RESULTS: Five RCTs were included in this review. Quality assessment of included RCTs was performed using the modified Jadad scale. The random-effects model (DerSimonian-Laird) was used to calculate pooled effect estimates when substantial heterogeneity was encountered otherwise, the fixed-effects (Mantel-Haenszel) model was implemented. Data on the study design, interventions, participants, and outcomes were extracted by two independent reviewers. METHODS: A systematic literature search of the PubMed, Cochrane, and Scopus databases was performed with respect to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement (end-of-search date: January 29, 2017). The aim of this study was to synthesize evidence from randomized controlled trials (RCTs) comparing nonoperative versus surgical management of uncomplicated acute appendicitis in adult patients. Addressing patients' expectations via a shared decision-making process is a crucial step in optimizing nonoperative outcomes.Ībstract = "BACKGROUND: Acute appendicitis continues to constitute a diagnostic and therapeutic challenge. CONCLUSIONS: Conservative management of uncomplicated appendicitis in adults warrants further study. ![]() ![]() No difference was found between the two treatment modalities in terms of perforated appendicitis rates (RR, 0.52 95% CI, 0.14-1.92), length of hospital stay (weighted mean difference, 0.20 95% CI,-0.16 to 0.56), duration of pain (WMD, 0.22 95% CI,-5.30 to-5.73), and sick leave (WMD,-2 95% CI,-5.2 to 1.1). Overall complications were significantly higher in the surgery group (166/703 ) compared with the antibiotics group (56/727 ) (RR, 0.32 95% CI, 0.24-0.43 p < 0.001). Treatment efficacy at 1-year follow-up was significantly lower (63.8%) for antibiotics compared with the surgery group (93%) (risk ratio, 0.68 95% confidence interval, 0.60-0.77 p < 0.001). Overall, 1,430 adult patients with uncomplicated acute appendicitis underwent either nonoperative (n = 727) or operative management (n = 703). It is our hope that this new tool will help researchers and clinicians integrate ethical knowledge into their analysis of ethical issues and contribute to fostering ethical analyses that are grounded in relevant philosophical and axiological foundations.BACKGROUND: Acute appendicitis continues to constitute a diagnostic and therapeutic challenge. The innovative particularity of the QET is that it encompasses three ethical theories (utilitarism, deontologism, and virtue ethics) and axiological ontology (professional values) and also draws on both deductive and inductive approaches. This tool can be incorporated into existing theoretical frameworks to enable professionals to integrate ethical knowledge into their ethical analyses. Consequently, we developed, for ethical analysis, a four-part prism which we have called the Quadripartite Ethical Tool (QET). Our main finding is that researchers and clinicians in physiotherapy rarely use ethical knowledge to analyze the ethical issues raised in their practice and that gaps exist in the theoretical frameworks currently used to analyze these issues. Our final analysis corpus consisted of thirty-nine texts. Does this assertion still hold true? Do the theoretical frameworks used by researchers and clinicians allow them to analyze thoroughly the ethical issues they encounter in their everyday practice? In our quest for answers, we conducted a literature review and analyzed the ethical theoretical frameworks used by physiotherapy researchers and clinicians to discuss the ethical issues raised by private physiotherapy practice. In the past, several researchers in the field of physiotherapy have asserted that physiotherapy clinicians rarely use ethical knowledge to solve ethical issues raised by their practice.
0 Comments
Leave a Reply. |