The Power of Observation

被引：12

作者：

Clark, David A. ^{[1
,2
,3
]}

机构：

[1] McMaster Univ, Dept Med, Hamilton, ON, Canada

[2] McMaster Univ, Dept Mol Med & Pathol, Hamilton, ON, Canada

[3] McMaster Univ, Dept Ob Gyn, Hamilton, ON, Canada

来源：

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY | 2011年 / 66卷 / 02期

关键词：

Controlled trials; evidence-based medicine; IVIG; recurrent spontaneous abortion; INTRAVENOUS IMMUNOGLOBULIN; RECURRENT MISCARRIAGE; WOMEN; THERAPY; REEXAMINE; RATES;

D O I：

10.1111/j.1600-0897.2010.00963.x

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Problem In the golden age of evidence-based medicine, how should one view the cohort-controlled study of IVIG + anti-TNF-alpha (Humira) in recurrent in vitro fertilization (IVF) failure patients with an elevated Th1/Th2 cytokine production ratio. Method Critical analysis of the nature of evidence for causation. Results A better delivery rate and a live birth rate per embryo approaching the estimated maximum possible in patients whose elevated Th1/Th2 ratio corrected to normal compared to those with an incomplete correction is a strong argument for causation. A maximal improvement when treatment was given 61-120 days before embryo transfer suggests a possible mechanism via improving the physiology during follicle development. Conclusion Independent replication to verify results would augment power.

引用

页码：71 / 75

页数：5

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