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Re: OB-GYN List Triumphs Again From: art fougner, md (evsono@pipeline.com) Tue Dec 15 06:51:39 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J Woolley: "Re: insurance and other things" Previous message: Braun, R. Daniel: "VBAC Patient info form" In reply to: John Robertson M.D.: "Re: OB-GYN List Triumphs Again" Next in thread: Robert J Woolley: "Re: OB-GYN List Triumphs Again" Reply: Robert J Woolley: "Re: OB-GYN List Triumphs Again" What? we treat patients???? what a concept! while we are on the subject, if we (collectively) are so good at analyzing a hodge podge of data, why are we such poor negotiators with mangled care companies over what reasonable reimbursement? there was one company in our area from which we finally withdrew, because their proposed reimbursement for amniocentesis was $36! Happy Holidays to all! Art At Tue, 15 Dec 1998, Bernard Cristalli wrote: > >So Luis, which one will you trust? The RCT or the meta-analysis? What will you do? >calcium or not. The final point is not to discuss the trials but to treat the >patient IMHO. > >-- >Luis Sanchez-Ramos, M.D. wrote: > >> ... >> I'll give you an example that shows disagreement between a large, well-designed >> double-blind RCT and a meta-analysis by the SAME author. >> >> RJ Levine et al. published a meta-analysis on Preeclampsia prevention with >> calcium supplementation (Clinics in Applied Nutrition 1992;2:30-38) which showed >> that subjects randomized to receive calcium had a lower incidence of >> preeclampsia OR 0.39 (95% CI 0.22-0.71). Subsequent to the publication of that >> meta-analysis, he published a large well-designed RCT which showed no benefit >> from calcium supplementation (New Engl J Med >> 1997;337:69-76). While I am at it, I'll give you a 2nd example: Belizan et al >> (New Engl J Med 1991) published a large RCT which showed that calcium >> supplementation did not reduce the incidence of preeclampsia OR 0.66 (95% cI >> 0.34-1.27). However in a subsequent meta-analysis by the same authors it was >> estimated that calcium supplementation did lead to a reduction in preeclampsia >> (Br J Obstet Gynaecol 1994;101:753-758). >> >> Luis Sanchez-Ramos, MD > >-- >Bernard Cristalli MD CNGOF >AIHP - ACCA >Paris - France >http://www.obgyn.net/corresp/cristalli.htm >http://www.cliniquedelessonne.fr/ > -- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com Next message: Robert J Woolley: "Re: insurance and other things" Previous message: Braun, R. Daniel: "VBAC Patient info form" In reply to: John Robertson M.D.: "Re: OB-GYN List Triumphs Again" Next in thread: Robert J Woolley: "Re: OB-GYN List Triumphs Again" Reply: Robert J Woolley: "Re: OB-GYN List Triumphs Again"

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