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Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability / F. Rivadeneira in Journal of bone and mineral research, 22(2007)11 ([11/01/2007])
[article] Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability : the Rotterdam Study [printed text] / F. Rivadeneira, Author ; M.C. Zillikens, Author ; Chris De Laet , Author ; A. Hofman, Author ; A.G. Uitterlinden, Author ; T.J. Beck, Author ; H.A. Pols, Author . - 2007 . - 1781-90.
Languages : English (eng)
in Journal of bone and mineral research > 22(2007)11 [11/01/2007] . - 1781-90
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Aged ; Bone Density ; Epidemiology ; Female ; Femur Neck ; Hip Fractures ; Humans ; Incidence ; Journal Article ; Male ; Netherlands ; Peer Review ; Prognosis ; Risk ; United StatesAbstract: We studied HSA measurements in relation to hip fracture risk in 4,806 individuals (2,740 women). Hip fractures (n = 147) occurred at the same absolute levels of bone instability in both sexes. Cortical instability (propensity of thinner cortices in wide diameters to buckle) explains why hip fracture risk at different BMD levels is the same across sexes.
INTRODUCTION: Despite the sexual dimorphism of bone, hip fracture risk is very similar in men and women at the same absolute BMD. We aimed to elucidate the main structural properties of bone that underlie the measured BMD and that ultimately determines the risk of hip fracture in elderly men and women.
MATERIALS AND METHODS: This study is part of the Rotterdam Study (a large prospective population-based cohort) and included 147 incident hip fracture cases in 4,806 participants with DXA-derived hip structural analysis (mean follow-up, 8.6 yr). Indices compared in relation to fracture included neck width, cortical thickness, section modulus (an index of bending strength), and buckling ratio (an index of cortical bone instability). We used a mathematical model to calculate the hip fracture distribution by femoral neck BMD, BMC, bone area, and hip structure analysis (HSA) parameters (cortical thickness, section modulus narrow neck width, and buckling ratio) and compared it with prospective data from the Rotterdam Study.
RESULTS: In the prospective data, hip fracture cases in both sexes had lower BMD, thinner cortices, greater bone width, lower strength, and higher instability at baseline. In fractured individuals, men had an average BMD that was 0.09 g/cm(2) higher than women (p < 0.00001), whereas no significant difference in buckling ratios was seen. Modeled fracture distribution by BMD and buckling ratio levels were in concordance to the prospective data and showed that hip fractures seem to occur at the same absolute levels of bone instability (buckling ratio) in both men and women. No significant differences were observed between the areas under the ROC curves of BMD (0.8146 in women and 0.8048 in men) and the buckling ratio (0.8161 in women and 0.7759 in men).
CONCLUSIONS: The buckling ratio (an index of bone instability) portrays in both sexes the critical balance between cortical thickness and bone width. Our findings suggest that extreme thinning of cortices in expanded bones plays a key role on local susceptibility to fracture. Even though the buckling ratio does not offer additional predictive value, these findings improve our understanding of why low BMD is a good predictor of fragility fractures.Link for e-copy: http://onlinelibrary.wiley.com/doi/10.1359/jbmr.070712/pdf Format of e-copy: PDF [Open Access] (Embargo: 1 year) (1986 to present) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2147 [article]Gene expression profiling and immunohistochemistry tests for personalised management of adjuvant chemotherapy decisions in early breast cancer / Lorena San Miguel / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2015)
Gene expression profiling and immunohistochemistry tests for personalised management of adjuvant chemotherapy decisions in early breast cancer : – a Rapid Assessment [printed text] / Lorena San Miguel , Author ; Joan Vlayen , Author ; Chris De Laet , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2015 . - 73 p. : ill., ; A4. - (KCE Reports. Health Technology Assessment (HTA); 237) .
ISSN : D/2015/10.273/13 : € 0,00
Study 2014 2014-15_HTA_Gene_expr_profiling
Languages : English (eng)
Descriptors: Classification
WP 870 - Breast - - Neoplasms
Indexation
2014-15 ; Breast Neoplasms ; Gene Expression Profiling ; Immunohistochemistry ; R237Contents note: SCIENTIFIC REPORT 6 -- 1 INTRODUCTION AND SCOPE 6 -- 2 BREAST CANCER 7 -- 2.1 EPIDEMIOLOGY 7 -- 2.2 BREAST CANCER CLASSIFICATIONS 7 -- 2.3 PROGNOSIS 8 -- 2.4 GUIDELINES FOR BREAST CANCER MANAGEMENT 8 -- 3 TESTS TO GUIDE PERSONALISED MANAGEMENT OF BREAST CANCER 9 -- 3.1 PERSONALISED MEDICINE IN BREAST CANCER 9 -- 3.2 GENE EXPRESSION PROFILING (GEP) 9 -- 3.3 EXPANDED IMMUNOHISTOCHEMISTRY TESTS (IHC) 9 -- 3.4 TESTS ADDRESSED IN THIS OVERVIEW 10 -- 4 EFFICACY, EFFECTIVENESS AND SAFETY 12 -- 4.1 METHODOLOGY 12 -- 4.2 RESULTS BY TEST 13 -- 5.1 INTRODUCTION 23 -- 5.2 METHODS 23 -- 5.3 OVERVIEW OF ECONOMIC EVALUATIONS 24 -- 5.4 DISCUSSION AND CONCLUSIONS 38 -- 6.1 BACKGROUND 39 -- 6.2 METHODS 39 -- 6.3 RESULTS 42 -- 7.1 CLINICAL VALIDITY AND UTILITY 47 -- 7.2 COST-EFFECTIVENESS 48 -- 7.3 BUDGETARY IMPACT 49 -- 7.4 OTHER LIMITATIONS 50 -- APPENDICES 51 -- APPENDIX 1. CLINICAL REVIEW 51 -- APPENDIX 1.1. SEARCH STRATEGIES 51 -- APPENDIX 1.2. QUALITY APPRAISAL OF INCLUDED SYSTEMATIC REVIEWS 54 -- APPENDIX 1.3. EVIDENCE TABLES OF INCLUDED SYSTEMATIC REVIEWS 55 -- APPENDIX 2. ECONOMIC REVIEW 63 -- APPENDIX 2.1. SEARCH STRATEGIES 63 -- APPENDIX 2.2. FLOW CHART SELECTION OF ECONOMIC EVALUATIONS 65 -- APPENDIX 2.3. TEMPLATE TABLE FOR DATA EXTRACTION – ECONOMIC EVALUATIONS 66 -- APPENDIX 2.4. POINTS RAISED BY DR FATIMA CARDOSO (ONE OF THE VALIDATORS OF THIS REPORT) 67 -- REFERENCES 69 Link for e-copy: http://doi.org/10.57598/R237C Format of e-copy: PDF (753 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3494 Copies(0)
Status No copy Gene expression profiling and immunohistochemistry tests for personalised management of adjuvant chemotherapy decisions in early breast cancer / Lorena San Miguel / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2015)
Gene expression profiling and immunohistochemistry tests for personalised management of adjuvant chemotherapy decisions in early breast cancer : – Scientific summary [printed text] / Lorena San Miguel , Author ; Joan Vlayen , Author ; Chris De Laet , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2015 . - 15 p. : ill., ; A4. - (KCE Reports. Health Technology Assessment (HTA); 237Cs) .
ISSN : D/2015/10.273/12 : € 0,00
Study 2014 2014-15_HTA_Gene_expr_profiling
Languages : English (eng)
Descriptors: Classification
WP 870 - Breast - - Neoplasms
Indexation
2014-15 ; Breast Neoplasms ; Gene Expression Profiling ; Immunohistochemistry ; R237Contents note: SYNTHESIS 4 -- 1. CONTEXT AND OBJECTIVES 6 -- 1.1. BREAST CANCER EPIDEMIOLOGY, CLASSIFICATION AND PROGNOSIS 6 -- 1.2. BREAST CANCER TREATMENT 6 -- 1.3. GENE EXPRESSION PROFILING 6 -- 1.4. EXPANDED IMMUNOHISTOCHEMISTRY 6 -- 1.5. RESEARCH QUESTIONS 6 -- 2. HOW EFFECTIVE ARE GENE EXPRESSION PROFILING AND EXPANDED IMMUNOHISTOCHEMISTRY TESTS IN EARLY BREAST CANCER? 7 -- 2.1. GENE EXPRESSION PROFILING (GEP) TESTS 7 -- 2.2. EXPANDED IHC TESTS 7 -- 3. HOW COST-EFFECTIVE ARE GENE EXPRESSION PROFILING AND EXPANDED IMMUNOHISTOCHEMISTRY TESTS IN EARLY BREAST CANCER? 8 -- 3.1. GENE EXPRESSION PROFILING (GEP) TESTS VERSUS STANDARD PRACTICE 10 -- 3.2. EXPANDED (IHC) TESTS VERSUS STANDARD PRACTICE 10 -- 3.3. COMPARISONS BETWEEN TESTS 10 -- 4. BUDGETARY ESTIMATIONS FOR GENE EXPRESSION PROFILING TESTS 10 -- 4.1. METHODOLOGY 10 -- 4.1.1. Data sources 10 -- 4.1.2. Perspective and scenarios analysed 11 -- 4.1.3. Results 11 -- 5. DISCUSSION AND LIMITATIONS 11 -- 5.1. CLINICAL VALIDITY AND UTILITY 11 -- 5.1.1. The evidence 11 -- 5.1.2. Limitations 11 -- 5.2. COST-EFFECTIVENESS 12 -- 5.2.1. The evidence 12 -- 5.2.2. Limitations 13 -- 5.3. BUDGETARY IMPACT 13 -- 5.3.1. Preliminary estimations 13 -- 5.3.2. Limitations 13 -- 5.4. OTHER LIMITATIONS 14 -- RECOMMENDATIONS 15 Link for e-copy: http://doi.org/10.57598/R237CS Format of e-copy: PDF (391 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3495 Copies(0)
Status No copy General framework for a multidisciplinary quality manual for cardiac care networks / Chris De Laet / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2013)
General framework for a multidisciplinary quality manual for cardiac care networks [printed text] / Chris De Laet , Author ; Koen Van Den Heede , Author ; Raf Mertens , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2013 . - 16 p. : ill. ; A4. - (KCE Reports. Good Clinical Practice (GCP); 213) .
ISSN : D/2013/10.273/94 : € 0,00
Languages : English (eng)
Descriptors: Classification
WG 100 Cardiovascular System - General works
Indexation
2013-19 ; Cardiovascular diseases ; Quality Assurance, Health Care ; R213Contents note: SCIENTIFIC REPORT 4 -- 1 SCOPE AND GENERAL APPROACH 4 -- 1.1 SCOPE 4 -- 1.2 METHOD 5 -- 1.3 RESULTS AND CONCLUSIONS FROM THE EXPERT PANEL . 5 -- 1.4 DEFINITIONS USED 5 -- 2 PROPOSED STRUCTURE FOR A MULTIDISCIPLINARY QUALITY MANUAL FOR CARDIAC -- NETWORKS . 7 -- PART 1: VISION AND MISSION OF THE CARE NETWORK 7 -- PART 2: DESCRIPTION OF THE CARE NETWORK 8 -- PART 3: SCIENTIFIC BASIS 8 -- PART 4: NETWORK FUNCTIONING . 8 -- PART 5: QUALITY ASSURANCE . 11 -- PART 6: DEVELOPMENT AND UPDATING PROCESS OF THE MANUAL . 12 -- APPENDIX . 13 -- STRUCTURE OF THE ORIGINAL ONCOLOGY MANUAL 13 -- REFERENCES . 16 Link for e-copy: https://doi.org/10.57598/R213C Format of e-copy: PDF (421 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3317 Copies(0)
Status No copy Geplande keizersnede / Sabine Stordeur / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
Geplande keizersnede : wat zijn de gevolgen voor de gezondheid van moeder en kind? – Synthese [printed text] / Sabine Stordeur, Author ; Pascale Jonckheer , Author ; Nicolas Fairon , Author ; Chris De Laet , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 23 p. : ill., ; A4. - (KCE Reports A. Health Technology Assessment (HTA); 275As) .
ISSN : D/2016/10.273/80 : € 0,00
Languages : Dutch (nla)
Descriptors: Indexation
2015-09 ; Cesarean Section ; Delivery, Obstetric ; Elective Surgical Procedures ; Mortality ; R275
Classification
WQ 415 Delivery (including preparatory manipulation)Abstract: De laatste dertig jaar is het aantal keizersneden overal ter wereld toegenomen. In België is de ingreep goed voor ongeveer 21% van het totale aantal geboorten, maar onder de ziekenhuizen bestaan er belangrijke verschillen (van ongeveer 12 tot 33 % van de bevallingen die zij uitvoeren). Wanneer er bij moeder of kind een medisch probleem is, kan een keizersnede ongetwijfeld (zeer) ernstige gevolgen voorkomen. Maar wat als als de ingreep om niet-medische redenen wordt uitgevoerd, wat steeds meer het geval is ? Wegen de voordelen dan nog op tegen de nadelen? Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) maakt de balans op van de gevolgen voor moeder en kind, op korte en op lange termijn.
Doordat talrijke studies tegenstrijdige resultaten opleveren, kunnen voor de gevolgen op lange termijn moeilijk definitieve conclusies worden getrokken. Voor de gevolgen op korte termijn worden de reeds gekende risico’s van ademhalingsproblemen bij de baby bevestigd, vooral als de keizersnede gepland is vóór de 39e week van de zwangerschap. Voor de moeder kunnen er vooral problemen optreden bij de volgende zwangerschappen, zoals een baarmoederscheur of problemen met de moederkoek (placenta). Vaak zal er dan een nieuwe keizersnede nodig zijn. Het KCE beveelt daarom aan om de toekomstige ouders over dit alles goed te informeren, en om de zorgverleners te sensibiliseren voor deze mogelijke gevolgen. Daarbij sluit het zich aan bij de Wereldgezondheidsorganisatie (WHO), die ervoor pleit om enkel een keizersnede uit te voeren als het echt nodig is.Contents note: VOORWOORD 1 -- KERN BOODSCHAPPEN 2 -- SYNTHESE 3 -- 1. CONTEXT VAN DEZE STUDIE 5 -- 2. KEIZERSNEDEN IN BELGIË 6 -- 3. LITERATUURSTUDIE 9 -- 3.1. DOELSTELLINGEN EN METHODE 9 -- 3.2. EFFECTEN VAN EEN KEIZERSNEDE OP DE GEZONDHEID VAN DE MOEDER 10 -- 3.2.1. Gezondheidsproblemen op korte termijn 10 -- 3.2.2. Moedersterfte 10 -- 3.2.3. Effecten op de borstvoeding 10 -- 3.2.4. Gezondheidsproblemen op lange termijn 11 -- 3.2.5. Effecten op de volgende zwangerschappen: resultaten voor de moeder 12 -- 3.3. EFFECTEN VAN DE KEIZERSNEDE OP DE GEZONDHEID VAN HET KIND 14 -- 3.3.1. Gezondheidsproblemen op korte termijn bij het kind 14 -- 3.3.2. Gezondheidsproblemen op lange termijn bij het kind 15 -- 3.3.3. Effecten op de volgende zwangerschappen: resultaten voor het kind 18 -- 4. CONCLUSIES 19 -- 5. BESTAANDE INITIATIEVEN 22 -- AANBEVELINGEN 23 Link for e-copy: http://doi.org/10.57598/R275AS Format of e-copy: PDF (528 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3939 Harmonizing HTA / I. Pasternack in International Journal of Technology Assessment in Health Care, 26(2010)02 ([04/01/2010])
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