Thanks Joe -- for pointing out the importance of evaluating sources of
information. For those interested, this is from a guide for evaluating
Medline (PubMed, GratefulMed) abstracts from the National Library of
Medicine (I substituted examples of abstracts on PD):
Guide to Medline Abstracts :Three Clues to look for:
I. Author's affiliation [AD] - Institutional affiliation and address
of the first author, such as a medical school, university, research
institute, or pharmaceutical company. Usually listed after the Authors'
names.
For example:
TITLE: Apomorphine can sustain the long-duration response to L-DOPA in
fluctuating PD.
AUTHORS: Nutt JG; Carter JH
AUTHOR AFFILIATION: Department of Neurology, School of Medicine, Oregon
Health Sciences University, Portland 97201-3098, USA. [log in to unmask]
SOURCE: Neurology 2000 Jan 11;54(1):247-50
or
TITLE :Lack of a pharmacokinetic interaction at steady state between
ropinirole and L-dopa in patients with Parkinson's disease.
AUTHORS:Taylor AC, Beerahee A, Citerone DR, Cyronak MJ, Leigh TJ,
Fitzpatrick KL, Lopez-Gil A, Vakil SD, Burns E, Lennox G
AUTHOR AFFILIATION: Division of Drug Metabolism and Pharmacokinetics,
SmithKline Beecham Pharmaceuticals, Welwyn, Herts, UK.
SOURCE : : Pharmacotherapy 1999 Feb;19(2):150-6.
II. MESH Headings (Medical Subject Headings) and TYPE OF SUPPORT:
If you look at a Full Medline record, it usually includes two lists of
MESH Headings
MAIN MESH HEADINGS: Describe the major subjects of the article. For
example:
Antiparkinson Agents
Dopamine Agents/*administration & dosage
Parkinson Disease/*drug therapy
ADDITIONAL MESH HEADINGS: Give more details such as information about
the type of study, characteristics of the subjects, *where the funding
came from.
For example:
ADDITIONAL MESH HEADINGS:
Female
Human
Levodopa/administration & dosage
Middle Age
* Support, Non-U.S. Gov't
* Support, U.S. Gov't, P.H.S.
Treatment Outcome
* There are 3 types of support that can be noted, and a combination of 2
or 3 can be listed for the same study:
1.Support, U.S. Govt, P.H.S. or United States Gov't Supported , N.I.H.
(or variations) - research was supported by Public Health Service or NIH
2. Support, U.S. Gov't, Non-P.H.S (Or variations) -research supported by
other US Govt agencies
3. Support, Non-U.S. Gov't - supported by American societies,
institutes, state govts, universities, private organizations (such as
drug companies) or by foreign sources.
III. PUBLICATION TYPES :
Tells about the type of article, who it was written for, if it is
reporting on a single study or clinical trial, or summarizing a number
of studies, whether it is an opinion piece (editorial), etc. Some
Publication Types are:
Clinical Trial [includes all types and phases of clinical trials] -
reports results of a single study.
Editorial
Letter [includes letters to editor]
Meta-Analysis - summary combining results a number of studies
Multicenter Study
News [medical or scientific news]
Practice Guideline - specific health care guidelines for practitioners
Review Literature [general review article] - gives summary of previously
published research articles on a given subject
Review, Tutorial - broad review for non-specialist or student
Here are some examples:
REVIEW TUTORIAL:
TITLE: New drugs for the treatment of Parkinson's disease.
AUTHORS: LeWitt PA
AUTHOR AFFILIATION: Department of Neurology, Wayne State University
School of Medicine, Detroit, Michigan, USA.
SOURCE: Pharmacotherapy 2000 Jan;20(1 Pt 2):26S-32S
CITATION IDS:PMID: 10641989 UI: 20104975
ABSTRACT: Since the introduction of levodopa to treat Parkinson's
disease (PD), several new therapies have been directed at improving
symptom control, which can decline after a few years of levodopa therapy.
Dopaminergic agents can serve as adjuncts or as alternatives to levodopa.
In addition, a new class of drugs, catechol-O-methyltransferase
inhibitors, can extend the duration of levodopa
action. Although surgical options such as pallidotomy offer improvement
of parkinsonism beyond the realm of pharmacologic treatment, judicious
administration of drugs in combination can generally solve most problems
of PD.
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
PT : CLINICAL TRIALS example:
TITLE : Lack of a pharmacokinetic interaction at steady state between
ropinirole and L-dopa in patients with Parkinson's disease.
AUTHOR : Taylor AC, Beerahee A, Citerone DR, Cyronak MJ, Leigh TJ,
Fitzpatrick KL, Lopez-Gil A, Vakil SD, Burns E,
Lennox G
AUTHOR AFFILIATION; Division of Drug Metabolism and Pharmacokinetics,
SmithKline Beecham Pharmaceuticals, Welwyn, Herts, UK.
ABSTRACT:
STUDY OBJECTIVE: To assess the interaction between therapeutic dosages of
ropinirole and L-dopa plus a decarboxylase inhibitor administered at
steady state in patients with Parkinson's disease.
DESIGN. Open, 6-week, overlap trial with random allocation.
PATIENTS: Thirty patients with Parkinson's disease not previously
treated with dopamine agonists, of whom 28 produced evaluable
pharmacokinetic data for ropinirole and 23 for L-dopa.
INTERVENTION: Group A (14 patients) received L-dopa for weeks 1-5 and
ropinirole in increasing increments for weeks 2-6; group B (16) received
ropinirole for weeks 1-5 and L-dopa for weeks 5 and 6.
MEASUREMENTS AND MAIN RESULTS: Primary end points were AUC0-8 and Cmax
for ropinirole, and AUC0-8, AUC0-infinity and Cmax for L-dopa. Secondary
end points were Tmax for ropinirole, and Tmax and half-life for L-dopa.
Coadministration with L-dopa at steady state did not affect rate or
extent of availability of ropinirole: point estimates of the geometric
mean ratio for ropinirole plus L-dopa compared with ropinirole alone for
both Cmax and AUC0-8 approximated to unity. The small (16%) increase in
peak concentrations of L-dopa on administration with ropinirole is
unlikely to be of clinical consequence, as peak concentrations of L-dopa
are typically highly variable.
CONCLUSION: There are no pharmacokinetic grounds for adjusting dosages of
either ropinirole or L-dopa when given in combination.
Publication Types: Clinical trial
Multicenter study
Randomized controlled trial
PT : PRACTICE GUIDELINES: example
TITLE: Clinical investigation of medicinal products in the treatment
of Parkinson's disease (CPMP note for guidance).
SOURCE: Eur Neuropsychopharmacol 1999 Sep;9(5):443-9
CITATION IDS: PMID: 10523052 UI: 99450887
ABSTRACT:These notes are intended to provide guidance for the evaluation
of drugs in the treatment of Parkinson's disease. They should be read in
conjunction with the Directive 75/318/EEC and 83-570/EEC and current and
future EC and ICH guidelines, especially those on: Studies in support of
special populations: geriatrics (ICH E7). The extent of population
exposure to assess clinical safety for drugs intended for long-term
treatment in non life threatening conditions . . . .
PUBLICATION TYPES: GUIDELINE
JOURNAL ARTICLE
PRACTICE GUIDELINE
TO search Medline go to :
Internet Grateful Med - designed for general public use; very user
friendly.
http:// http://igm.nlm.nih.gov/
or PubMed http://www.ncbi.nlm.nih.gov/PubMed
Both are free to search, and provide abstracts, and there are now links
to some full-text articles that are available online (not too many yet,
but growing). You can also order articles from the National Library of
Medicine ( thru Lonesome Doc) but there are charges for these copies.
Or you can also request articles through your local public library --
most offer Inter-library loan services, at no charge.
Linda Herman
