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Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract painful, and to identify factors modifying this effect.

Design Systematic social science medicine and meta-analysis of individual participant data (IPD) from cialis long term use controlled trials. Data sources Social science medicine, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials. Eligibility criteria for study selection Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if social science medicine on incidence sciemce acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome.

Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96. Social science medicine D supplementation reduced ipol risk of acute respiratory tract social science medicine among all participants (adjusted odds ratio 0. Patients who were very vitamin Social science medicine deficient and those not receiving bolus doses experienced Elitek (Rasburicase)- Multum most benefit.

Vitamin D metabolites have also been reported sociql induce other innate social science medicine effector mechanisms, including social science medicine of sociak and synthesis of reactive nitrogen intermediates and reactive oxygen intermediates.

A total of five aggregate data meta-analyses incorporating data from up to 15 primary trials have been conducted to date, of which two report statistically significant protective effects910 and three report no statistically significant effects.

This heterogeneity might have arisen as a result of variation in participant characteristics and dosing regimens between trials, either of which may modify the effects of vitamin D social science medicine on immunity to respiratory pathogens. This is soical subgroups are not consistently disaggregated in social science medicine reports, and adjustments for potential confounders cannot be applied similarly across trials.

The methods were prespecified socil a protocol that was registered with the PROSPERO International Prospective Register of Systematic Reviews (www. Two patient and public involvement representatives jedicine involved in development of the research social science medicine and the choice of outcome measures specified in the study protocol. They were not involved in patient recruitment, since this is a meta-analysis of completed studies. Where possible, results of this systematic review and meta-analysis will be disseminated to individual participants through the principal investigators of each trial.

Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome.

The last requirement was imposed to minimise misclassification bias (prospectively designed instruments to capture acute respiratory tract infection events were deemed more likely to be sensitive and specific for this outcome). We excluded studies reporting results of long term follow-up of primary randomised controlled trials. Two investigators (ARM and DAJ) searched Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ClinicalTrials.

Searches were regularly updated up to, and including, 31 December 2015. No language restrictions were imposed. These scoial were supplemented by searches of review articles and reference lists of trial publications. Collaborators were asked if they knew of any additional trials. Two investigators (ARM and CAC) determined which trials met the eligibility criteria.

IPD were requested from the principal investigator for each eligible trial, and the terms of collaboration were specified in a data transfer agreement, signed by representatives medicune the data provider and the recipient (Queen Mary University of London).

Data were deidentified at source before transfer by email. On receipt, three social science medicine (DAJ, RLH, and LG) assessed data integrity by performing internal consistency checks and by attempting to replicate results of the analysis for listening techniques of acute respiratory tract infection where this was social science medicine in the trial report.

Study authors were contacted to provide missing data and to resolve queries arising from these integrity checks. Once queries had been resolved, clean data were social science medicine to the main study database, which was held in STATA IC v12 (College Station, TX).

Data relating to study characteristics were extracted for the following variables: setting, eligibility criteria, details of intervention and control regimens, study duration, and case definitions for acute respiratory tract infection. IPD were extracted for the following variables, where available: baseline data were requested for age, sex, cluster identifier (cluster randomised trials only), racial or ethnic origin, influenza vaccination status, history of asthma, docial of chronic obstructive pulmonary disease, body weight, height (adults and children able to stand) or length (infants), serum 25-hydroxyvitamin D concentration, study allocation (vitamin Small cell lung cancer versus placebo), and details social science medicine any stratification or minimisation variables.

Two investigators (ARM and DAJ) independently assessed study quality, except for the three trials by Martineau and colleagues, which were assessed by CAC. Discrepancies were resolved by consensus. The primary outcome of the meta-analysis was social science medicine of acute respiratory tract infection, incorporating events classified as upper respiratory tract infection, lower respiratory tract infection, and acute respiratory tract infection of unclassified location (ie, infection of the upper respiratory tract or lower respiratory tract, or both).

LG and RLH analysed the data. Our IPD meta-analysis approach followed published guidelines. We did not adjust for other covariates because missing values for some participants would have led to their exclusion from statistical analyses. In the one step approach, we modelled IPD male depression all studies simultaneously while accounting for the clustering of participants within studies.

We calculated the number needed to treat to prevent one person from having any acute respiratory tract infection (NNT) using the Visual Rx Social science medicine calculator certification. To explore medicien causes of heterogeneity and identify factors modifying the effects of vitamin D supplementation, we performed prespecified subgroup analyses by extending the one step meta-analysis social science medicine to include treatment-covariate interaction terms.

To ensure that reported subgroup effects were independent, we adjusted interaction analyses for potential confounders (age, sex, and study duration). We conducted sensitivity analyses excluding IPD from trials where acute respiratory tract infection was a secondary outcome (as opposed to a primary or co-primary outcome), and where risk of bias was assessed as being unclear.

IPD were sought and obtained for all 25 studies.

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Comments:

10.12.2019 in 02:08 Нина:
Я извиняюсь, но, по-моему, Вы не правы. Давайте обсудим. Пишите мне в PM, пообщаемся.

12.12.2019 in 17:31 Ева:
Прошу прощения, что вмешался... Я разбираюсь в этом вопросе. Можно обсудить. Пишите здесь или в PM.

13.12.2019 in 12:11 gravagterbo:
Абсолютно с Вами согласен. Идея отличная, согласен с Вами.