This work presents an algorithm for modeling a static spherically symmetric compact object satisfying the Eiesland condition (Eiesland in Am Math Soc 27:213, 1925), a necessary and sufficient ...condition that a general centro-symmetric space shall be of the class 1. The model parameters are obtained accordingly by employing the boundary conditions to the interior solutions. The equation of state has been extracted from the solution and one found that it is almost linear. These models are free of physical and geometric singularities and satisfy the necessary physical conditions to have astrophysical significance. The central and surface densities, and pressures of some compact stars like PSR J1614-2230, Vela X-1 have been calculated from these models. Detailed analyses of these models have also been made with the help of numerical and graphical studies.
Published research should be reported to evidence users with clarity and transparency that facilitate optimal appraisal and use of evidence and allow replication by other researchers. Guidelines for ...such reporting are available for several types of studies but not for meta-epidemiological methodology studies. Meta-epidemiological studies adopt a systematic review or meta-analysis approach to examine the impact of certain characteristics of clinical studies on the observed effect and provide empirical evidence for hypothesised associations. The unit of analysis in meta-epidemiological studies is a study, not a patient. The outcomes of meta-epidemiological studies are usually not clinical outcomes. In this guideline, we adapt items from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to fit the context of meta-epidemiological studies.
It is common to measure continuous outcomes using different scales (eg, quality of life, severity of anxiety or depression), therefore these outcomes need to be standardized before pooling in a ...meta-analysis. Common methods of standardization include using the standardized mean difference, the odds ratio derived from continuous data, the minimally important difference, and the ratio of means. Other ways of making data more meaningful to end users include transforming standardized effects back to original scales and transforming odds ratios to absolute effects using an assumed baseline risk. For these methods to be valid, the scales or instruments being combined across studies need to have assessed the same or a similar construct
ABSTRACT
Background
Decision makers rely on meta-analytic estimates to trade off benefits and harms. Publication bias impairs the validity and generalizability of such estimates. The performance of ...various statistical tests for publication bias has been largely compared using simulation studies and has not been systematically evaluated in empirical data.
Methods
This study compares seven commonly used publication bias tests (i.e., Begg’s rank test, trim-and-fill, Egger’s, Tang’s, Macaskill’s, Deeks’, and Peters’ regression tests) based on 28,655 meta-analyses available in the Cochrane Library.
Results
Egger’s regression test detected publication bias more frequently than other tests (15.7% in meta-analyses of binary outcomes and 13.5% in meta-analyses of non-binary outcomes). The proportion of statistically significant publication bias tests was greater for larger meta-analyses, especially for Begg’s rank test and the trim-and-fill method. The agreement among Tang’s, Macaskill’s, Deeks’, and Peters’ regression tests for binary outcomes was moderately strong (most
κ
’s were around 0.6). Tang’s and Deeks’ tests had fairly similar performance (
κ
> 0.9). The agreement among Begg’s rank test, the trim-and-fill method, and Egger’s regression test was weak or moderate (
κ
< 0.5).
Conclusions
Given the relatively low agreement between many publication bias tests, meta-analysts should not rely on a single test and may apply multiple tests with various assumptions. Non-statistical approaches to evaluating publication bias (e.g., searching clinical trials registries, records of drug approving agencies, and scientific conference proceedings) remain essential.
Objective Critical limb ischemia (CLI) is associated with high morbidity and mortality. Because most patients with CLI will eventually undergo some type of revascularization, the natural history of ...CLI is not well defined, although it is important to know when patients decide to pursue treatment. Methods We systematically searched multiple databases for controlled and uncontrolled studies of patients with CLI who did not receive revascularization with a minimum follow-up of ≥1 year. Predefined outcomes of interest were mortality, major amputation, and wound healing. Random-effects meta-analysis was used to pool cumulative incidence across studies. Results We identified 13 studies enrolling 1527 patients. During a median follow-up of 12 months, all-cause mortality rate was 22% (confidence interval CI, 12%-33%) and major amputation rate was 22% (CI, 2%-42%). Worsened wound or ulcer was found at 35% (CI, 10%-62%). There was a trend toward improvement in mortality and amputation rate in studies done after 1997. The quality of evidence was low because of increased risk of bias and inconsistency. Conclusions Mortality and major amputations are common in patients who have untreated CLI during a median follow-up of 1 year, although these outcomes have improved in recent times.
Summary
Background
Nonalcoholic steatohepatitis (NASH) is a common cause of chronic liver disease. There is a major need to understand the efficacy of different pharmacological agents for the ...treatment of NASH.
Aim
To assess the relative rank‐order of different pharmacological interventions in fibrosis improvement and NASH resolution.
Methods
A comprehensive search of several databases was conducted by an experienced librarian. We included randomised controlled‐trials (RCTs) comparing pharmacological interventions in patients with biopsy‐proven NASH. The primary outcome was ≥1 stage improvement in fibrosis. The secondary outcome was NASH resolution.
Results
A total of 26 RCTs with 23 interventions met the eligibility criteria. Lanifibranor and obeticholic acid had the highest probability of being ranked the most effective intervention for achieving ≥1 stage of fibrosis improvement (SUCRA 0.78) and (SUCRA 0.77), respectively. For NASH resolution, semaglutide, liraglutide and vitamin E plus pioglitazone had the highest probability of being ranked the most effective intervention for achieving NASH resolution (SUCRA 0.89), (SUCRA 0.84) and (SUCRA 0.83), respectively. Lanifibranor, obeticholic acid, pioglitazone and vitamin E were significantly better than placebo in achieving ≥1 stage of fibrosis improvement. Conversely, semaglutide, liraglutide, vitamine E plus pioglitazone, pioglitazone, lanifibranor and obeticholic acid were significantly better than placebo in achieving NASH resolution.
Conclusion
These data provide relative rank‐order efficacy of various NASH therapies in terms of their improvements in liver fibrosis and NASH resolution. Therapies that have been shown to improve NASH resolution may be combined with therapies that have an antifibrotic effect to further boost treatment response rate in future.
Lanifibranor and obeticholic acid have the highest probability of being ranked the most effective intervention for achieving ≥1 stage fibrosis improvement (Figure 1A). For NASH resolution, semaglutide, liraglutide and vitamin E plus Pioglitazone have the highest probability of being ranked the most effective intervention for achieving NASH resolution (Figure 1B).
Hepatocellular carcinoma (HCC) is a complex disease most commonly arising in the background of chronic liver disease. In the past two decades, there has been a significant increase in our ...understanding of both the clinical and molecular heterogeneity of HCC. There has been a robust increase in clinical trial activity in patients with poor prognostic factors, such as macrovascular invasion and extrahepatic spread (EHS). We aimed to synthesize the evidence for the treatment of patients with advanced HCC based on these baseline characteristics, including patients with both Child‐Pugh (CP) scores of A and B. A comprehensive search of several databases from each database inception to February 15, 2016 any language was conducted. We included 14 studies (three randomized controlled studies RCTs and 11 observational studies). We included studies that compared sorafenib, transarterial bland embolization/transarterial chemoembolization, yttrium‐90/radiation therapy, ablation (or combination), and no therapy. Two RCTs comparing sorafenib to best supportive care demonstrated a consistent improvement in overall survival (OS) for patients with advanced HCC and metastatic vascular invasion (MVI) and/or EHS and CP A liver disease (hazard ratio, 0.66 95% confidence interval, 0.51‐0.87; I2 = 0%). Several observational studies evaluated locoregional therapies alone or in combination with other treatments and were limited by very‐low‐quality of evidence. This was true for both patients with EHS and MVI. Conclusion: In patients with advanced HCC and CP A liver function, sorafenib is the only treatment that has been shown to improve OS in randomized studies. High‐quality data supporting the use of other treatment modalities in this setting, or in the setting of patients with less compensated (CP B) liver disease, are lacking. (Hepatology 2018;67:422‐435)
Objective:
The aim was to formulate clinical practice guidelines for acromegaly.
Participants:
The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee ...(CGS), five experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This guideline is cosponsored by the European Society of Endocrinology.
Evidence:
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews.
Consensus Process:
One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society and the European Society of Endocrinology reviewed drafts of the guidelines.
Conclusions:
Using an evidence-based approach, this acromegaly guideline addresses important clinical issues regarding the evaluation and management of acromegaly, including the appropriate biochemical assessment, a therapeutic algorithm, including use of medical monotherapy or combination therapy, and management during pregnancy.
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