Yield of bone scintigraphy for the detection of metastatic disease in treatment-naive prostate cancer: a systematic review and meta-analysis.

AIM: To evaluate the yield of staging bone scintigraphy in patients with treatment-naive prostate cancer. MATERIALS AND METHODS: A computerised search of the MEDLINE and EMBASE databases was performed to find relevant original literature. Studies that investigated the positivity of a staging bone scintigraphy according to prostate-specific antigen (PSA) levels and/or Gleason score in patients with treatment-naive prostate cancer were eligible for inclusion. Meta-analytic pooling was performed using the inverse variance method for calculating weights. RESULTS: Fifty-four eligible studies, which included a total sample size of 20,421 patients, were included. The pooled proportions of the positive bone scintigraphy in patients with PSA ≤10, 10 20 were 3.5% (95% confidence interval [CI]: 2.4-5%), 6.9% (95% CI: 4.5-10.3%), and 41.8% (95% CI: 36.3-47.6%). The pooled proportions of the positive bone scintigraphy examinations in patients with Gleason score ≤6, 7, and ≥8 were 4.1% (95% CI: 2-8%), 10% (95% CI: 6.1-15.8%), and 28.7% (95% CI: 21.8-36.8%). Meta-regression analysis revealed that the Gleason score was a significant factor affecting study heterogeneity in patients with PSA ≤10 (p = 0.04). Pooled proportions of positive bone scintigraphy examinations showed 3.4% in patients with a PSA of ≤10 and 3.3% in patients with 10

Peer reviewing and curating the health care information infrastructure: experiences and recommendations.

As part of a digital health sciences library's continuous quality improvement process, a digital textbook of common medical problems was created which contained links to authoritative medical information on the Internet for patients and health care providers. The accomplishments of this project were the: 1) Identification of 50 common medical problems, 2) Development of a methodology for identifying authoritative medical information related to these problems, 3) Creation of a digital textbook containing links to this information with a problem-based interface, 4) Development of a methodology to allow local peer review of this information, and 5) Evaluation of the use of the information and the local peer review methodology.