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Analgesics for Osteoarthritis—An Update

Background: Nonopioid Analgesics for Osteoarthritis

Background: Glucosamine and Chondroitin

Knowledge Gaps and Future Research Needs (1 of 3)

Knowledge Gaps and Future Research Needs (2 of 3)

Study Parameters Affect Applicability. Study parameters may affect applicability through these different mechanisms: Effect modifiers. Modifiers of baseline rates. Factors that reduce ability to generalize results to everyday practice.

Study Parameters Affect Applicability

This slide discusses study population and applicability.  It presents a table divided into two columns with one header row and six data rows. Column one is titled “Conditions that limit applicability” and column two is titled “Features that should be extracted into evidence tables.” Each of the six data rows contains conditions described in column one and associated features to be extracted in column two.  In the first row, the limiting conditions are: narrow eligibility criteria, high exclusion rate, low enrollment. The features that should be extracted are: eligibility criteria and proportion of screened individuals enrolled. In the second row, limiting conditions are: differences between patients in study and the community. The features that should be extracted are: demographics (range and mean): age, gender, race and ethnicity.  In the third row, the limiting conditions are: narrow or unrepresentative severity or stage of illness. The features that should be extracted are: severity or stage of illness (referral or primary care population). In the fourth row, limiting conditions are: run-in periods with high exclusion rates. The features that should be extracted are: run-in period: attrition rate before randomization and reason (e.g., nonadherence, adverse drug events and no response). In the fifth row, limiting conditions are: event rates markedly different than in community. The features that should be extracted are: event rates in treatment and control groups. In the sixth row, limiting conditions are: disease prevalence in study population different than community. The features that should be extracted are: prevalence of disease (for diagnostic studies).

Population and Applicability

Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer

This slide includes a table with two columns and four rows. Column 1, row 1: potential advantages. Column 2, row 1: potential disadvantages.Column 1, row 2: Higher dose delivered to tumor. Column 2, row 2: Higher total body dose. Column 1, row 3: Sparing of normal, surrounding tissue from radiation damage. Column 2, row 3: Increased risk of marginal miss and dose perturbation. Column 1, row 4: Decreased toxicity. Column 2, row 4: time and expense. A definition of abreviations is included on the slide: IMRT = intensity-modulated radiation therapy; 2DRT = two-dimensional radiation therapy; 3DCRT = three-dimensional conformal radiation therapy. A footnote includes the following references: (1) Ballivy O, Santamaria RG, Borbalas AL, et al. Clinical application of intensity-modulated radiotherapy for head and neck cancer. Clin Transl Oncol 2008;10:407-14; (2) Burri MK, Bevan A, Roach M III. Advances in radiation therapy: conventional to 3D, to IMRT, to 4D, and beyond. CA Cancer J Clin 2005;55:117-34; (3) Mendenhall WM, Amdur RJ, Palta JR. Intensity-modulated radiotherapy in the standard management of head and neck cancer: promises and pitfalls. J Clin Oncol 2006;24:2618-23; (4) Samson DJ, Ratko TA, Rothenberg BM, et al. Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer, Comparative Effectiveness Review No. 20 (Prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-02-0026). Rockville, MD: Agency for Healthcare Research and Quality; May 2010. AHRQ Publication No. 10-EHC014-EF. Available at: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=447.

Potential Advantages and Disadvantages of IMRT When Compared With 2DRT and 3DCRT

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