JOURNAL CLUBDr.Yassin alsaleh

And we made every living thing of water.

And we made every living thing of water.

J Clin Endocrinol Metab. 2015 Apr 29:jc20144527.

Introduction

Introduction

Introduction

Introduction

Introduction

Introduction

Introduction

HYPOTHESIS

AIM

METHODS

METHODS

METHODS

METHODS

METHODS

METHODS

METHODS

METHODS

•Patients with postoperative DI has significantly lower median [IQR] initial postsurgery copeptin levels compared to those without DI:• 2.9 [1.9 –7.9] pmol/L vs 10.8 [5.2–30.4] pmol/L, P <.001. •The difference was more pronounced in the subgroup with copeptin values from< 12 hours postsurgery (n157):• 2.9 [1.8 –10.3] pmol/L vs 17.0 [7.6 –39.1] pmol/L, P <.001

Critical apprasial

PICO• Population: patients undergoing surgery

for sellar lesions or tumor near the hypothalamus or pituitary gland.

• Intervention: copeptin measurment

• Control: clinical and laboratory assesment.

• Out come: developing of DI

Relevance• 1. Does the study address a common

problem in your practice? • YES

• 2. Does the study address an important outcome to you or to your patient? (DOE vs. POEM).

• YES

Relevance3. Assuming that the study conclusion is true

would it lead to a change in your practice?

yes

Are the Results of the Study Valid?• Was the assignment concealed? NO• Was follow-up complete& long enough? YES• Sensitivity analysis (WCS) not applicable

Are the Results of the Study Valid?Were all clinically important outcomes

considered? yes

Are the Results of the Study Valid? Is reference standard used acceptable?• No.

• Were both reference standard and test applied to all patients?

• YES

Are the Results of the Study Valid?

• Did the patient sample include an appropriate spectrum of patients to whom the diagnostic test will be applied in clinical practice?

• yes

Are the Results of the Study Valid?• Did the results of the test being evaluated

influence the decision to perform the reference standard?

• NO

Are the Results of the Study Valid?• Were the methods for performing the test

described in sufficient detail to permit replication?

• YES

Will the results Help Me in Caring for My Patients?

• Are the results applicable to my patient?

• Similar distribution of disease severity? (spectrum)

• YES.

Will the results Help Me in Caring for My Patients?

• Will the results change my management?

• Test and treatment thresholds? (is it between)

• May be.

Will the results Help Me in Caring for My Patients?

• Will patients be better off as a result of the test?

• Is target disorder dangerous if left undiagnosed?• YES.• Is test risk acceptable?• YES

Will the results Help Me in Caring for My Patients?

• Does effective treatment exist?• YES.• Information from test will lead to change of

Management beneficial to patient?• YES.

•It may identify patients benefitting from It may identify patients benefitting from closer inpatient observation and patients in closer inpatient observation and patients in whom safe hospital discharge is possible.whom safe hospital discharge is possible.

Thank You