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Wahyuningsih Lauma - One of the best experts on this subject based on the ideXlab platform.
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PERBEDAAN INFORMASI ANATOMI MRI KNEE Joint IRISAN SAGITAL ANTARA PEMBOBOTAN PROTON DENSITY DAN PEMBOBOTAN PROTON DENSITY SPIR PADA KASUS RUPTUR ANTERIOR CRUCIATE LIGAMENTPERBEDAAN INFORMASI ANATOMI MRI KNEE Joint IRISAN SAGITAL ANTARA PEMBOBOTAN PROTON DENSITY DAN PEMBOBOTAN PROTON DENSITY SPIR PADA KASUS RUPTUR ANTERIOR CRUCIATE LIGAMENT
Prodi DIV T. Radiodiagnostik dan Radioterapi Semarang POLTEKKES KEMENKES SEMARANG, 2017Co-Authors: Wahyuningsih LaumaAbstract:Background: MRI knee Joint Examination is usually view ruptures or unseen images of x-rays, because using MRI can exhibit very small images such as ligaments. In some condition, MRI Examination has diffiiculty to distinguish fat and soft tissue. Fat often be asource of a problem in MRI, because fat sorrounds in anatomical structures, but fat does not have a firm limit. To overcome these obstacles then developed a fat pressing technique called fat suppression. The purpose of this research is to know the difference anatomical information of MRI knee Joint in sagittal section with proton density weighted and proton density weighted SPIR in ruptur anterior cruciate ligament case, and to know which sequence is better to display knee Joint anatomy information. Methods: This study is a quantitative study with experimental approach. It was conducted at Dr. Saiful Anwar Malang. The data in the form of MRI knee Joint images of sagittal section betwen proton density weighted and proton density weighted SPIR 10 patients. The data assessment was done by two respondents and the data were analyzed using Wilcoxon to assess the clarity of anatomical information and mean rank results to see the better sequence. Results: The results showed that there were significant differences in the anatomical information of MRI knee Joint in sagittal section between proton density weighted and proton density weighted SPIR with p-value 0.001. The differences in anatomical information in SPIR use occur in anterior cruciate ligament, posterior cruciate ligament, meniscus and rupture anterior cruciate ligament. The proton density weighted SPIR is better sequence to visualize anatomical information of knee Joint in anterior cruciate ligament rupture cases. Conclusion: There is a significant difference in anatomical information of MRI Knee Joint in sagittal section between proton density and proton density spir in ruptur anterior cruciate ligament case in the ACL Rupture case with p-value 0.001 (p-valu
Christopher J Edwards - One of the best experts on this subject based on the ideXlab platform.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background; Synovitis (inflamed Joint synovial lining) in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective; To investigate the added value of US, compared with CE alone, in RA synovitis in terms of clinical effectiveness and cost-effectiveness. Data sources; Electronic databases including MEDLINE, EMBASE and the Cochrane databases were searched from inception to October 2015. Review methods; A systematic review sought RA studies that compared additional US with CE. Heterogeneity of the studies with regard to interventions, comparators and outcomes precluded meta-analyses. Systematic searches for studies of cost-effectiveness and US and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model; A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease-modifying anti-rheumatic drugs (DMARDs) and serious infections at which the addition of US had a cost per quality-adjusted life-year (QALY) gained of £20,000 and £30,000. Furthermore, the reduction in the costs of DMARDs at which US becomes cost neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in number of patients escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in number of patients escalating treatment for US to become cost neutral was also estimated. Results; Fifty-eight studies were included. Two randomised controlled trials compared adding US to a Disease Activity Score (DAS)-based treat-to-target strategy for early RA patients. The addition of power Doppler ultrasound (PDUS) to a Disease Activity Score 28 Joints-based treat-to-target strategy in the Targeting Synovitis in Early Rheumatoid Arthritis (TaSER) trial resulted in no significant between-group difference for change in Disease Activity Score 44 Joints (DAS44). This study found that significantly more patients in the PDUS group attained DAS44 remission (p = 0.03). The Aiming for Remission in Rheumatoid Arthritis (ARCTIC) trial found that the addition of PDUS and grey-scale ultrasound (GSUS) to a DAS-based strategy did not produce a significant between-group difference in the primary end point: composite DAS of < 1.6, no swollen Joints and no progression in van der Heijde-modified total Sharp score (vdHSS). The ARCTIC trial did find that the erosion score of the vdHS had a significant advantage for the US group (p = 0.04). In the TaSER trial there was no significant group difference for erosion. Other studies suggested that PDUS was significantly associated with radiographic progression and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogeneity between trials made conclusions uncertain. No studies were identified that reported the cost-effectiveness of US in monitoring synovitis. The model estimated that an average reduction of 2.5% in the costs of biological DMARDs would be sufficient to offset the costs of 3-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations; Heterogeneity of the trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs and health-related quality of life decrements, relating to a flare following tapering or disease progression, have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion; Limited evidence suggests that US monitoring of synovitis could provide a cost-effective approach to selecting RA patients for treatment tapering or escalation avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies. Study registration; This study is registered as PROSPERO CRD42015017216. Funding; The National Institute for Health Research Health Technology Assessment programme.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background Synovitis (inflamed Joint synovial lining), in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective To investigate the added value of US, compared to CE alone, in RA synovitis, to clinical and cost-effectiveness. Data sources Electronic databases, inception-October 2015, including MEDLINE, EMBASE and Cochrane Databases. Review methods A systematic review sought RA studies, comparing additional US with CE. Heterogeneity in intervention, comparators and outcomes precluded meta-analyses. Systematic searches of costeffectiveness and US, and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease modifying drugs (DMARDs) and serious infections, at which the addition of US had a cost per quality adjusted life year (QALY) gained of £20,000 and £30,000. Further, the reduction in the costs of DMARDs at which US become cost-neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in patients not escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in patients escalating treatment for US to become cost-neutral was also estimated. Results Fifty-eight studies were included. Two RCTs compared adding US to a DAS-based treat-to-target strategy for early RA patients. The addition of PDUS to DAS28 based treat-to-target strategy in TaSER reported no significant between group difference for change in DAS44. This study found the PDUS group had significantly more patients attaining DAS44 remission (p=0.03). ARCTIC found the addition of PDUS and GSUS to a DAS based strategy did not produce a significant between group difference in the primary endpoint: composite DAS<1.6, no swollen Joints, and no progression in van der Heijde-modified total Sharp Score (vdHSS). ARCTIC did find the erosion score of vdHS had a significant advantage for US group (p=0.04). Erosion in the TaSER study did not find a significant group difference. Other studies suggested PDUS was significantly associated with radiographic progression, and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogenity between trials made conclusions uncertain. No papers were identified reporting cost-effectiveness of US in monitoring synovitis. The model estimated an average reduction of 2.5% in costs of biological disease-modifying anti-rheumatic drug (bDMARDs) would be sufficient to offset the costs of three-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations Heterogeneity of trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs, and health related quality of life decrement, relating to a flare following tapering or disease progression have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion Limited evidence suggests US monitoring of synovitis could provide a cost effective approach to selecting RA patients for treatment tapering or escalation-avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies.
Philip G Conaghan - One of the best experts on this subject based on the ideXlab platform.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background; Synovitis (inflamed Joint synovial lining) in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective; To investigate the added value of US, compared with CE alone, in RA synovitis in terms of clinical effectiveness and cost-effectiveness. Data sources; Electronic databases including MEDLINE, EMBASE and the Cochrane databases were searched from inception to October 2015. Review methods; A systematic review sought RA studies that compared additional US with CE. Heterogeneity of the studies with regard to interventions, comparators and outcomes precluded meta-analyses. Systematic searches for studies of cost-effectiveness and US and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model; A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease-modifying anti-rheumatic drugs (DMARDs) and serious infections at which the addition of US had a cost per quality-adjusted life-year (QALY) gained of £20,000 and £30,000. Furthermore, the reduction in the costs of DMARDs at which US becomes cost neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in number of patients escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in number of patients escalating treatment for US to become cost neutral was also estimated. Results; Fifty-eight studies were included. Two randomised controlled trials compared adding US to a Disease Activity Score (DAS)-based treat-to-target strategy for early RA patients. The addition of power Doppler ultrasound (PDUS) to a Disease Activity Score 28 Joints-based treat-to-target strategy in the Targeting Synovitis in Early Rheumatoid Arthritis (TaSER) trial resulted in no significant between-group difference for change in Disease Activity Score 44 Joints (DAS44). This study found that significantly more patients in the PDUS group attained DAS44 remission (p = 0.03). The Aiming for Remission in Rheumatoid Arthritis (ARCTIC) trial found that the addition of PDUS and grey-scale ultrasound (GSUS) to a DAS-based strategy did not produce a significant between-group difference in the primary end point: composite DAS of < 1.6, no swollen Joints and no progression in van der Heijde-modified total Sharp score (vdHSS). The ARCTIC trial did find that the erosion score of the vdHS had a significant advantage for the US group (p = 0.04). In the TaSER trial there was no significant group difference for erosion. Other studies suggested that PDUS was significantly associated with radiographic progression and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogeneity between trials made conclusions uncertain. No studies were identified that reported the cost-effectiveness of US in monitoring synovitis. The model estimated that an average reduction of 2.5% in the costs of biological DMARDs would be sufficient to offset the costs of 3-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations; Heterogeneity of the trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs and health-related quality of life decrements, relating to a flare following tapering or disease progression, have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion; Limited evidence suggests that US monitoring of synovitis could provide a cost-effective approach to selecting RA patients for treatment tapering or escalation avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies. Study registration; This study is registered as PROSPERO CRD42015017216. Funding; The National Institute for Health Research Health Technology Assessment programme.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background Synovitis (inflamed Joint synovial lining), in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective To investigate the added value of US, compared to CE alone, in RA synovitis, to clinical and cost-effectiveness. Data sources Electronic databases, inception-October 2015, including MEDLINE, EMBASE and Cochrane Databases. Review methods A systematic review sought RA studies, comparing additional US with CE. Heterogeneity in intervention, comparators and outcomes precluded meta-analyses. Systematic searches of costeffectiveness and US, and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease modifying drugs (DMARDs) and serious infections, at which the addition of US had a cost per quality adjusted life year (QALY) gained of £20,000 and £30,000. Further, the reduction in the costs of DMARDs at which US become cost-neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in patients not escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in patients escalating treatment for US to become cost-neutral was also estimated. Results Fifty-eight studies were included. Two RCTs compared adding US to a DAS-based treat-to-target strategy for early RA patients. The addition of PDUS to DAS28 based treat-to-target strategy in TaSER reported no significant between group difference for change in DAS44. This study found the PDUS group had significantly more patients attaining DAS44 remission (p=0.03). ARCTIC found the addition of PDUS and GSUS to a DAS based strategy did not produce a significant between group difference in the primary endpoint: composite DAS<1.6, no swollen Joints, and no progression in van der Heijde-modified total Sharp Score (vdHSS). ARCTIC did find the erosion score of vdHS had a significant advantage for US group (p=0.04). Erosion in the TaSER study did not find a significant group difference. Other studies suggested PDUS was significantly associated with radiographic progression, and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogenity between trials made conclusions uncertain. No papers were identified reporting cost-effectiveness of US in monitoring synovitis. The model estimated an average reduction of 2.5% in costs of biological disease-modifying anti-rheumatic drug (bDMARDs) would be sufficient to offset the costs of three-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations Heterogeneity of trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs, and health related quality of life decrement, relating to a flare following tapering or disease progression have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion Limited evidence suggests US monitoring of synovitis could provide a cost effective approach to selecting RA patients for treatment tapering or escalation-avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies.
Emma Simpson - One of the best experts on this subject based on the ideXlab platform.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background; Synovitis (inflamed Joint synovial lining) in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective; To investigate the added value of US, compared with CE alone, in RA synovitis in terms of clinical effectiveness and cost-effectiveness. Data sources; Electronic databases including MEDLINE, EMBASE and the Cochrane databases were searched from inception to October 2015. Review methods; A systematic review sought RA studies that compared additional US with CE. Heterogeneity of the studies with regard to interventions, comparators and outcomes precluded meta-analyses. Systematic searches for studies of cost-effectiveness and US and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model; A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease-modifying anti-rheumatic drugs (DMARDs) and serious infections at which the addition of US had a cost per quality-adjusted life-year (QALY) gained of £20,000 and £30,000. Furthermore, the reduction in the costs of DMARDs at which US becomes cost neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in number of patients escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in number of patients escalating treatment for US to become cost neutral was also estimated. Results; Fifty-eight studies were included. Two randomised controlled trials compared adding US to a Disease Activity Score (DAS)-based treat-to-target strategy for early RA patients. The addition of power Doppler ultrasound (PDUS) to a Disease Activity Score 28 Joints-based treat-to-target strategy in the Targeting Synovitis in Early Rheumatoid Arthritis (TaSER) trial resulted in no significant between-group difference for change in Disease Activity Score 44 Joints (DAS44). This study found that significantly more patients in the PDUS group attained DAS44 remission (p = 0.03). The Aiming for Remission in Rheumatoid Arthritis (ARCTIC) trial found that the addition of PDUS and grey-scale ultrasound (GSUS) to a DAS-based strategy did not produce a significant between-group difference in the primary end point: composite DAS of < 1.6, no swollen Joints and no progression in van der Heijde-modified total Sharp score (vdHSS). The ARCTIC trial did find that the erosion score of the vdHS had a significant advantage for the US group (p = 0.04). In the TaSER trial there was no significant group difference for erosion. Other studies suggested that PDUS was significantly associated with radiographic progression and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogeneity between trials made conclusions uncertain. No studies were identified that reported the cost-effectiveness of US in monitoring synovitis. The model estimated that an average reduction of 2.5% in the costs of biological DMARDs would be sufficient to offset the costs of 3-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations; Heterogeneity of the trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs and health-related quality of life decrements, relating to a flare following tapering or disease progression, have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion; Limited evidence suggests that US monitoring of synovitis could provide a cost-effective approach to selecting RA patients for treatment tapering or escalation avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies. Study registration; This study is registered as PROSPERO CRD42015017216. Funding; The National Institute for Health Research Health Technology Assessment programme.
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what is the added value of ultrasound Joint Examination for monitoring synovitis in rheumatoid arthritis and can it be used to guide treatment decisions a systematic review and cost effectiveness analysis
Health Technology Assessment, 2018Co-Authors: Emma Simpson, Emma Hock, Mark Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip G Conaghan, Cristina Estrach, Christopher J EdwardsAbstract:Background Synovitis (inflamed Joint synovial lining), in rheumatoid arthritis (RA) can be assessed by clinical Examination (CE) or ultrasound (US). Objective To investigate the added value of US, compared to CE alone, in RA synovitis, to clinical and cost-effectiveness. Data sources Electronic databases, inception-October 2015, including MEDLINE, EMBASE and Cochrane Databases. Review methods A systematic review sought RA studies, comparing additional US with CE. Heterogeneity in intervention, comparators and outcomes precluded meta-analyses. Systematic searches of costeffectiveness and US, and treatment-tapering studies (not necessarily including US) were undertaken. Mathematical model A model was constructed that estimated, for patients in whom drug tapering was considered, the reduction in costs of disease modifying drugs (DMARDs) and serious infections, at which the addition of US had a cost per quality adjusted life year (QALY) gained of £20,000 and £30,000. Further, the reduction in the costs of DMARDs at which US become cost-neutral was also estimated. For patients in whom dose escalation was being considered, the reduction in patients not escalating treatment and in serious infections at which the addition of US had a cost per QALY gained of £20,000 and £30,000 was estimated. The reduction in patients escalating treatment for US to become cost-neutral was also estimated. Results Fifty-eight studies were included. Two RCTs compared adding US to a DAS-based treat-to-target strategy for early RA patients. The addition of PDUS to DAS28 based treat-to-target strategy in TaSER reported no significant between group difference for change in DAS44. This study found the PDUS group had significantly more patients attaining DAS44 remission (p=0.03). ARCTIC found the addition of PDUS and GSUS to a DAS based strategy did not produce a significant between group difference in the primary endpoint: composite DAS<1.6, no swollen Joints, and no progression in van der Heijde-modified total Sharp Score (vdHSS). ARCTIC did find the erosion score of vdHS had a significant advantage for US group (p=0.04). Erosion in the TaSER study did not find a significant group difference. Other studies suggested PDUS was significantly associated with radiographic progression, and that US had added value for wrist and hand Joints rather than foot and ankle Joints. Heterogenity between trials made conclusions uncertain. No papers were identified reporting cost-effectiveness of US in monitoring synovitis. The model estimated an average reduction of 2.5% in costs of biological disease-modifying anti-rheumatic drug (bDMARDs) would be sufficient to offset the costs of three-monthly US. The money could not be recouped if oral methotrexate was the only drug used. Limitations Heterogeneity of trials precluded meta-analysis. Therefore, no summary estimates of effect were available. Additional costs, and health related quality of life decrement, relating to a flare following tapering or disease progression have not been included. The feasibility of increased US monitoring has not been assessed. Conclusion Limited evidence suggests US monitoring of synovitis could provide a cost effective approach to selecting RA patients for treatment tapering or escalation-avoidance. Considerable uncertainty exists for all conclusions. Future research priorities include evaluating US monitoring of RA synovitis in longitudinal clinical studies.
Brian K. Hall - One of the best experts on this subject based on the ideXlab platform.
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descent with modification the unity underlying homology and homoplasy as seen through an analysis of development and evolution
Biological Reviews, 2003Co-Authors: Brian K. HallAbstract:Homology is at the foundation of comparative studies in biology at all levels from genes to phenotypes. Homology similarity because of common descent and ancestry, homoplasy is similarity arrived at via independent evolution However, given that there is but one tree of life, all organisms, and therefore all features of organisms, share degree of relationship and similarity one to another. That sharing may be similarity or even identity of structure the sharing of a most recent common ancestor–as in the homology of the arms of humans and apes–or it reflect some (often small) degree of similarity, such as that between the wings of insects and the wings of groups whose shared ancestor lies deep within the evolutionary history of the Metazoa. It may reflect sharing entire developmental pathways, partial sharing, or divergent pathways. This review compares features classified homologous with the classes of features normally grouped as homoplastic, the latter being convergence, parallelism, reversals, rudiments, vestiges, and atavisms. On the one hand, developmental mechanisms may be conserved, when a complete structure does not form (rudiments, vestiges), or when a structure appears only in some individuals (atavisms). On the other hand, different developmental mechanisms can produce similar (homologous) features Joint Examination of nearness of relationship and degree of shared development reveals a continuum within expanded category of homology, extending from homology → reversals → rudiments → vestiges → atavisms → parallelism, with convergence as the only class of homoplasy, an idea that turns out to be surprisingly old. realignment provides a glimmer of a way to bridge phylogenetic and developmental approaches to homology homoplasy, a bridge that should provide a key pillar for evolutionary developmental biology (evo-devo). It will and in a practical sense cannot, alter how homoplastic features are identified in phylogenetic analyses. But rudiments, reversals, vestiges, atavisms and parallelism as closer to homology than to homoplasy should guide toward searching for the common elements underlying the formation of the phenotype (what some have called deep homology of genetic and/or cellular mechanisms), rather than discussing features in terms of shared independent evolution.
