Showing papers by "Gordon H. Guyatt published in 1985"
Journal Article•
TL;DR: It is concluded that the 6-minute walk is a useful measure of functional exercise capacity and a suitable measure of outcome for clinical trials in patients with chronic heart failure.
Abstract: Cycle and treadmill exercise tests are unsuitable for elderly, frail and severely limited patients with heart failure and may not reflect capacity to undertake day-to-day activities. Walking tests have proved useful as measures of outcome for patients with chronic lung disease. To investigate the potential value of the 6-minute walk as an objective measure of exercise capacity in patients with chronic heart failure, the test was administered six times over 12 weeks to 18 patients with chronic heart failure and 25 with chronic lung disease. The subjects also underwent cycle ergometer testing, and their functional status was evaluated by means of conventional measures. The walking test proved highly acceptable to the patients, and stable, reproducible results were achieved after the first two walks. The results correlated with the conventional measures of functional status and exercise capacity. The authors conclude that the 6-minute walk is a useful measure of functional exercise capacity and a suitable measure of outcome for clinical trials in patients with chronic heart failure.
2,024 citations
TL;DR: This work explores the implications of index purpose for each stage of instrument development: selection of the item pool, item scaling, item reduction, determination of reliability, of validity, and of responsiveness.
1,567 citations
TL;DR: It is suggested that exercise capacity in the laboratory can be differentiated from functional exercise capacity (the ability to undertake physically demanding activities of daily living) and that the walk test provides a good measure of function in patients with heart and lung disease.
453 citations
TL;DR: Large improvements in dyspnea, fatigue, and emotional function seen in patients undergoing treatment optimization were comparable using blind and informed methods, suggesting that by letting patients see their previous responses the authors can decrease the sample size needed to detect changes in quality of life in clinical trials.
114 citations
TL;DR: Clinicians should consider major differences when deciding which search system to use, including the higher the cost, the worse the product.
Abstract: Although clinicians can now search the medical literature electronically from the clinic, bedside, or operating suite, little is known about the performance characteristics of online information services. Fourteen access routes to the MEDLINE database of journal literature were compared for retrieval quantity and quality, user and online search time, and cost for randomly ordered, standardized searches on common clinical problems. All routes produced the articles we judged to be the most definitive on the clinical problem. However, routes differed significantly (p less than 0.01) for the same searches with respect to online time (range, 5.15 to 18.72 minutes), total search time (8.37 to 20.55 minutes), cost (US $3.38 to $11.62), and proportion of articles relevant to the topic (98% to 75%). "User friendliness" aside, our results showed that the higher the cost, the worse the product. Clinicians should consider these major differences when deciding which search system to use.
61 citations
TL;DR: Trials designed to establish the effectiveness of pharmacologic therapy in chronic heart failure illustrate methodologic problems associated with intervention trials in chronic disease.
43 citations
TL;DR: The rules for assessing causation applied here can be used to integrate new information concerning the health hazards of smoking and passive smoking as a cause of respiratory illness and decreased pulmonary function in children.
27 citations
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TL;DR: Weinstein and Wulff as mentioned in this paper have raised legitimate and important concerns about the ethical acceptability and feasibility of randomized control trials (RCTs) of diagnostic technologies and highlighted several issues which they believe merit further discussion.
Abstract: Drs. Weinstein and Wulff (in issue 1:3) have raised legitimate and important concerns about the ethical acceptability and feasibility of randomized control trials (RCTs) of diagnostic technologies. Their criticisms are all the more compelling in light of their strong advocacy of rigorous evaluation, and their insights into the advantages of RCTs and potential problems with alternative approaches as outlined with great clarity in Dr. Weinstein's paper. We shall not attempt a point by point rebuttal (partly because we are in full or partial agreement with most of their comments) but instead will highlight several issues which we believe merit further discussion.
01 Jan 1985
TL;DR: One patient with heart failure experienced increasing symptoms after his first twowalking tests and declined to continue and the remainingsix patients expressed dissatisfaction with the study.
Abstract: the area, development of concurrent illnessor family problems. One patient with heart failureexperienced increasing symptoms after his first twowalking tests and declined to continue. The remainingsix patients expressed dissatisfaction with the study(e.g., "I felt ill after the walking tests"; "The walksdidn't seem to be beneficial"; "A doctor wasn't pres-