“Background: The impact of adherence to clinical practice

“Background: The impact of adherence to clinical practice guidelines (CPGs) for loco-regional treatment (i.e. surgery and radiotherapy) and chemotherapy on local disease control and survival in sarcoma patients was investigated in a European study conducted

in an Italian region (Veneto).\n\nPatients and methods: The completeness of the adherence to the Italian CPGs for sarcomas treatment was assessed by comparing the patient’s charts and the CPGs. Propensity score-adjusted multivariate survival analysis was used to assess the impact of CPGs adherence on patient clinical outcomes.\n\nResults: A total of SB203580 151 patients were included. Adherence to CPGs for loco-regional therapy and chemotherapy was observed in 106 out of 147 (70.2%) and 129

out of 139 (85.4%) patients, respectively. Non-adherence to CPGs for loco-regional treatment was independently associated with AJCC stage III disease [odds ratio (OR) 1.77, P = 0.0111 and tumor-positive excision margin (OR 3.55, P = 0.003). Patients not treated according to the CCI-779 CPGs were at a higher risk of local recurrence [hazard ratio (HR) 5.4, P <0.001] and had a shorter sarcoma-specific survival (HR 4.05, P< 0.001), independently of tumor stage.\n\nConclusions: Incomplete adherence to CPGs for loco-regional treatment of sarcomas was associated with worse prognosis in patients with non-metastatic tumors.”
“Background: It was still unclear whether the methodological reporting quality of randomized controlled trials (RCTs) in major hepato-gastroenterology journals improved after the Consolidated Standards of Reporting Trials (CONSORT) Statement was revised in 2001.\n\nMethods: RCTs in five major hepato-gastroenterology journals published in 1998 or 2008 were retrieved from MEDLINE using a high sensitivity search method and their reporting quality of methodological details were evaluated based on the CONSORT Statement and Cochrane Handbook for Systematic Reviews of interventions. Changes of the methodological reporting quality between 2008 and 1998 were calculated by risk ratios with 95% confidence intervals.\n\nResults: A total

of 107 RCTs published Alvocidib mw in 2008 and 99 RCTs published in 1998 were found. Compared to those in 1998, the proportion of RCTs that reported sequence generation (RR, 5.70; 95% CI 3.11-10.42), allocation concealment (RR, 4.08; 95% CI 2.25-7.39), sample size calculation (RR, 3.83; 95% CI 2.10-6.98), incomplete outecome data addressed (RR, 1.81; 95% CI, 1.03-3.17), intention-to-treat analyses (RR, 3.04; 95% CI 1.72-5.39) increased in 2008. Blinding and intent-to-treat analysis were reported better in multi-center trials than in single-center trials. The reporting of allocation concealment and blinding were better in industry-sponsored trials than in public-funded trials. Compared with historical studies, the methodological reporting quality improved with time.

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