| Types of studies used to support treatment recommendations in medical toxicology. | |
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MedLine Citation:
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PMID: 20405268 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There are few controlled clinical trials in medical toxicology to guide treatment decisions. Given the relative paucity of definitive data, we determined the types of evidence used to support treatment recommendations given in three major toxicology textbooks. One author reviewed the acetaminophen, tricyclic antidepressant, calcium channel blocker plus any relevant antidote chapters in three textbooks: Goldfranks Toxicologic Emergencies, Critical Care Toxicology, and Medical Toxicology. We identified statements that gave a treatment recommendation and classified the citation using the following system: No citation, general review article, in vitro study, animal study, case reports (n<3), case series (n>2), retrospective study, prospective observational study, and controlled clinical trial. Proportions for each type of citation with 95% confidence intervals were determined. We identified 469 treatment recommendations. We could not classify 57/742 citations. A large number of statements were not referenced (14%, 95% CI 12-17%). The most common citation types were case reports (28%, 95% CI 25-31%) and animal studies (18%, 16-21%). The proportions for the remaining types of citations were: review article (9%, 7-11%), clinical trials (9%, 7-11%), retrospective studies (8%, 6-10%), prospective observational studies (5%, 3-6%), and case series (4%, 3-6%). There is a need for more systematic studies of poisoned patients. As case reports are commonly used to support treatment recommendations, they should be held to rigorous scientific standards and include information to assess the validity of the conclusions. Case reports and animal studies are commonly used as evidence to support treatment recommendations in medical toxicology textbooks. |
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Authors:
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Ryan Chuang; Kennon J Heard |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of medical toxicology : official journal of the American College of Medical Toxicology Volume: 6 ISSN: 1556-9039 ISO Abbreviation: J Med Toxicol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-30 Completed Date: 2010-11-09 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 101284598 Medline TA: J Med Toxicol Country: United States |
Other Details:
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Languages: eng Pagination: 345-8 Citation Subset: IM |
Affiliation:
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Rocky Mountain Poison & Drug Center, 777 Bannock St. MC-0180, Denver, CO 80204-4507, USA. Ryan.chuang@rmpdc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Evidence-Based Medicine Humans Poisoning / therapy* Toxicology* |
| Grant Support | |
ID/Acronym/Agency:
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K08 DA020573-02/DA/NIDA NIH HHS; K08DA020573/DA/NIDA NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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