.
Gaelen P Adam - One of the best experts on this subject based on the ideXlab platform.
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prevention and treatment of tympanostomy tube otorrhea a meta analysis
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Children with tympanostomy tubes often develop ear discharge. OBJECTIVE: Synthesize evidence about the need for water precautions (ear plugs or swimming avoidance) and effectiveness of topical versus oral antibiotic treatment of otorrhea in children with tympanostomy tubes. DATA SOURCES: Searches in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Excerpta Medica Database, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles independently screened by 2 investigators. DATA EXTRACTION: 25 articles were included. RESULTS: One randomized controlled trial (RCT) in children assigned to use ear plugs versus no precautions reported an odds ratio (OR) of 0.68 (95% confidence Interval, 0.37–1.25) for >1 episode of otorrhea. Another RCT reported an OR of 0.71 (95% confidence Interval, 0.29–1.76) for nonswimmers versus swimmers. Network meta-analyses suggest that, relative to oral antibiotics, topical antibiotic–glucocorticoid drops were more effective: OR 5.3 (95% Credible Interval, 1.2–27). The OR for antibiotic-only drops was 3.3 (95% Credible Interval, 0.74–16). Overall, the topical antibiotic–glucocorticoid and antibiotic-only preparations have the highest probabilities, 0.77 and 0.22 respectively, of being the most effective therapies. LIMITATIONS: Sparse randomized evidence (2 RCTs) and high risk of bias for nonrandomized comparative studies evaluating water precautions. Otorrhea treatments include non–US Food and Drug Administration approved, off-label, and potentially ototoxic antibiotics. CONCLUSIONS: No compelling evidence of a need for water precautions exists. Cure rates are higher for topical drops than oral antibiotics.
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Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.
Pediatrics, 2017Co-Authors: Dale W. Steele, Gaelen P Adam, Christopher H. Halladay, Ethan M Balk, Thomas A TrikalinosAbstract:CONTEXT: Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. OBJECTIVES: The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. DATA SOURCES: Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles were independently screened by 2 investigators. DATA EXTRACTION: A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. RESULTS: Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% Credible Interval: −14.0 to −3.4) at 1 to 3 months and 0.0 (95% Credible Interval: −4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. LIMITATIONS: Sparse evidence is available, applicable only to otherwise healthy children. CONCLUSIONS: Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events.