How strong is the evidence for the use of perioperative β blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials
Notice bibliographique
Résumé
Introduction Little is published on the health impact of irritable bowel syndrome with diarrhoea (IBS-D) on patients. We aimed to assess the gastrointestinal and wider health burden of IBS-D, including medications used for symptom relief and perceived care shortfalls. Method A 30 min online survey was completed in France, Germany, Italy, Spain, UK, Canada and Australia. Target sample size was 80 patients per country. Screening criteria included: age 18–65 years, being diagnosed with IBS-D by a doctor, having symptoms present within the past 12 months, and currently using prescription or over-the-counter (OTC) medicines for IBS-D. The maximum quota was 30% male and 25% of patients who had never seen a gastroenterologist for their IBS. Attitudes to IBS-D and its management were scored using a 7-point scale (Table). Results 513 eligible patients completed the survey; 357 (70%) were female and mean age was 40.9 (range 18–65) years. As well as stomach pain and diarrhoea, 269 (52%) patients had bloating before treatment, 204 (40%) had urgency and 88 (17%) had faecal incontinence. Mean duration of symptoms was 9.8 years. The most troublesome current symptom was urgency in 136 (27%) patients. In the past 3 months, symptoms were intermittent in 390 (76%) patients and continual in 123 (24%). The most common comorbidities were anxiety in 189 (37%) patients, depression in 137 (27%) and migraine in 133 (26%). OTC drugs were used by 372 (73%) patients (214 [42%] OTC only, 158 [31%] OTC + prescription). The most commonly used agents were antidiarrhoeals in 416 (81%) patients and antispasmodics in 300 (58%); notably, 91 (18%) used codeine-based painkillers and 79 (15%) used antidepressants. Antidiarrhoeals were used daily by 63 (12%) patients and 58 (11%) used daily antispasmodics; 178/384 (46%) and 99/217 (46%) were not satisfied with these agents. Patients had mixed attitudes towards their condition (Table: score 6–7): 216 (42%) reported having learned to live with their IBS but 189 (37%) were constantly worried about when their symptoms would return, and 58 (11%) agreed with the statement “When my IBS is bad, I wish I was dead”. A substantial proportion (170; 33%) wanted doctors to listen and support more and 165 (32%) agreed that healthcare professionals do not take IBS seriously. The majority of patients (296; 58%) wanted treatment to significantly improve their quality of life and 237 (46%) were willing to try anything to help manage their IBS. Conclusion We report the substantial impact of IBS-D on quality of life, medication use and the desire for more services in this patient population. There is a distinct opportunity for improved pharmacological and supportive management of IBS-D patients. Disclosure of Interest H. Törnblom Conflict with: Almirall, Allergan and Shire, Conflict with: Shire, Almirall, Probi, Tillotts, A Emmanuel Conflict with: Allergan, Kyowa Kirin, Shionogi, Shire, Takeda, R Goosey Conflict with: Kantar Health, paid consultants to Allergan plc, G Wiseman Conflict with: Allergan plc, S Baker Conflict with: Allergan plc
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,029 | 0,078 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,026 | 0,041 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».