Title: Seminars in Reproductive Medicine

Title: Seminars in Respiratory and Critical Care Medicine

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: Impact Factor

? Chalfin, D.B. (1999), Assessing the cost-effectiveness of emerging therapies in the ICU. Seminars in Respiratory and Critical Care Medicine, 20 (3), 263-270.

Full Text: Sem Res Cri Car Med20, 263.pdf

Abstract: Medical care in the United States and the developed world is increasingly under heightened financial and economic pressure to reduce cost yet maintain and even improve quality. Perhaps nowhere is this pressure more evident than in the critical care areas and intensive care units (ICUs), In part this arises from an awareness of the disproportionate amount of resources consumed by critical care patients and ICU services. American ICUs, for example, account for only 5-10% of all hospital beds yet they consume over 30% of scarce inpatient resources, a figure which according to some estimates accounts for approximately 1% of the nation’s Gross Domestic Product (GDP).(1, 2, 3) Although the total level of spending in terms of both actual numbers and percent of GDP is different for ICU services in other developed nations, this disproportionate level of spending nevertheless exists between cost of care in the ICU and resource consumption on the general medical and surgical ward.(4) However, concern over high cost is not the sole and perhaps not even the primary reason for increased scrutiny levied upon critical care. Cost concerns and budgetary issues wane if the resources which are expended yield the desired clinical benefits, in terms of higher survival and enhanced quality of life. Similarly, economic issues are magnified if there is a perception of waste and inefficiency, in that better outcomes could possibly have been attained with the same resources or even that fewer resources would have been required to attain the current level of benefit. The essence of this argument boils down to a matter of value, in terms of what one attains relative to the resources which are consumed. As health care rapidly shifts away from a fee-for-service environment to systems which embrace varying measures of economic accountability, there will be a heightened demand for quantitative approaches to technology assessment and the valuation of new and emerging therapies from a collective clinical and economic perspective, In the ICU environment, this has already occurred, due in large part to the dependence upon high technology and the ongoing evaluation of expensive therapies with still-to-be-proven benefit, This paper will discuss methods and approaches often employed for the evaluation of emerging technologies, with an emphasis upon cost-effectiveness analysis, pharmacoeconomics, and related techniques.

Keywords: ICU, Gross Domestic Product, Cost-Effectiveness, Intensive-Care Unit, Diagnosis-Related Groups, Gram-Negative Sepsis, Medical Literature, Descriptive Analysis, Resource Utilization, Clinical-Practice, Users Guides, Health-Care, Impact

Title: Seminars in Thrombosis and Hemostasis

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: Impact Factor

? Favaloro, E.J. (2008), Measuring the quality of journals and journal articles: The impact factor tells but a portion of the story. Seminars in Thrombosis and Hemostasis, 34 (1), 7-25.

Abstract: Much emphasis has been placed on the impact factor, a measure of journal article citation rates used as a surrogate marker of both journal and article quality. There is little doubt that the impact factor is an important audit of journal article usage, as it in essence provides a measure of the level of peer attention being given to articles within journals and (by extrapolation) of the level of attention being given to the journal containing those articles. However, the impact factor has its limitations and only tells a very small fraction of the overall story regarding the utility of journals and the articles within them. In addition, the impact factor can be easily manipulated. The current article includes a brief review of the current and past uses and abuses of the impact factor and describes some of its strengths and limitations. In addition, a review of past publications, primarily from this journal, has been undertaken to help show the potential use of alternative measures of journal utility, such as Internet-based journal sessions and article downloads. The evaluation of previously published articles also helps serve to illustrate, by example, some of the limitations to the use of the impact factor as the sole determinant of a journal’s “quality.”.

Keywords: Alternative, Audit, Citation, Evaluation, Extrapolation, Impact, Impact Factor, Journal, Journal Article, Journal Articles, Journals, Potential, Publications, Quality, Quality of, Rates, Review, Small, Surrogate, Utility

? Kenet, G., Aronis, S., Berkun, Y., Bonduel, M., Chan, A., Goldenberg, N.A., Holzhauer, S., Iorio, A., Journeycake, J., Junker, R., Male, C., Manco-Johnson, M., Massicotte, P., Mesters, R., Monagle, P., van Ommen, H., Rafini, L., Simioni, P., Young, G. and Nowak-Gottl, U. (2011), Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children: A systematic review and meta-analysis. Seminars in Thrombosis and Hemostasis, 37 (7), 802-809.

Full Text: 2011\Sem Thr Hem37, 802.pdf

Abstract: The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1966 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, TE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either fixed-effects or random-effects models. Of 504, 16 pediatric studies met the inclusion criteria. In total 1403 patients and 1667 population-based controls <= 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. Thus, data from arterial and venous TE were analyzed together. In addition, meta-regression analysis did not reveal statistically significant differences between site of TE, age at first TE, country, or publication year. A statistically significant association with a first TE was demonstrated for persistent aPL antibodies, with an overall summary ORs/CI of 5.9/3.6-9.7 (arterial 6.6/3.5-12.4; deep vein thrombosis 4.9/2.2-10.9). The present meta-analysis indicates that detection of persistent aPL is clinically meaningful in children with, or at risk for, TE and underscores the importance of pediatric thrombophilia screening programs.

Keywords: Analysis, Antibodies, Antiphospholipid Antibodies, Arterial Ischemic-Stroke, Association, At Risk, Authors, Bias, Cerebral Venous Thrombosis, Childhood, Children, Citations, Cochrane, Confidence Intervals, Databases, Deep Vein Thrombosis, Design, Differences, Embase, Ethnicity, Factor-V-Leiden, Follow-Up, Frequency, Impact, Infants, Lupus-Erythematosus, Medline, Meta Analysis, Meta-Analysis, Multicenter, Observational, Observational Studies, Patients, Pediatric, Publication, Publication Bias, Recurrence, Registry, Review, Risk, Science, Screening, Systematic, Systematic Review, Thromboembolism, Thrombophilia, Thrombosis, Web of Science, Web-of-Science

? Bidlingmaier, C., Kenet, G., Kurnik, K., Mathew, P., Manner, D., Mitchell, L., Krumpel, A. and Nowak-Gottl, U. (2011), Safety and efficacy of low molecular weight heparins in children: A systematic review of the literature and meta-analysis of single-arm studies. Seminars in Thrombosis and Hemostasis, 37 (7), 814-825.

Full Text: 2011\Sem Thr Hem37, 814.pdf

Abstract: Within the last two decades low molecular weight heparins (LMWH) have gained increasing widespread use as anticoagulants in children. The use of LMWH has been implemented into clinical care even though there is a lack of firm evidence on the efficacy and safety of LMWH in this population due to the absence of sufficiently powered randomized controlled trials. In the absence of clinical trials, we performed a meta-analysis of available single-arm studies using LMWH in children. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1980 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients, ethnicity, venous thromboembolic events type, and frequency of recurrence and major bleedings were abstracted. Pooled incidence rates (IR) including 95% confidence intervals (95% CIs) on efficacy and safety data of LMWH administration on primary prophylaxis, as well as on secondary prophylaxis in children following symptomatic thromboembolism (TE) were shown. We included 2251 pediatric patients derived from 35 single-arm studies from 12 study countries who were eligible for analysis in the present systematic review. Pooled incidence rates (95% CI) to develop first TE on primary prophylaxis, further TE event on LMWH secondary prophylaxis, or a major bleeding event on LMWH were 0.047 (0.023 to 0.091), 0.052 (0.037 to 0.073) for efficacy, and 0.054 (0.039 to 0.074) for safety (treatment data only), respectively. Efficacy and safety data are comparable with adult data. The present systematic review suggests that use of LMWH in children as primary prophylaxis and in treatment of symptomatic thrombosis is effective and safe. However, properly designed randomized controlled trials are needed.

Keywords: Acute Lymphoblastic-Leukemia, Adult, Analysis, Anticoagulants, Authors, Care, Cerebral Sinovenous Thrombosis, Children, Citations, Clinical Trials, Cochrane, Confidence Intervals, Countries, Daily Enoxaparin, Databases, Design, Efficacy, Embase, Ethnicity, Frequency, Heparins, Incidence, Ir, Ischemic-Stroke, L-Asparaginase Treatment, Literature, Low, Low Molecular Weight Heparin, Low-Molecular-Weight, Medline, Meta Analysis, Meta-Analysis, Molecular, Multicenter Cohort, Patients, Pediatric, Pediatric Thrombosis, Pediatric-Patients, Primary, Primary Prophylaxis, Prophylactic Therapy, Prophylaxis, Publication, Randomized Controlled Trials, Randomized Controlled-Trial, Recurrence, Review, Safety, Safety and Efficacy, Science, Systematic, Systematic Review, Thromboembolism, Thrombosis, Treatment, Venous Thromboembolic Disease, Web of Science, Web-of-Science