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Cochrane Database of Systematic Reviews

Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding

Overview of attention for article published in Cochrane database of systematic reviews, July 2010
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (91st percentile)

Mentioned by

blogs
5 blogs
policy
2 policy sources
twitter
30 tweeters
facebook
2 Facebook pages
wikipedia
3 Wikipedia pages

Citations

dimensions_citation
164 Dimensions

Readers on

mendeley
218 Mendeley
citeulike
1 CiteULike
connotea
1 Connotea
Title
Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding
Published in
Cochrane database of systematic reviews, July 2010
DOI 10.1002/14651858.cd005415.pub3
Pubmed ID
Authors

Aravamuthan Sreedharan, Janet Martin, Grigorios I Leontiadis, Stephanie Dorward, Colin W Howden, David Forman, Paul Moayyedi

Abstract

There is conflicting evidence regarding the clinical efficacy of proton pump inhibitors (PPI) initiated before endoscopy for upper gastrointestinal bleeding. To systematically review evidence from randomised controlled trials (RCTs) of PPI treatment initiated before endoscopy for upper gastrointestinal bleeding. We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE and CINAHL databases and major conference proceedings to September 2005, using the Cochrane Upper Gastrointestinal and Pancreatic Diseases model. Searches were re-run in February 2006 and October 2008. We selected randomised controlled trials (RCTs), of hospitalised participants with unselected upper gastrointestinal bleeding, undergoing active treatment with a proton pump inhibitor PPI (oral or intravenous) and control treatment with either placebo, histamine-2 receptor antagonist (H2RA) or no treatment prior to endoscopy. Outcomes were assessed at 30 days and included mortality, rebleeding and surgery. Also assessed were stigmata of recent haemorrhage (SRH; active bleeding, non bleeding visible vessel or adherent clot) at index endoscopy, length of hospital stay, blood transfusion requirements and requirement for endoscopic therapy at index endoscopy. At least two review authors assessed eligibility criteria and extracted data regarding outcomes and factors affecting methodological quality. Six RCTs comprising 2223 participants were included. There was no statistical heterogeneity among trials for dichotomous outcomes. There were no statistically significant differences in mortality, rebleeding or surgery between PPI and control treatment. Unweighted pooled mortality rates were 6.1% and 5.5% respectively (odds ratio (OR)1.12; 95% CI 0.72 to 1.73). Unweighted pooled rebleeding rates were 13.9% and 16.6% respectively (OR 0.81; 95%CI 0.61 to 1.09). Pooled rates for surgery were 9.9% and 10.2% respectively (OR 0.96 95% CI 0.68 to 1.35). PPI treatment compared to control significantly reduced the proportion of participants with SRH at index endoscopy; unweighted pooled rates were 37.2% and 46.5% respectively (OR 0.67; 95% CI 0.54 to 0.84). However, this result was not robust to sensitivity analysis. PPI treatment compared to control significantly reduced endoscopic therapy at index endoscopy; unweighted pooled rates were 8.6% and 11.7% respectively (OR 0.68; 95% CI 0.50 to 0.93). For continuous outcomes (length of hospital stay and blood transfusion requirements), quantitative analysis could not be performed. PPI treatment initiated before endoscopy for upper gastrointestinal bleeding might reduce the proportion of participants with SRH at index endoscopy and significantly reduces requirement for endoscopic therapy during index endoscopy. However, there is no evidence that PPI treatment affects clinically important outcomes, namely mortality, rebleeding or need for surgery.

Twitter Demographics

The data shown below were collected from the profiles of 30 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 218 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 <1%
Spain 2 <1%
Brazil 2 <1%
Sweden 1 <1%
United Kingdom 1 <1%
Mexico 1 <1%
Ecuador 1 <1%
Tanzania, United Republic of 1 <1%
Unknown 207 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 31 14%
Student > Bachelor 30 14%
Researcher 27 12%
Student > Postgraduate 23 11%
Other 20 9%
Other 45 21%
Unknown 42 19%
Readers by discipline Count As %
Medicine and Dentistry 130 60%
Nursing and Health Professions 10 5%
Pharmacology, Toxicology and Pharmaceutical Science 7 3%
Agricultural and Biological Sciences 7 3%
Psychology 5 2%
Other 10 5%
Unknown 49 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 56. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 January 2021.
All research outputs
#524,075
of 19,645,988 outputs
Outputs from Cochrane database of systematic reviews
#1,126
of 11,954 outputs
Outputs of similar age
#2,312
of 128,797 outputs
Outputs of similar age from Cochrane database of systematic reviews
#6
of 60 outputs
Altmetric has tracked 19,645,988 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,954 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 27.6. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 128,797 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 60 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.