Bridging regional and global perspectives.

摘要: In recent years, medical practice has evolved towards greater reliance on evidence-based medicine. Societies and reimbursement agencies often publish recommendations for treatment based literature review trial data. Despite this, growth hormone (GH) replacement therapy in adults varies substantially from region to region. The reasons this include differing beliefs quality of life benefits, the cost-effectiveness GH role reducing cardiovascular mortality. Reimbursement almost complete take-up Sweden Germany, strict guidelines UK, while some countries is not reimbursable with deficiency, leaving patients open short- long-term consequences condition. Clearly, there a need further evidence regarding overall value replacement. Randomized, controlled trials are foundation medicine, but difficult assess such trials. Thus, an important large-scale registries gathering evidence. For example, MEGHA (Metabolic Endocrinology Growth Hormone Assessment) database provides participants sub- studies function, allowing them create design collective, observational investigate areas medicine that particular interest or concern their patients.