BACKGROUND Creatine and minocycline were prioritized for testing in Phase II clinical trials based on a systematic evaluation of potentially disease modifying compounds for Parkinson disease (PD). OBJECTIVE To test whether creatine and minocycline alter the course of early PD relative to a predetermined futility threshold for progression of PD in a randomized, double-blind, Phase II futility ...

The irreversible cessation of life may be diffi cult to determine with complete confi dence, particularly in the austere environment of out-of-hospital emergency care. As a result, resuscitation efforts are often initiated and continued by EMS providers, even in circumstances that are likely to be medically futile. In cases of nontraumatic cardiac arrest, few unassailable criteria exist for det...

background: autologous skin graft is frequently used in the field of plastic, and reconstructive surgery. the engraftment is dependent upon revascularization and angiogenesis, which can be regulated by different factors. in addition to its hematopoietic effects, erythropoietin is shown to positively affect the wound healing process. objectives: we studied effects of human erythropoietin on reva...

n engl j med 357;1 www.nejm.org july 5, 2007 was an 18-month-old boy who had Leigh’s disease, a progressive and fatal neurometabolic disorder. He had been on life support in the intensive care unit for 5 months. The hospital had invoked the Texas Advance Directives Act, which authorized it to withdraw life support if an ethics committee had determined that further life support was medically ina...

he past few years in health care have been a story of extraordinary turbulence. After decades of uncontrolled cost escalation, the businesses and governments that directly pay for most health care finally mandated a fiscal restraint that, in the early 1990s, launched in earnest the upheaval known as “managed care.” One major result has been the replacement of such values as, “If it might help a...

Many biomarkers identified in marker discovery are shown to have inadequate performance in validation studies. This motivates the use of group sequential designs that allow early termination for futility. However, an option for early termination will lead to biased estimates for studies that reach full enrollment. We propose conditional estimators and confidence intervals that correct for this ...