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Retinal Detachment
Huan J. Chang; Cassio Lynm; Richard M. Glass
JAMA. 2009;302:2274
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Therapeutic Innovations, Diminishing Returns, and Control Rate Preservation
David M. Kent; Thomas A. Trikalinos
JAMA. 2009;302:2254-2256.
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Figure. Marginal Benefit and Unit Cost for Successive Rounds of Innovation

When sequentially testing treatments with similar relative risk reductions (efficacy, E), the absolute risk reduction (incremental benefit, B) for ith therapeutic trial in the series can be described by the declining exponential function B_i=B₁(1–E)^i–1. In turn, the required sample size (S) for the ith trial approximates an increasing exponential function, described by the equation S_i~S₁/(1–E)^i–1, and the number of trial participants for each incremental 1% benefit (unit cost, U) increases at twice this rate, described by the equation U_i~U₁/(1–E)^2(i–1). The rate of change of unit costs, U, is sensitive to the magnitude of the risk reduction, E. The derivation of the formulas used to calculate B, S, and U at the ith generation of treatment trial is available from the author upon request. In this example, the baseline mortality rate is 8% and the relative risk reduction with each therapy is 25% (and B₁ is thus 2%).

The First Composite Face and Maxilla Transplant
Wayne F. Larrabee; Peter A. Hilger
JAMA. 2009;302:2250-2251.
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Figure. Preoperative and 7-Month Postoperative Images of the Patient

Reprinted from the Archives of Facial Plastic Surgery.¹

Acute-Onset Floaters and Flashes: Is This Patient at Risk for Retinal Detachment?
Hussein Hollands; Davin Johnson; Anya C. Brox; David Almeida; David L. Simel; Sanjay Sharma
JAMA. 2009;302:2243-2249.
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Table 2. Suggested Approach for Referral of Patients With Presumed Posterior Vitreous Detachment

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Table 1. Association of Historical and Ocular Examination Findings With Retinal Tear in Patients With Acute Posterior Vitreous Detachment

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Figure 3. Fundus Photograph of Vitreous Hemorrhage

Superiorly, vitreous hemorrhage is completely obscuring retinal details. Inferiorly, some hazy retinal details (including vessels) can be observed through the vitreous hemorrhage.

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Figure 2. Area of Peripheral Retina With 2 Horseshoe-Shaped Retinal Tears in an Area of Billowing Retinal Detachment

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Figure 1. Normal Eye Anatomy, PVD, Retinal Tear, and Retinal Detachment

A, Normal eye anatomy. B, Posterior vitreous detachment (PVD) involves separation of the posterior vitreous from the retina as a result of vitreous degeneration and shrinkage. C, In the acute phase of PVD, as the vitreous shrinks and detaches from the retina, tractional forces may be sufficient to cause a full-thickness tear in the retina. D, When a retinal tear occurs, fluid is allowed entry into the subretinal space, which can lead to retinal detachment (separation of the neurosensory layer from the underlying retinal pigment epithelium).

Motor Development in Very Preterm and Very Low-Birth-Weight Children From Birth to Adolescence: A Meta-analysis
Jorrit F. de Kieviet; Jan P. Piek; Cornelieke S. Aarnoudse-Moens; Jaap Oosterlaan
JAMA. 2009;302:2235-2242.
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Table. Description of the Meta-analytic Sample of Very Premature and VLBW Children

10.

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Figure 3. Effect Sizes and Heterogeneity Statistics for the Bruininks-Oseretsky Test of Motor Proficiency Ordered by Age at Assessment

CI indicates confidence interval.

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