Analysis of prescriptions of alpha-blockers and phosphodiesterase 5 inhibitors from the urology department and other departments

Evidence Is Enough?: A Systematic Review and Network Meta-Analysis of the Efficacy of Tamsulosin 0.2 mg and Tamsulosin 0.4 mg as an Initial Therapeutic Dose in Asian Benign Prostatic Hyperplasia Patients

Purpose

We compared the efficacy of tamsulosin between 0.2 mg and 0.4 mg in Asian prostatic hyperplasia (BPH) patients using network meta-analysis due to lack of studies with direct comparison.

Methods

The literature search was conducted using the MEDLINE, Embase, and Cochrane Library. Keywords used were “BPH,” “tamsulosin,” “placebo.” Experimental groups were defined as tamsulosin 0.2 mg (Tam 0.2) and 0.4 mg (Tam 0.4) and common control group was defined as placebo for indirect treatment comparison. Mixed treatment comparison was performed including one direct comparison study.

Results

Seven studies met the eligible criteria. Indirect treatment comparison revealed that total International Prostate Symptoms Score (IPSS) and quality of life score of IPSS were not significantly different in Tam 0.2 and Tam 0.4 (P>0.05). There was no significant difference of maximal flow rate and postvoid residual urine volume in Tam 0.2 and Tam 0.4 (P>0.05). Mixed treatment comparison including one direct comparison study showed inconsistency (P<0.001). Therefore, analysis using direct treatment comparison effect sizes of Tam 0.2 vs. placebo and Tam 0.4 vs. placebo was done and there was no significant difference.

Conclusions

Network meta-analysis showed no difference of efficacy between tamsulosin 0.2 mg and 0.4 mg and the evidence of tamsulosin 0.4 mg as initial dose for Asian BPH patient seems to be insufficient. Therefore, initial dose of tamsulosin for Asian BPH patient should be 0.2 mg.

An Evidence-Based Evaluation of Health Information on Erectile Dysfunction From 10 Nationwide Daily Newspapers in Korea

Purpose

A rapid growth in the socioeconomic status of Koreans has triggered an unprecedented explosion of health information for the general population. Despite its obvious benefits, this increase in information could also result in potentially harmful effects for both consumers and professionals who do not use it appropriately. Thus, this study was conducted to evaluate the quality and accuracy of health information on erectile dysfunction from 10 nationwide daily newspapers.

Materials and Methods

This study analyzed health information from 10 nationwide daily newspapers in Korea from January 2011 through December 2011. We reviewed the health information for quality by using evidence-based medicine tools and evaluated the accuracy of the information provided. Articles that simply summarized scientific congresses or journal articles and that did not include direct quotations were excluded, as were advertisements.

Results

A total of 47 articles were gathered. Among them, 27 (57.4%) contained inaccurate or misleading statements on the basis of an evidence-based medicine evaluation. These statements included using inappropriate surrogate outcomes as clinical endpoints (three cases, 6.4%), extrapolating nonhuman results to humans (two cases, 4.3%), exaggerating the significance of results (eight cases, 17.0%), and using incorrect words (14 cases, 29.8%). The rate of error was higher in the information from Korean sources than in that from international sources (22 cases vs. 5 cases).

Conclusions

Approximately 57% of all articles on erectile dysfunction from 10 nationwide daily newspapers were found to contain inaccuracies.