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No cures, only treatments
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03/05/2005 23:01
Michael

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03/05/2005 23:01
Michael

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Dups never reverses


No, the progression of Dupuytren's has been known to stop, but never to reverse. - MML

03/06/2005 23:05
No Name

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03/06/2005 23:05
No Name

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Dups Study

The following link is to a 2003 study published in the UK that addresses dups and raises questions with NA studies. Its worth reading. In summary, some of the conclusions are:

""http://www.nice.org.uk/pdf/ip/177overview.pdf

National Institute for Clinical Excellence, UK, “Validity and generalisability of the studies (Of Needle Aponeurotomy)

• In general the studies are of poor methodological quality. Little information was reported on factors such as patient characteristics, selection and measurement of outcomes.

• In a number of papers the severity of the condition in study participants was unclear, and one paper excluded from the analysis those patients who initially did not have a successful outcome.

• While recurrence rates after the procedure ranged from 11% to 65%. These rates should be interpreted with some caution, given the different populations and time points in which they were measured.

• Considerable loss to follow up was reported in the Badois and co-workers (1993) paper. It is unclear whether there was similar loss to follow up in the results of the 1995 study. It is also unclear what impact this loss to follow up might have on re-operation and/or recurrence rates.

• The papers by Foucher and co-workers (2001a, b), although separate reviews, do include a subset of the same patients. This is also the case for the results reported by Badois and co-workers (1993).

• A considerable amount of literature on this procedure is published in French. This literature does not include comparative information; instead most of the studies seem to be case-series papers.

In general, papers reported on a limited number of outcomes and it was often unclear at what time point outcomes were measured. The number of hands was frequently used as a denominator to measure outcomes.""



If sample groups are excluding poor outcomes, that would be very troubling. Be interested in other studies (pro or con) and hope others can share those.

03/06/2005 23:39
Michael

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03/06/2005 23:39
Michael

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NA and recurrence


Interesting report. It's remarkable how little really solid data is available on Dup's and Dup's treatments, considering the number of people affected. Even the recurrence rate of fasciectomy is in doubt, much less that of NA. You'd think it'd be worth someone's while to finance a proper long-range study.

But NA has clear advantages even if one accepts a higher recurrence rate. They are: the ease and short duration of recovery, it's repeatability, and it's low cost. Even if contracture were to recur, you can always have it done again, or opt for fasciectomy, and you're not out too much money. - MML

03/07/2005 23:30
Michael

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03/07/2005 23:30
Michael

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Eaton~sq~s report

I doubt if Eaton's report will really resolve the questions regarding recurrence. The basic trouble is, tracking the results of a procedure over a period of years is an expensive and lengthy undertaking, especially if the patients come from all over the country. People aren't going to be willing to fly back to Florida 5 years after their NA just so Dr. Eaton can monitor the progress of their Dup's. But I think the report can publicize NA's advantages: efficacy, recoverability, repeatability and low cost. - MML

03/07/2005 23:46
No Name

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03/07/2005 23:46
No Name

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Studies

Does anyone know if any doctor doing NA is or will be doing a study. Michael is right, it would hard to track all patients, but working with a study group is pretty routine. The problems with the prior poorly done studies was interesting, but these problems can certainly be overcome.

I found this report interesting. I encourage others to share papers on any subject.

03/07/2005 23:44
Get real

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03/07/2005 23:44
Get real

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ref Randy H

Quote :
"The French are simply discounted, and perhaps rightly so from a professional point of view"

Quote :
"is sure to publish the fist American NA study which will presumably carry far more weight, and far fewer flaws"

I presume you are one of those American Uebermenschen ?

03/07/2005 23:04
Anon

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03/07/2005 23:04
Anon

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Tracking

Issue of tracking 'Rate of reoccurance' in a long-term study of NA... this could be addressed easily by having patients send photos of their hands via email or snail mail at one/two/three/four/five year intervals taken on the anniversary date of their NA procedure. :-)

If necessary, their family doctor could sign and date it...
or priest...or minister...an official witness of some type...etc...

Anon

03/07/2005 23:30
Stan the Man

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03/07/2005 23:30
Stan the Man

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Tracking

When Dr. Eaton did NA on my finger I was giving a paper that wanted me to send pictures of my hand every three months. I have been doing that for over a year now. I assumed that was how Dr. Eaton monitored his work.

03/08/2005 23:03
Graeme

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03/08/2005 23:03
Graeme

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Randy H.

To "Get Real"

It's not really necessary to hurl barbs at Randy using language like "uebermenschen". He is doing stirling work for this forum. What has to be looked at is his general meaning and input in that post.
It is a fact that the NA practioners in Paris have not produced scientifically accepted data which would/could stand up to the world medical college critique. Therefore from a professional point of view they have been discounted not only by the Americans but certainly by NICE in the UK. It does therefore underscore Dr Eaton's immersion into this field where scepticism has reigned.
Clearly a scientific study of NA along internationaly accepted standards is necessary and we are told Eaton is collating this. If this happens then good on Dr Eaton and -good on the first (American!!) study of this proceedure.
I am interested to know if those who have been to Dr Eaton have been asked to participate in post operative follow -
ups and if so what form this is taking. Also does anyone know when Dr Eaton's findings are due to be published?

07/02/2006 23:34
Bill James

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07/02/2006 23:34
Bill James

not registered

Dr. Eaton

I also take pictures of my hand and fingers 4 times each uear. I mail them to Dr. Eaton's office.

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