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Objectives The primary objective was to assess the utility of the number needed to treat (NNT) to inform decision-making in the context of paediatric oncology and to calculate the NNT in all superiority, parallel, paediatric haematological cancer, randomised controlled trials (RCTs), with a comparison to the threshold NNT as a measure of clinical significance. Design Systematic review Data sources MEDLINE, EMBASE and the Cochrane Childhood Cancer Group Specialized Register through CENTRAL from inception to August 2018. Eligibility criteria for selecting studies Superiority, parallel RCTs of haematological malignancy treatments in paediatric patients that assessed an outcome related to survival, relapse or remission; reported a sample size calculation with a delta value to allow for calculation of the threshold NNT, and that included parameters required to calculate the NNT and associated CI. Results A total of 43 RCTs were included, representing 45 randomised questions, of which none reported the NNT. Among acute lymphoblastic leukaemia (ALL) RCTs, 29.2% (7/24) of randomised questions were found to have a NNT corresponding to benefit, in comparison to acute myeloid leukaemia (ALM) RCTs with 50% (3/6), and none in lymphoma RCTs (0/13). Only 28.6% (2/7) and 33.3% (1/3) had a NNT that was less than the threshold NNT for ALL and AML, respectively. Of these, 100% (2/2 ALL and 1/1 AML) were determined to be possibly clinically significant. Conclusions We recommend that decision-makers in paediatric oncology use the NNT and associated confidence limits as a supportive tool to evaluate evidence from RCTs while placing careful attention to the inherent limitations of this measure. [ABSTRACT FROM AUTHOR]

QUESTION In patients with cancer and venous thromboembolism (VTE), is long-term treatment with low-molecular-weight heparin (LMWH) effective and safe compared with oral anticoagulants? REVIEW SCOPE Studies selected compared LMWH with oral anticoagulants (vitamin K antagonists or ximelagatran) for long-term treatment in patients with cancer and objectively diagnosed VTE. Outcomes were mortality, symptomatic recurrent VTE, major bleeding, and thrombocytopenia. REVIEW METHODS Cochrane Central Register of Controlled Trials, Medline, EMBASE/Excerpta Medica, and ISI the Web of Science (to Jan 2007); conference proceedings; reference lists; and the "related articles" feature of PubMed were searched for randomised controlled trials (RCTs). Drug companies were consulted. 6 RCTs (n = 1661) met the selection criteria. 3 trials reported adequate allocation concealment, and 4 reported blinding of outcome assessors. Follow-up ranged from 3 to 12 months. MAIN RESULTS Compared with vitamin K antagonists, LMWH reduced recurrent VTE, but not mortality, with no increase in risk of major bleeding or thrombocytopenia (table). CONCLUSIONS In patients with cancer and venous thromboembolism (VTE), long-term treatment with low-molecular-weight heparin (LMWH) reduced recurrent VTE by about half compared with oral anticoagulants but did not reduce mortality. LMWH did not increase adverse events. [ABSTRACT FROM AUTHOR]

The article focuses on a study concerned with the meanings of living with bodily problems as narrated by men with advanced metastatic prostate cancer. The subjects of the study were 18 men with hormone refractory prostate cancer and skeletal metastases. Conversational interviews that lasted 35-97 minutes were employed. Cyclical movements between experiencing wellness and illness represented "living with bodily problems," in men with advanced metastatic prostate cancer.