Northern Hospital

About: Northern Hospital is a healthcare organization based out in Epping, New South Wales, Australia. It is known for research contribution in the topics: Myocardial infarction & Population. The organization has 1308 authors who have published 1131 publications receiving 20528 citations.

The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain

Abstract: Objective —To determine whether minimum clinically significant difference in visual analogue scale (VAS) pain score varies according to the severity of pain reported. Method —Prospective descriptive study of adult patients in an urban emergency department (ED). On presentation to the ED, patients marked the level of their pain on a 100 mm, non-hatched VAS scale. At 20 minute intervals thereafter they were asked to give a verbal categorical rating of their pain as “a lot better”, “a little better”, “much the same”, “a little worse” or “much worse” and to mark the level of pain on a VAS scale of the same type as used previously. It was pre-defined that patients with VAS pain scores of 30 mm or less would be categorised as having mild pain, those with scores of 70 mm or more were categorised as having severe pain and those from 31 mm to 69 mm, moderate pain. The minimal clinically significant difference (MCSD) in VAS pain score was defined as the mean difference between current and preceding scores when the subject reported “a little worse” or “a little better” pain. Results —156 patients were enrolled in the study, yielding 88 evaluable comparisons where pain was rated as “a little better” or “a little worse”. The MCSD in VAS score in the group overall was 12 mm (95%CI 9 mm to 15 mm). MCSD in VAS score for the “mild pain” group was 11 mm (95%CI 4 mm to 18 mm), for the “moderate pain” group 14 mm (95%CI 10 mm to 18 mm) and for the severe pain group, 10 mm (95%CI 6 mm to 14 mm). There is no statistical difference between the MCSD in VAS score between the severity groups. Conclusions —The MCSD in VAS pain score does not differ with the severity of pain being experienced.

Does the Clinically Significant Difference in Visual Analog Scale Pain Scores Vary with Gender, Age, or Cause of Pain?

Abstract: . Objectives: To determine the minimum clinically significant difference in visual analog scale (VAS) pain scores for acute pain in the ED setting and to determine whether this difference varies with gender, age, or cause of pain. Methods: A prospective, descriptive study of 152 adult patients presenting to the ED with acute pain. At presentation and at 20-minute intervals to a maximum of three measurements, patients marked the level of their pain on a 100-mm, nonhatched VAS. At each follow-up they also gave a verbal rating of their pain as “a lot better,”“much the same,”“a little worse,” or “much worse.” The minimum clinically significant difference in VAS pain scores was defined as the mean difference between current and preceding scores when pain was reported as a little worse or a little better. Data were compared based on gender, age more than or less than 50 years, and traumatic vs nontraumatic causes of pain. Results: The minimum clinically significant difference in VAS pain scores is 9 mm (95% CI, 6 to 13 mm). There is no statistically significant difference between the minimum clinically significant differences in VAS pain scores based on gender (p = 0.172), age (p = 0.782), or cause of pain (p = 0.84). Conclusions: The minimum clinically significant difference in VAS pain scores was found to be 9 mm. Differences of less than this amount, even if statistically significant, are unlikely to be of clinical significance. No significant difference in minimum significant VAS scores was found between gender, age, and cause-of-pain groups.

ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting.

Abstract: Background In patients receiving aspirin, the optimal duration of clopidogrel therapy after drug-eluting stent (DES) implantation remains unclear. Methods This multicentre, randomized, double-blind, placebo-controlled trial tested the hypothesis that in patients undergoing DES implantation, 6 months of clopidogrel is non-inferior to 12 months in terms of clinical outcomes. At 6 months after DES implantation, patients on clopidogrel were randomly assigned to either a 6-month period of placebo or an additional 6-month period of clopidogrel. The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, and thrombolysis in myocardial infarction major bleeding at 9 months after randomization. Results Owing to slow recruitment and low event rates, the trial was stopped prematurely after enrolment of 4005 of 6000 planned patients. Of 4000 patients included in the final analysis, 1997 received 6 months of clopidogrel and 2003 received 12 months. The primary endpoint occurred in 29 patients (1.5%) assigned to 6 months of clopidogrel and 32 patients (1.6%) assigned to 12 months, observed difference −0.1%, upper limit of one-sided 95% confidence interval (CI) 0.5%, limit of non-inferiority 2%, P for noninferiority <0.001. Stent thrombosis was observed in five patients (0.3%) assigned to 6 months of clopidogrel and three patients (0.2%) assigned to 12 months; hazard ratio (HR) 1.66, 95% CI: 0.40–6.96, P = 0.49. Thrombolysis in myocardial infarction major bleeding was observed in 4 patients (0.2%) assigned to 6 months clopidogrel and 5 patients (0.3%) assigned to 12 months; HR 0.80, 95% CI: 0.21–2.98, P = 0.74. Conclusions In the present trial, characterized by low event rates, we did not observe a significant difference in net clinical outcome between 6 and 12 months of clopidogrel therapy after DES implantation. However, the results of the trial must be considered in view of its premature termination and lower than expected event rates. The trial is registered with ClinicalTrials.gov, Identifier: [NCT00661206][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00661206&atom=%2Fehj%2F36%2F20%2F1252.atom

A genome-wide association study identifies two new lung cancer susceptibility loci at 13q12.12 and 22q12.2 in Han Chinese

Abstract: Hongbing Shen and colleagues report a genome-wide association study for lung cancer in individuals of Han Chinese ancestry. The authors identify two new lung cancer susceptibility loci.