Clinical Outcomes Research

Introduction
For PEEK to be used as a valid material for dental restorations, much evidence is needed regarding its clinical application. This includes search for certain characteristics like good mechanical and biological properties. The purpose of this review was to observe and analyze the clinical use of PEEK reported in the previous literature. Until now, this has never been done before.
Material and Methods
A combined electronic search was carried out via PubMed (Medline) database using different key words (dent* AND impl* AND peek) and (peek, dental, clinical), respectively.
The review method involved a systematic screening of all the studies on the basis of titles and abstracts to determine whether they met the inclusion criteria. The full text of the studies was then reviewed to ensure complete relevance of the included studies. Constructing tables summarizing the most important findings reported in the included studies did export of relevant data. Several descriptive statistics were done as a quantitative method for the description of data. All analysis was done using GraphPad Prism 8.0 software.
Results
In total 13 clinical studies were included in the review. 9 studies suggested the use of PEEK as a prosthesis framework. As a crown, PEEK was mentioned in 2 studies. One study used it as a healing abutment and 2 other studies as an abutment.
Conclusion
It can be concluded that PEEK is a promising material for use in restorative dentistry and if combined with proper clinical evidence and in-vitro outcomes, it could be suggested as a valid alternative for some restorative materials.

INTRODUCTION: It is unclear how the risk of aneurysm recurrence varies over 10 years between ruptured and unruptured patients with a successfully treated aneurysm. This study was undertaken to compare the long-term angiographic outcome of surgically treated aneurysms between ruptured and unruptured patients. METHODS: We analyzed 502 patients who were independent in daily life and younger than 75 years in age and who had undergone surgery to treat a ruptured or unruptured cerebral aneurysm at our institution more than 10 years before the study. A letter explaining the objective and method of follow-up angiography was sent to each of the patients, and cerebral angiography was scheduled for those patients who showed an interest in undergoing angiography. A reply was obtained from 252 out of the 502 patients, with 99 patients expressing their willingness to undergo follow-up angiography. RESULTS: Ninety-nine patients (85 ruptured and 14 unruptured patients) underwent cerebral angiography. The mean interval from surgery was 15.6 years for all patients (range, 11 to 27 years). De novo aneurysms were detected in 28 out of 85 (32.9%) ruptured and in two out of 14 (14.3%) unruptured patients. The annual rate of de novo aneurysm formation was 2.8% for ruptured patients and 1.2% for unruptured patients. Aneurysm regrowth occurred only in patients with ruptured aneurysms, but not unruptured aneurysms. CONCLUSION: The annual rate of de novo aneurysm formation significantly increased in patients with a previous subarachnoid hemorrhage compared with those with surgically treated unruptured aneurysms. This rate was considerably higher than the previously reported risk, especially in female patients surgically treated for ruptured aneurysms. It is suggested that the cumulative recurrence rate becomes significant more than 10 years after the original treatment, and that follow-up angiography to detect recurrent aneurysms may be indicated for patients with clipped aneurysms 10 to 20 years after surgery.

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I was invited to share this ongoing work at the Research Seminar in the Georgetown University Neurology Department. This talk outlines a manuscript that is in progress. A new set of patient-centered, patient reported instruments are in development to document and assess the patient experience of urinary signs and symptoms in the presence of neurogenic bladder. These instruments, Urinary Symptoms Questionnaires for Neurogenic Bladder (USQNB) were developed specifically for cohorts according to bladder management, yielding one for intermittent catheterization (USQNB-IC), one for indwelling catheters (USQNB-IUC), and one for voiders (USQNB-v). Their development followed a model that prioritizes the patient experience, but integrates the clinical perspective with a research-oriented perspective. Because it prioritizes the patient perspective and experience, this model does not follow the psychometric approach to creating measurement instruments; as such, scoring on these instruments is not amenable to traditional scoring methods. This talk will outline the different methods for scoring these instruments that the group is currently considering/writing up, discussing pros and cons according to the use and interpretation that different users may have: patient in self-management; clinician in patient management; and investigator studying patients, clinicians, interventions, or combinations of these.

Consecutive admissions of 214 women with borderline personality disorder were investigated for patterns of specific forms of self-harm and reported developmental experiences. Systematic examination of clinical notes found that 75% had previously reported a history of childhood sexual abuse. These women were more likely to self-harm, and in specific ways that may reflect their past experiences. Despite this, treatment within a dialectical behaviour therapy-informed therapeutic community leads to relatively greater clinical gains than for those without a reported sexual abuse trauma history. Notably, greater behavioural and self-reported distress and dissociation were not found to predict poor clinical outcome.

Introduction For PEEK to be used as a valid material for dental restorations, much evidence is needed regarding its clinical application. This includes search for certain characteristics like good mechanical and biological properties. The purpose of this review was to observe and analyze the clinical use of PEEK reported in the previous literature. Until now, this has never been done before. Material and Methods A combined electronic search was carried out via PubMed (Medline) database using different key words (dent* AND impl* AND peek) and (peek, dental, clinical), respectively. The review method involved a systematic screening of all the studies on the basis of titles and abstracts to determine whether they met the inclusion criteria. The full text of the studies was then reviewed to ensure complete relevance of the included studies. Constructing tables summarizing the most important findings reported in the included studies did export of relevant data. Several descriptive statistics were done as a quantitative method for the description of data. All analysis was done using GraphPad Prism 8.0 software. Results In total 13 clinical studies were included in the review. 9 studies suggested the use of PEEK as a prosthesis framework. As a crown, PEEK was mentioned in 2 studies. One study used it as a healing abutment and 2 other studies as an abutment. Conclusion It can be concluded that PEEK is a promising material for use in restorative dentistry and if combined with proper clinical evidence and in-vitro outcomes, it could be suggested as a valid alternative for some restorative materials.

Randomized controlled trials (RCTs) reflect priorities established by regulators. Recently, pragmatic clinical trials (PCTs) have begun to attract interest. Unlike RCTs, PCTs aim to better inform post-regulatory decision making by using head-to-head comparisons of alternative treatments, diverse patient populations, and outcomes meaningful to patients, prescribers, and payers. To describe how U.S. insurers and public payers perceive the value of PCTs for assessment of new prescription drugs. Criterion-based sample of U.S. insurers and public payers. We gathered qualitative evidence from intensive interviews with formulary decision makers at 15 payers, representing 10 major types of U.S. payers. Prior literature and exploratory interviews informed our question selection. Payers viewed PCTs favorably despite wariness of drug company-sponsored trials. Payers would accept results from PCTs as part of payers' synthesis of multiple sources of evidence. Payers were enthusiastic about 2...