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Analysis of evidence Where Do You Get nike jordans shoes for more
and more drugs in antiretroviral combination therapy Main outcome
methods:Changes in disease further evolvement or death(Clinical
consequences);Cd4 count and plasma display panels viral load(Surrogate
guns).Search prepare:Six virtual databases, to include medline, embase, and the
cochrane study, discovered up to february 2001.Ultimate:54 randomised avoided
trials, Most of the right, With 66 comparison groups were as part of the
analysis.For the clinical outcomes and surrogate markers, combinations with up
to three(Triple treatments)Were progressively and a lot more effective.The odds
ratio for disease progression or death for triple therapy in comparison to
double therapy was0.6(95% attitude interval0.5 in order to be able for you to
help0.8).Heterogeneity in effect sizes was present in many outcomes but was
largely due to the drugs used and trial quality.A conclusion:Evidence from
randomised controlled trials props up use of triple therapy.Research is needed
on the potency of quadruple therapies and the relative effectiveness of specific
combinations of drugs.What is already known on this topicwhat is already known
on this topic triple combination antiretroviral therapy is accepted by
clinicians and patients as the usual treatment for hiv and has evolved through
an incremental strategy in the amount of drugs combinedguidance on treatment,
additionally, has predominantly been based on early reports of researchthere are
no published analyses that assess the effectiveness of the more and more drugs
used in combinationin 1987 zidovudine was introduced for the treatment of hiv
infection.Since then there's been an escalation in the number of antiretroviral
agents.Sequentially, treatment with two and then three drugs is now rapidly
accepted.1 5 Treatment with four or more drugs is proposed.3 6Influential
clinical guidelines usually are based on individual selected clinical trials,
Often published as national gathering abstracts.3 4 7 Early results from the
woman studies can be unrepresentative.8 Support for the clinical benefit of
increasing drug combos comes from well conducted cohort studies, 9 14 but the
length of follow up is still too short to assess the long run clinical benefit
of triple therapy.Systematic reviews have examined questions about the potency
of specific drugs and combinations or have included trials with a mixture of
patients who have and have not received drug treatment.15 20 We carried out a
systematic review on the effectiveness of more and more drugs used in
combination.To reduce the opportunity of confounding by established drug
resistance we looked only at those patients who had not previously received
antiretroviral therapy.Search strategy and inclusion criteriathis review was
conducted to the suggested quorom policies standards.21 We looked for randomised
directed trials of antiretroviral therapy in HIV patients(Up to the end of
january 2001)From medlappearing as part ofe, the cochrane choices, embase,
cinahl, psyclit, healthstar, appropriate web sites such as aidstrials, and
quotation lists.We also contacted drug companies.There was no language
limitation.We included studies only if they included patients who had been hiv
positive(Any place)And were aged 12 years with less than six months' previous
antiretroviral therapy or if less than 30% of patients had previous therapy or
if patients who had never had therapy were reported on an individual basis.The
accepted surgery were any licensed(British isles or united states)Antiretroviral
stuff(Or solution)Balanced with any other antiretroviral drug or placebo or no
treatment.We excluded studies if they lasted as few as 12 weeks.We assessed
studies for quality using a common checklist.22 Data were extracted by two
independent testers.To take account of the large dropout rates but to maximise
how long in the trial, we measured cd4 count and viral load at the longest time
point when the majority of the total number of patients in each arm
remained.View this game:View popupview inlineantiretroviral drug comparisons
constructed into analyses of clinical outcomes and surrogate markersfor jordans for sale
continuous outcomes(Cd4 count and viral load enhancement)We calculated
treatments effect for individual trials as process effect(Commonly, mean
differ)Without the control effect.We calculated the common error of the weighted
mean difference by adding the variances of the change in outcome in both groups
and taking the square root.For triple therapy we also present data on viral load
as the proportion of patients in whom levels of plasma virus became too low to
be detected(23 value was set at P2 test.24 25 When there were several arms
within a trial that allowed more than one comparison per arm we weighted the
quantity of events and could be participants so that each participant was used
only once.We explored heterogeneity using level of level of responsiveness and
subgroup analyses and fixed effects weighted regression techniques(Stata 5.0
pc), For this covariates of trial duration, Basic CD4 count/viral load, Dropout
policies, Tablet dose, Specified drug or drugs(Position of protease inhibitors
or zidovudine), Difference in CD4/viral load(Mean/median/change/end juncture),
Tact of the viral load assay, And blinding and concealment of portion.We
assessed magazine bias visually using a funnel plot and statistically using
egger's and begg's tests(Stata 5.0).
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