Overviews and meta-analysis

Lickey ME, Gordon B. (1991). Medicine and Mental Illness. New York W. H. Freeman and Company. Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D. (1996). St. John s wort for depression—an overview and meta-analysis of randomised clinical trials. BMJ. 313(7052) 253-58. Lingjaerde 0, Foreland AR, Magnusson A. (1999). Can winter depression be prevented by Ginkgo biloba extract A placebo-controlled trial. Acta Psychlatr Scand. 100(1) 62-66. 

Piepoli M, Villani GQ, Ponikowski P, Wright A, Flather MD, Coats AJ. Overview and meta-analysis of randomised trials of amiodarone in chronic heart failure. IntJCard 1998 66(1) 1-10. 

Linde, K., Ramirez, G., Mulrow, C.D., Pauls, A., Weidenhammer, W, and Melchart, D. (1996) St. John s wort for depression an overview and meta-analysis of randomised clinical trials. BMJ 313 253-258. 

Linde K, Ramirez G, Mulrow CD, et al. St John s wort for depression — an overview and meta-analysis of randomized clinical trials. BMJ 1996 313 258-261. 

Linde, K. el al St. John s Wort for Depression An Overview and Meta-analysis of Randomised Clinical Trials, BMJ, Vol 313 253-8, Aug, 1996. 

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Geddes J, Freemantle N, Harrison P, et al. Atypical antipsychotics in the treatment of schizophrenia systematic overview and meta-regression analysis. BMJ 2000 321(7273) 1371-1376. 

Geddes J, Freemantle N, Harrison P, Bebbington P. Atypical antipsychotics in the treatment of schizophrenia systematic overview and meta-regression analysis. BMJ 2000 321 1371-6 Hirsch S, Gaind R, Rohde PD et al. Outpatient maintenance of chronic schizophrenia patients with long-acting fluphenazine double-bhnd placebo trial. BMJ 1973 1 633-7 Johnstone E, Crow TJ, Frith CD etal. Mechanism of the antipsychotic effect in the treatment of schizophrenia. Lancet 1978 i 848-51... 

This chapter adds the socio-economic dimension to the medical or technical perspectives of the proceeding contributions of this book. As its health economic terminology and approach might be unfamiliar to some readers, we start with a section on methodology. In particular, we present an overview of the concept of Cost-of-Illness (COI) and of relevant health economic evaluation techniques. In Sect. 2, we present the basic findings of a meta-analysis of the socio-economic costs of HIV/AIDS and of the socio-economic impact of antiviral intervention. The major findings are reflected in Sect. 3. The chapter closes with a speculation on long-term socio-economic costs of antiviral intervention. 

While comprehensive research and surveys were delayed, or lacking, no significant effort had been put toward the overview of the existing data of emissions, sources, distribution, exposure, and fate of POPs. Lee and Kim (1999) collected published data on concentrations of EDCs for almost all environmental media and human tissues and performed a meta-analysis to examine the relationship between the sperm quality of South Korean... 

With the data included in the overview of Garg et al. (316), it is possible to calculate that 18 patients need to be treated for 90 days to avoid one death or one hospitalization for congestive heart failure (95% confidence interval [Cl] 16-23). This meta-analysis includes 32 trials with the ACE inhibitors captopril, enalapril, lisinopril, quinapril, ramipril, and perindopril. It is likely that high doses (for instance, lisinopril 35 mg daily) are more effective than low doses (lisinopril 5 mg daily) (302). Treating 30 patients for 4 years with a high dose of lisinopril (95% Cl 16-509) will avoid one hospitalization for cardiovascular reasons or one death in comparison with a low dose, without increasing the number of adverse effects requiring withdrawal from treatment. 

In the 1994 APT overview fetal extracranial bleeding was rare, and there was no clear excess with prolonged antiplatelet therapy. Most major extracranial bleeds are gastrointestinal, and a meta-analysis of the placebo-controlled trials demonstrated that prolonged aspirin treatment increased the risk of gastrointestinal bleeding by around 1.5 to 2-fold (70). However, unlike serious vascular events, such bleeds rarely result in permanent disability or death. 

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Since then the importance of meta-analysis has grown. Not only has there been an explosion in published analyses over the past twenty years, but initiatives such as that of the Cochrane collaboration of databases as well as the trend towards evidence-based medicine make it both easier to use meta-analysis on the one hand and less acceptable not to do so on the other. In drug development, while being satisfied with an expert s judgement alone in the past, the regulator now expects to see it backed up with a formal overview of all studies. (See, for example, ICH E9 (International Conference on Harmonisation, 1999).) Like them or hate them, meta-analyses are here to stay. 

Before presenting oin discussion, we present a brief and select overview of some relevant literature. Peto (1987) discusses some foimdational issues in systematic reviews of randomized trials for rare outcomes, in particular the need for such reviews and considerations of heterogeneity of the treatment effect. Hammad et al. (2011) present a thorough overview of the issues associated with the secondary use of randomized trials to evaluate safety. Bradbum et al. (2007) evaluate statistical meta-analysis methods for rare events. Kaizer et al. (2006) present an interesting example of a hierarchical Bayesian method for meta-analysis of safety. Crowe et al. (2009) provide recommendation for a premarket safety program. 

ABSTRACT This document represents an overview of the Function Interaction Structure (FIS) modeling, where the goal is to represent a system and the risk analysis that is made, and to obtain a simulation model from the risk analysis. This model is able to show the results of risk analysis. This model is supplemented by information on its behavior, in order to generate the dynamic model in degraded mode. Our proposed meta model is also used to analyze the risk associated with a system such as evacuation system, transport of dangerous goods,... 

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